Reviewed via Brian St. Pierre, MS, RD and Helen Kollias, PhD
It’s like my ideas had been below a pile of rubbish.
On a Friday evening, as my husband and I attempted to determine the place to consume, a normal dialog would move like this:
Me: Do you need to visit that eating place?
Him: What eating place?
Me: I will’t call to mind the title. We’ve eaten there sooner than. It’s that position with the peanut shells at the ground? It’s subsequent to… You realize… It’s on that street the place we used to take the canine to the vet. Are you aware the only I’m speaking about??
It used to be as though positive main points were given misplaced in a pile of sludge within the deep recesses of my mind. Then, hours later, the main points would break out, and I’d shout into an empty room…
“Texas Roadhouse!”
Sludginess with right kind nouns is conventional for people who find themselves middle-aged and past.
On the other hand, what gave the impression to be taking place to me, an increasing number of in my past due 40s and early 50s, felt a ways from conventional.
Now not best may I by no means appear to spit out the names of more than a few eating places or other folks or books or motion pictures or such a lot of different issues, however my mind used to be additionally pooping out all the way through the workday.
I’d take a seat in entrance of my visual display unit, stare at a record, and can myself to do one thing positive with my fingertips. The entirety appeared hazy, like the ones first few moments within the morning whilst you’re conscious sufficient to show off the alarm however too sleepy to do simple math.
I had my just right moments, in most cases within the morning, once I tried to pack 8 hours of writing into the 2 or 3 hours I possessed psychological readability.
On my worst days, alternatively, I aroused from sleep with a haze I by no means controlled to shake. Paintings used to be a non-starter. Nor did I’ve sufficient bandwidth to learn, or do a lot of anything else, truly.
I sought scientific recommendation.
3 healthcare execs advisable antidepressants. I attempted one, and felt even worse. I attempted any other. I attempted but any other at a better dose. Nonetheless, I felt like a zombie. Any other skilled gave me a dozing tablet. It left me feeling much more drugged.
Any person examined my thyroid. There used to be not anything mistaken with it. Nor used to be I anemic. I attempted dietary supplements, mushroom espresso, and with reference to any product with the phrase “suppose” someplace on its label.
After all, after just about two years of seeing a revolving door of docs, I made an appointment with a gynecologist for my once a year examination. I discussed vaginal dryness. That knowledge brought about her to invite a string of questions that had not anything to do with my undercarriage. How used to be my sleep? Temper? Power ranges? Was once I experiencing scorching flashes? How about mind fog?
“Humorous you will have to point out mind fog,” I stated in my same old hazy monotone. “I believe like I’m slightly alive.”
By means of the tip of the consult with, I understood that I’d most probably by no means had despair.
What I “had” used to be menopause.
My gynecologist despatched me house with prescriptions for estradiol and progesterone.
Inside of days, it used to be as though somebody had flipped a transfer.
I may suppose once more. I may sort phrases once more. I may practice conversations. I may paintings previous midday.
And, for the primary time in years, I may sleep greater than two hours with out waking.
Over 150,000 well being & health execs qualified
Save as much as 37% at the business’s most sensible vitamin certification
Lend a hand other folks enhance their well being and health—whilst making an ideal full-time or part-time dwelling doing what you like.
Be told Extra
Now, menopause isn’t a scientific situation.
Neither is it a illness.
As a substitute, like puberty, it’s a lifestyles degree—a transitional second to be actual.
While you’ve long gone 12 consecutive months and not using a duration, you’ve reached menopause. And from that second onwards, you’re formally “postmenopausal.”
As ladies way this transitional second, hormone ranges differ and fall, triggering dozens of signs. Weight achieve and lowered intercourse force get numerous consideration.
On the other hand, all the way through and after menopause, more or less 40 % of ladies record higher irritability, temper swings, nervousness, fatigue, and hassle concentrating, in keeping with the American Faculty of Obstetricians and Gynecologists.1 2 As the next symbol displays, it’s additionally probably the most prone occasions in a lady’s lifestyles to expand despair,3 in particular in the event that they’ve struggled prior to now with it sooner than.
Sooner than beginning hormones, I frequently discovered myself sobbing for no explanation why. Different occasions, the sector’s stimuli felt too… stimulating.
