Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Ghostgirl on March 13, 2017, 11:59:49 PM
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Ladies I have a question about HRT, I don't know if it's a common one, in fact I can't even be certain that it's not just my imagination, but here goes...
Has anyone found that after embarking on a course of HRT they've found a deterioration in overall mental acuity?
This isn't a joke to me, for years now I've genuinely worried about the fact that since I started on HRT around 6 years ago in several ways my brain seems not to be working like it used to, I'm less alert, my memory has deteriorated, my powers of deduction can only be described as sluggish, my creativity of thought feels like it's still there, but somehow coated in a layer of fog ... in short, I guess what I'm trying to say is that I feel less "intelligent" than I used to.
I'm 52, and started on HRT just over 6 years ago mainly to combat the onset of a ridiculously debilitating case of hot flushes, and day and night sweats, that started practically overnight, and very soon had me drenched in sweat every 20/30 minutes of every day and night. The HRT relatively quickly alleviated those symptoms, or at least reduced them by a good 75%, but I've never felt quite like the ME I used to be, ever since.
What i would like to know is, can HRT have this effect, is it my imagination, is this just a coincidental feature of getting older, or should I have been long since looking for a completely separate diagnosis?
Thanks in advance for your thoughts!
Ghostgirl
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Probably not your imagination, it's something many of us mention on here ::)
It is something you can live with? Maybe make notes etc. to help through the day?
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Wow, thank you, CLKD, not just for your response but for the extremely quick reply, much appreciated!
You know, I really didn't expect that answer at all as it's not something I've ever before heard discussed in relation to HRT, in fact I genuinely hesitated even to even ask the question. I actually wrote my opening post, and then dithered for about 10 minutes before finally clicking the Post button, for fear of sounding like a bit of a fruitcake ;D And it's not that I previously considered myself a genius or anything, but not long after starting on HRT I did start to feel like I was missing a bit of my brain power in a not quite definable way.
And to answer your question, yes, I think I would find it a lot easier to live with, so long as I was able to put aside certain concerns about its actual cause. You see, although (I don't think) the initial feeling has further deteriorated over the ensuing years of taking HRT I've always had at the back of the mind the fact that both my Sister (who is 20 years older than me) and my Mum (who died a few years ago) suffer/ed from senile dementia, and so I've always worried about it, but until now never had the courage to raise the subject with even close friends never mind my Doctor, for fear that I would not like what i heard.
So anyway you can imagine it's quite a relief to read your very prompt, and somewhat reassuring response, so thank you again, CLKD :)
Oh, one last thing, do you know of any literature on the subject that I might read?
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Ghost girl, not to worry you but with such a strong first level familial association with dementia, I'd get myself checked out. You really cannot expect us to diagnose or assure you.
My experience is exactly opposite to yours with hrt making me more competent and having increased mental acuity when on it.
I would make an appointment with your GP and ask for further referral and tests to put my mind at rest.
Hope this helps
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I think question to ask Ghostgirl is would it be worse without the hrt?x
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I certainly have brain fog - I tell my boss that I occasionally have "meno mind" ! I think I am aware that I'm not as alert as I once was but then I suppose we cannot expect to be the same in middle age as we were at 25 for example. Silly things like which tube line do I need and stuff like that but luckily nothing super important (for that, I write notes in my online diary). We have no dementia in the family so am not overly concerned although its annoying at times. If you do have family history, it might be worth having some tests even if just to put your mind at rest? The fact that you are aware of it indicates (to me anyway) that it could just be HRT related but of course am no expert. Chat to your doc
Good luck
SP x
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Hello Ghostgirl and welcome to the forum. I do not take HRT so I am unable to answer the original question you posted but I think we do slow down mentally as well as physically as we age. I know I have and I don't know how it might have been if I had used HRT. I also have an underactive thyroid and when I am under pressure or over busy then my levels slip and that affects my cognitive function. Have you had your thyroid levels checked?
I sympathise with your concern over the familial connection for dementia. My aunt (mother's sister) started with early onset Alzheimer's at 58 and died aged 62 and it is at the back of my mind when I have one of my 'brain fart' days so I can appreciate your comments. My paternal grandmother also had mental health issues from a fairly young age so it is in my family too.
Hope you enjoy the forum :)
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I think if you are taking progesterone in your hrt, that could account for the mental sluggishness.
However one of the reasons I saw my GP in the first place is because my performance dropped at work. He then carried out tests and diagnosed peri - menopause. To be honest, now I'm on HRT, I still don't feel my sharpness has improved.
