Leading neuroscientists from Monash University, the University of Melbourne and University College London are calling for clinical studies to understand the causes of brain fog in menopause and find effective treatments.
In a new study published in The Lancet Obstetrics, Gynaecology, & Women's Health, the researchers propose a new clinical definition that acknowledges the presentation of brain fog in menopause and how it is distinct from other conditions like dementia.
The definition includes "self-reported" cognitive impairment that can be debilitating and impact quality of life but notes the "absence of a notable objective cognitive decline".
Brain fog encompasses a variety of symptoms including forgetfulness and difficulties with attention or concentration.
Clinicians don't know exactly why it presents in women experiencing menopause and there are no specific treatments for it.
But the hormonal changes associated with menopause, as well as other menopause symptoms, are likely to be key contributors.
Lead researcher Associate Professor Caroline Gurvich, a clinical neuropsychologist and researcher from Monash's HER Centre, said a clear definition is a good starting point, because it paves the way for it to be considered a primary symptom and for subjective measures of impairment to be used in clinical studies.
"There's a lot of pressure to use objective measures of cognitive decline, like a memory test, for example, in a clinical trial, but the key symptom of brain fog is a subjective experience," Associate Professor Gurvich said.
"So having a definition that acknowledges the key cognitive symptom is critical.
"This is not without precedent – we already use subjective or self-report measures for depression, anxiety and other mental health conditions with great success."
Associate Professor Gurvich said the proposed definition would also validate women's individual experiences while empowering them through the reassurance that any objective decline in their cognitive ability is subtle.
"This is a decrease in cognitive or learning efficiency, not functionality or capacity," Associate Professor Gurvich said.
"For many women, the perception they are losing capacity is what drives them to stop work or lose the confidence to live fulfilling lives during and after menopause.
"I hear all the time from women who have gone through menopause that validation would have made a significant difference to their resilience and the approach they took to living with menopause."
Professor Martha Hickey, from the University of Melbourne and Royal Women's Hospital, said the study fills much-needed gaps in understanding of brain fog.
"Our analysis of the best available research shows that many women experience some degree of cognitive symptoms, such as brain fog, during the menopause transition," Professor Hickey said.
"But there's a lack of long-term data, which means that there's a gap in our knowledge about how the brain fog symptom develops and changes from peri-menopause to after menopause ends."
Read the research paper: doi.org/xxx