Commonplace on a regular basis sounds—like the excitement of site visitors or other folks on the mall—actually harm. I used to be jumpy and irritable and felt worried about scenarios that had by no means stricken me prior to now, reminiscent of using over bridges or thru development.
It’s no longer utterly clean what drives those cognitive and emotional signs.
Fluctuating hormone ranges most probably play a task, as do conventional age-related adjustments within the mind.
As well as, all the way through this degree of lifestyles, ladies frequently care for a number of problems that siphon cognitive capability sooner than a thirsty vampire drains a carotid.
All over their 40s and 50s, as an example, many ladies have reached the height in their careers, with obligations that practice them house and stay them up at evening. They can also be parenting angst-filled teenagers, taking care of ageing oldsters, adjusting to an empty nest, wondering their marriage, or looking to wrap their checking account round the most recent remark from the school bursar or health center billing division.
On the other hand, some of the lesser-known and mentioned triggers for cognitive discontent has not anything to do with ageing or lifestyles tension and the whole lot to do with that hallmark menopausal symptom: the new flash.
Anatomy of a scorching flash
Scorching flashes, which take place all the way through the day, and evening sweats, which take place at evening, fall below the class of vasomotor signs. (The phrase “vasomotor” refers back to the constriction or dilation of blood vessels which, in flip, can affect the whole lot from blood force to sweating.)
All over a scorching flash or evening sweat, norepinephrine and cortisol ranges upward push. Blood vessels dilate in an try to shed warmth. Blood force and middle fee building up.
Relying at the severity of the new flash, your pores and skin may redden as sensations of heat unfold thru your face, neck, and chest.
You could sweat, enjoy middle palpitations, or really feel worried, drained, or faint.4
It’s no longer completely clean why scorching flashes crop up round menopause.
In line with one concept, falling estrogen ranges have an effect on the hypothalamus, the world of the mind desirous about temperature law. The mind’s inner thermostat will get wonky and on occasion thinks your physique is simply too scorching or chilly (when it’s no longer).
How vasomotor signs alternate the mind
For a few years, mavens considered vasomotor signs as mere inconveniences or resources of embarrassment.
(To be truthful, so did I. All over all of the ones fruitless visits to more than a few healthcare execs, it by no means befell to me to say them.)
On the other hand, an expanding physique of study has printed that scorching flashes might do greater than make us uncomfortable or drive us to switch our sheets in the midst of the evening.
They may additionally have an effect on our blood vessels and brains—and no longer for the easier.5 Because of this, more and more mavens now believe vasomotor signs to be a treatable scientific situation.6 7 8
Scorching flashes and mind lesions
In a single find out about, researchers requested 226 ladies to put on screens that tracked once they had been experiencing a scorching flash. The ladies additionally underwent magnetic resonance imaging (MRI), crammed out sleep diaries, and wore smartwatches that recorded how frequently they woke at evening.9
As researchers regarded on the mind photographs acquired from ladies who skilled essentially the most scorching flashes, they spotted an abundance of patchy spaces referred to as whole-brain white subject intensities.
Those lesions had been as soon as regarded as a normal result of ageing. On the other hand, neuroscientists now consider that the presence of whole-brain white subject intensities is predictive of long term cognitive decline.
Other people with an abundance of those mind lesions are two times as prone to get identified with dementia and 3 times as prone to have a long term stroke.10
The blood vessel connection
It’s concept that the higher presence of whole-brain white subject intensities might stem, partly, from adjustments going down within the blood vessels that feed the mind.
A 3-year find out about of 492 ladies helps that concept. It made up our minds that ladies who skilled common scorching flashes additionally tended to enjoy bad adjustments of their blood vessels, reminiscent of an incapacity to dilate to deal with higher blood glide.11
Different examine has related common scorching flashes with will increase within the following:
Thickening within the carotid arteries that provide blood to the mind, face, and neck12
Frame fats
Overall and LDL ldl cholesterol
Insulin resistance13 14 15 16
The sleep connection
Along with immediately affecting the blood vessels, common scorching flashes may additionally have an effect on the mind via anxious sleep.17
Curiously, many ladies don’t essentially know that scorching flashes are anxious their sleep.
They are going to as a substitute—as I did—think they have got insomnia or sleep apnea.
That’s as a result of evening sweats aren’t at all times sweaty.