Apparently testosterone helps with cognition, focus and mood.
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Six weeks in on Femoston and I've noticed I am getting things done much more - my organisational skills have come back and i'm doing lots of little jobs as I go along. Sharper? Maybe.
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Gosh thanks for all the replies, ladies, I'm pleased that I broached the subject now :)
I think question to ask Ghostgirl is would it be worse without the hrt?x
Peri, a year past in November my doctor explained to me that my GP's surgery made it a kind of policy to have HRT users try to come off HRT at around 5 year mark, just to see how they got on without it, I agreed, albeit reluctantly, to give it a go. I had reservations, because I did still suffer from the original hot flushes and day and night sweats although certainly they had greatly reduced since starting on Prempak C, 5 years previously. In a matter of weeks I was right back to square one, breaking into sweats every half hour and doing the covers off, covers on, covers off, covers on, all through the night, shattering not just my own sleep but my husband's as well. The spare room got used quite a bit!!
However there was a plus side, I did experience a definable "lifting of the fog", mentally, and so I persevered for a further 3 or 4 months, hoping that things would settle down. The sweats got so bad though and I felt so yucky all the time, that I decided really the trade off wasn't worth it and went back to see my GP at the end of March and went back on the pills.
Still, it wasn't until now, with my Prempak C being discontinued, that I've ever thought to ask around, or do a bit of my own research. Silly of me, I guess. Particularly after browsing around this forum over the past few days and starting to realise that not all GP's are terribly well-informed on the subject of HRT.
Anyhow I'm on it now, and determined to learn all I can so that when I see my GP on Friday I know what to ask, and what to ask for. Perhaps I should see this as an opportunity to find something that suits me better, rather than going with whatever he sees fit to prescribe me.
I think if you are taking progesterone in your hrt, that could account for the mental sluggishness.
However one of the reasons I saw my GP in the first place is because my performance dropped at work. He then carried out tests and diagnosed peri - menopause. To be honest, now I'm on HRT, I still don't feel my sharpness has improved.
Apparently testosterone helps with cognition, focus and mood.
Thanks Marchone71, I'm sorry to hear that you still feel less sharp and that your work has suffered, that must be extremely frustrating for you! Really interesting comments about progesterone and testosterone though, I would like to find out more about this whole subject.
Six weeks in on Femoston and I've noticed I am getting things done much more - my organisational skills have come back and i'm doing lots of little jobs as I go along. Sharper? Maybe.
I've noticed a number of ladies talking about Femoston, ancient runner, mostly positive one I might add, and it sounds like this is one of the more modern types of HRT?
Thank you again everyone, it's nice to feel able to discuss things. And, as TheOtherOne mentions above, I do realise that this is not about medical advice. In fact thanks to you all I've decided that this time when I speak to my GP I will lay out my concerns in full, especially in regard to my family history! I'd still like to hear a bit more about your individual experiences though?
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Nowt is silly on here ;D - you'll fit right in ;)
My brain has never been sharp. As a pre-baby I think it got sluggish right from the start >:(. Currently it feels like cotton wool in there :-\ ..... probably because it is no longer 'pushed' in that I am retired so don't have to think too far ahead, interact on the 'phone or keep stuff in my brain, something that I was *never* good at. I have problems remembering what I did yesterday, what I saw on TV last week ....... but this hasn't got any worse so I try not to worry ::)
I have joined a 'research' group for dementia but I'm bugred if I can remember which one >sigh<
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Hi, first time I've commented on here; I'm 47 year old professional women and was diagnosed as menopausal last June. Since then I've been working reduced hours and duties as I'm just not able to do my job which involves complex problem solving. I've been describing my symptoms as 'losing my sharpness' 'being slow' , unable to concentrate etc and i also have severe anxiety with many physical symptoms (dry mouth, lump in throat, digestive problems etc). I don't know if the cognitive problems caused the anxiety or the other way round.
Any way I want to endorse the point that menopause can cause cognitive impairment... this has been proven in my case as my work asked me to complete a 3 hour cognition test and I had the results last week and it shows significant cognitive function problems in a number of areas.
I'm sick of hearing flippant comments about being a bit forgetful or having a dumb moment or a bit of brain fog... for me this has stopped my 30 year career in its tracks and if I can't get well soon it will have significant impact on my family's situation as I'm the main earner.
At least now people believe me as I have a test which proves impairment and I know it's not all in my head, but it is very difficult to accept you can't function the way you used to. Best wishes to all women out there who are experiencing same x
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:thankyou: and :welcomemm: would it be worth while informing the dementia groups of this test ? I would love to do similar, do let us know more ?!?
Would you be able to 'train' someone else to bring them up to speed so that you get some help in the workplace, that way you remain useful to the Company as so much of what you know will be 'automatic' ;) or go into a Consultancy role so that you can work less hours but still gain benefit?
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Hi, first time I've commented on here; I'm 47 year old professional women and was diagnosed as menopausal last June. Since then I've been working reduced hours and duties as I'm just not able to do my job which involves complex problem solving. I've been describing my symptoms as 'losing my sharpness' 'being slow' , unable to concentrate etc and i also have severe anxiety with many physical symptoms (dry mouth, lump in throat, digestive problems etc). I don't know if the cognitive problems caused the anxiety or the other way round.
Any way I want to endorse the point that menopause can cause cognitive impairment... this has been proven in my case as my work asked me to complete a 3 hour cognition test and I had the results last week and it shows significant cognitive function problems in a number of areas.
I'm sick of hearing flippant comments about being a bit forgetful or having a dumb moment or a bit of brain fog... for me this has stopped my 30 year career in its tracks and if I can't get well soon it will have significant impact on my family's situation as I'm the main earner.
At least now people believe me as I have a test which proves impairment and I know it's not all in my head, but it is very difficult to accept you can't function the way you used to. Best wishes to all women out there who are experiencing same x
Oh heavens, Qwerty, so sorry to hear about your problems, it must be a dreadful worry for you!
My peri-menopause started at around the same time as yours, I think I was 46. I wonder, now, if my perception of a reduced cognitive impairment started with peri, or with starting on HRT, since I started on Prempak C within weeks of suffering from the quite sudden onset of wild temperature fluctuations every few minutes. As I said above though, I think I did feel a bit of sharpness returning to my thoughts during the few months that my GP requested I see how it went without the HRT.
Are you currently taking HRT yourself? And if so has it improved, or alternatively worsened your situation?
Thank you for your input, I do hope you feel better soon.
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Thanks for the welcome and happy to help if I can. It was a psychological capacity assessment which included 6 or 7 different test for memory and processing , it was completed by a medical professional and I think? It's a standard test for cognition and uses established methods.
I have a referral to a gynaecologist next month to try to improve my medication and help get me well... my work are supporting me at the moment and have made adjustments but I know they can't keep doing this indefinitely. I'm just hoping if I can get the right medication/ hrt then I'll get myself back. X
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Hi Qwerty
I'd love to hear what they recommend for you medication wise.
Please report back if you can and good luck.
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Foggy thinking and poor concentration were one of the first symptoms for me when I hit peri menopause and I remember it's quite frightening. Once I started hrt I noticed a big improvement but I still wasn't what I used to be. I read somewhere (probably this forum) it's fluctuating hormone levels that causes it and hrt will halt but not reverse it. I think that's why I plan to stay on hrt because I don't want to deteriorate. Having said that since I've had the mirena fitted my short term memory has been terrible (interestingly though not all the time), I think it's my body getting used to the progesterone x
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Oh yes it's definitely hormone linked!
My worse thing is losing the thread you're on when explaining something where you just get a mental block. Also recalling names and words you use all the time!
I've noticed on the progesterone that I have my fluidity back and can think whilst speaking (important in my work).
I did also used to not feel myself when on the pill when younger, even after finding one that suited me in most ways. When I stopped it after many years (before more recent hormone probs started) I felt less subdued in my thinking.
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I'm finding this discussion all quite fascinating in one way, and a bit terrifying in another.
I loved my ability to think quickly, my aptitude for readily discerning patterns in seemingly improbable topics, and most especially my ability to recall details of subjects I read about and acquired knowledge of... even years later. I miss those skills! And its all to do with the fact that I know they're still there, it's just that they seem to take a great deal more concentration and focus than was required when I was younger and it was all so effortless.
That doesn't even properly describe what's changed I don't think. It occurs to me suddenly that "confidence" might even come into it. Maybe I used to rely a lot on my mental quickness in social situations, and actually the slight loss of cognitive function makes me feel a bit more vulnerable? Now there's a thing... :-\
Again, thank you all for the forthright and honest responses, I really appreciate this ladies, it's given me something, maybe even a LOT to think about :) x
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Hi ghost girl, I completely agree with everything you've said. I too enjoyed quick mental agility and this gave me great confidence in many aspects of my life ; it's such a large part of who you are and has enabled me to build a successful career and enjoy a lovely lifestyle.
When I say that I'm not just talking about earnings (although that has enabled me to have and do things I want) but I mean it made me the person I am (was) ..... confident in myself, confident with my family, with my friends , with my colleagues, and in all different situations. Confident to do and be involved in the things I want. In a way it defined who I was and now without this I feel like a different person , constrained and almost good for nothing and I wonder if the old / real me will ever come back. That's the scary bit!!
I wanted to post my situation as having had a formal and substantial cognitive test at least I know my reduced mental ability is real (the tests included validation to ensure I wasn't faking anything) and I want others to know this. Overall I think it's good that my test showed significant impairment as, whilst it's still difficult to accept, it does indicate this is caused by menopause (as nothing else has changed in my life) and as we know menopause doesn't last forever and so I've got to be hopeful the real me will emerge at the other end.
Would love to hear from any women who have experienced this and come out the other end.
Wish you well x
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Well I spoke to my doctor this morning with all of my concerns, both about his choice of substituting low doze Premique for my now discontinued Prempak C, and about the "cognitive" issues mentioned above, including family history. He has referred me to the Menopause Clinic at the Infirmary, and I have an appointment next Thursday morning. He freely admitted that he was no expert on the many different types of HRT, and would happily be guided by someone with greater expertise.
As to the cognitive side of things, he asked me a bunch of questions about the symptoms, and whether or not they have altered at all over the 6 (ish) years whilst I've been on HRT, and seemed to conclude that I wasn't experiencing anything that indicated any type of dementia. He told me to discuss it further with the Clinic next week though, and then return for another appointment.
I also spoke to the Pharmacist - the Pharmacy is attached to my GP surgery - and he was really helpful. He said that both Prempak C and Premique are really old types of HRT, and that with the discontinuance of both Prempak C and the "medium doze" Premique, his feeling is that the low doze Premique (the one I've just been prescribed as a supposed alternative) will not be long for this world either. I asked if there was a brand of HRT that he thought would be a better alternative and he straight away mentioned Femiston. Interesting, because I've also read good reports about that one here on the forum.
Anyway I'll see what the Clinic advise next week.
Thanks again to you all, and my sympathies to those who were kind enough to offer confidences about their own experiences. I'll report back soon!
Ghostgirl
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Do let us know how you get on and well done on the GP admitting that he too is on a learning curve. Maybe take a list of queries next week?
:bighug:
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I will CLKD, I've got some things scribbled down and I'll add more as I think of them.
No matter what though, I'm preparing myself for what might be a bit of upheaval over the next 2 or 3 months, because the medium doze Prempak C (0.625/0.15mg) was sequential, so I still had a monthly bleed, whereas the Premique low doze (0.3/1.5mg) prescription left at the pharmacy for me is non-sequential, so as well as being a change for me in the dosage will likely produce no monthly bleed. :-\
To be honest I'm a bit unhappy about the fact that I wasn't even told that the new prescription was different to my old one, and just left to get on with it without the doctor even feeling that I needed to be informed of the sequential/non-sequential change, and what that might mean as far as periods were concerned, etc, but having spoken again to him on Friday I'm not sure he even realised the difference himself!? In fact I had to point out the difference to him, having gained some knowledge of the subject from the lovely ladies on this forum ;) xx
I'm taking the Premique in the meantime, because the alternative is to take nothing at all :o but after less than 2 weeks in I've already noticed the day/night sweats creeping back a bit more than usual, so I've a feeling that after my appointment with Catriona at the menopause clinic I might be switching to something else again. I'd really prefer to be back on sequential, as that's what I'm used to, but I'll have to wait and see and will be obviously guided by the expert! lol x
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That's us then, Experts ;D.
Some GPs don't think to tell patients, I've had it happen with ADs and as you said, some GPs aren't even aware but they should be if they have a prescribing qualifycation >:(
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Hi Ghostgirl
I do hope that you get some answers when you go to the menopause clinic, and hope that they can advise with some suitable medication. I will watch with interest to see if the consultant can help.
I can relate to you regarding loss of mental ability. I started menopausal symptoms at about 43. I didn't really notice the gradual decline in my mental abilities. Like Qwerty, I had a professional career, and have always been a quick thinker.
I did some training for a new role and really struggled taking on board the new information. I ended up making a few mistakes and then found myself on a performance improvement plan. Whilst on the plan my peri-menopausal symptoms dramatically worsened, giving me hot flushes and insomnia.
I ended up being dismissed due to medical capability in November last year (age 45) as the HRT didn't resolve all my symptoms, and I didn't feel like me at all.
I do feel better now the stress of work has gone, but am aware of my reduced mental ability, which makes me feel less good about myself, and reluctant to consider a formal 9-5 job again. I have picked up some casual work, but hope that the foggy thinking may improve as I go through the menopause.
Ghostgirl, thanks for posting, and thanks to everyone who has replied - it helps to know that it is not just me experiencing these symptoms.
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A fascinating thread and one I can relate to, though don't have any specific advice to offer.
I'm rather seriously hoping HRT can help improve my mental abilities (pretty quickly!). Like Qwerty, I feel like a decades long career is about to come to end with major financial consequences ...
So this is really just a note to offer empathy to those in a similar situation ...
S
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Hi Binbon, Hi Sally, good to meet you both :)
You know when I first decided to post a thread on this subject I didn't expect to hear about so many other ladies with similar issues, it honestly surprised me! Just shows you that sometimes it's good to talk, at least I now know that a) I'm not imagining it all, b) I'm not nutty as a fruitcake, and c) there are others' suffering similar problems. Not that that in itself is a good thing, you understand!!... but you know what I mean I'm sure :)
It's a bit ridiculous though, isn't it? It feels like ...oh my god what on earth is my body thinking?? This can't be right!? I mean, I expected certain things from "getting older", creaky joints, aches and pains, even weight gain, but I definitely did NOT see this coming!
Anyway thanks for introducing yourselves, and posting your experiences, I'll let you know how I get on at the Clinic, and pass on any help or advice I'm given. Hopefully others can then benefit as well.
Ghostgirl x
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Hello again ladies, I just thought you might like to know about something quite interesting that appears to be happening to me!
As those who have read through this thread will be aware, I had a bit of a bungle with my HRT prescription after the unexpected news that my Prempak C had been discontinued. My doctor put me on low doze Premique as an alternative, however that, as it turned out, wasn't really a decent alternative at all, being as my Prempak C was "medium doze" and "sequential" (so, with a monthly bleed), however the Premique was "low doze" and "non-sequential" (no monthly bleed). After speaking to a very nice lady called Catriona at the local menopause clinic I went back to my doctor armed with her advice, which was to try something like Femiston 2/10. Fortunately the doctor was more than happy to comply.
Anyway, after around 3 weeks of struggling by on the Premique, as I'd started the packet so was advised to finish (night sweats started returning rather rapidly just over a week in ::) ) and then a further couple of weeks of symptoms gradually improving after I started on the first packet of Femiston 2/10, something appears to be happening that I DID'NT expect, I have noticed a perceptible lifting of the "brain fog" and slow-wittedness that's proved so tiresome for the past few years, AND I've recently been feeling a whole lot more alive and alert, in general, which is just so much more fabulous than I can express In fact, it may sound daft, I actually feel younger! :bouncing:
So what's this all about? Was I just on the wrong HRT - for me, anyway - for all those years?
I know that Prempak C and Premique are two of the much older versions of HRT, and that Femiston is far newer and more modern, as well as being synthetically made in the lab rather than using the old, ah, horse piss... ;D ...so maybe the older types alleviated my symptoms, but on the other hand just didn't really suit me as far as my mental acuity was concerned??
Who knows. What I do know is that I've gone on a diet, bought some new clothes, had my hair re-styled and and changed the colour, and yesterday I went out and bought paper and paint to start decorating two fights of stairs and a landing!!
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Glad that the new HRT regime is helping you feel so much better and helping with the brain fog :)
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Glad that the new HRT regime is helping you feel so much better and helping with the brain fog :)
Thanks Binbon, this experience has made me realise that sometimes it's not good to just accept without question what the doctor prescribes for you, assuming that one-size-fits-all, so to speak. Fingers crossed the unexpected discontinuance of my original prescription may yet turn out to be a blessing in disguise!
If I've learned one thing it's that if a medication is working in some respects, but causing unwanted side-effects in another, then clearly it's worth requesting an alternative to try.
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Good news Ghostgirl and glad you've found a regime which suits you. It just goes to show how low levels of oestrogen can impact and how simply bringing levels back up enables functioning. I do feel for all those missing out x