By the point a surge in cortisol and norepinephrine jolts a lady conscious, the hotness of the flash will have dissipated. So, it may well really feel as though she’s again and again waking, over and again and again, for no discernable explanation why.
Those common awakenings might intervene with the mind’s skill to consolidate recollections, metabolize toxins, and retailer all of the names, dates, and details one encounters day by day.
It might probably additionally result in misplaced connectivity within the hippocampus, part of the mind that’s vital for finding out and reminiscence.
Sleep loss additionally method the amygdala, part of the mind desirous about emotion, turns into extra reactive, inflicting other folks to really feel extra simply wired, worried, irritable, pissed off, or enraged.18 19
All of those mind adjustments can set in after simply days to every week of misplaced sleep. So, believe what occurs whilst you’ve been waking again and again—for years.
Why it may be exhausting to get assist
To diagnose despair, healthcare execs use a device referred to as the Affected person Well being Questionnaire (PHQ-9) despair scale. If you happen to take a look at off 4 of the 9 signs at the scale, you’re thought to be depressed.
On the other hand, 4 of the indicators at the tick list additionally overlap with the indicators of menopause-related sleep deprivation:
Little hobby or excitement in doing issues
Hassle falling or staying asleep
Feeling drained or having little power
Hassle focusing on issues, reminiscent of studying the newspaper or gazing tv
Take a look at off the ones 4 pieces, and also you could be identified with despair, even though what’s truly unwell you is the fight with sleep you’ve been waging because you became 47.
A loss of menopause-specific coaching
Any other downside: On surveys, 80 % of scientific citizens admit they really feel “slightly at ease” speaking about menopause.20 As well as, few residency techniques—together with ob-gyn residency techniques—be offering coaching in it.21
Given the above, it’s no marvel such a lot of healthcare execs by no means suppose to invite about scorching flashes or sleep disturbances when other folks like me display up complaining of fatigue, loss of gumption, and an incapacity to center of attention.
As well as, even if it’s clean that vasomotor signs are resulting in cognitive and emotional signs, many healthcare execs nonetheless shy clear of prescribing menopausal hormone remedy (often known as hormone substitute remedy, or HRT), frequently telling ladies that supplemental hormones are “no longer secure” or “too dangerous.”
Those execs are training what Michigan-based menopause-trained gynecologist Jerrold H. Weinberg, MD, calls “defensive drugs.”
“It’s some of the first reflexes docs have once they suggest a remedy,” says Dr. Weinberg. “They fear they’re going to get sued.”
What the examine in fact says about hormone remedy
Those worries are in line with examine performed a number of a long time in the past that related the usage of positive forms of hormones with a relatively higher possibility of creating breast most cancers or stroke.22
On the other hand, in keeping with more moderen examine, that small higher possibility turns out to rely on a number of different components, reminiscent of age, dose, the kind of hormonal preparation, and the length of hormone use.23 24
So long as you’re more youthful than 60 and feature been postmenopausal for fewer than 10 years, many mavens now say the advantages outweigh the dangers for ladies with reasonable to serious menopausal signs.25
It’s additionally counterbalanced via well being advantages reminiscent of lowered possibility of creating Alzheimer’s illness or osteoporosis, says Dr. Weinberg, who confirms the well being advantages of menopause hormone remedy a ways outweigh the dangers for most ladies.
As a result of some antidepressants can raise temper, enhance sleep, and cut back scorching flashes, some healthcare execs flip to them as a substitute of menopause hormone remedy. As with every drugs, antidepressants have their very own record of uncomfortable side effects. On the other hand, for somebody training defensive drugs, they frequently appear to be a more secure guess, says Dr. Weinberg.26 27 28
Tips on how to recommend on your well being
If you happen to or your consumer are on what turns out like a endless quest to discover a healthcare skilled who understands menopause, use the following tips from Dr. Weinberg and Helen Kollias, PhD, a professional on body structure and molecular biology and science guide at Precision Diet and Ladies Long gone Robust.
▶ Search care from a menopause-trained well being skilled.
In most cases, those execs record this coaching and hobby of their bio. For instance, they may record “menopause” as a space of center of attention.
You’ll additionally seek this database for practitioners who’ve earned a certification from the Menopause Society.
▶ Record your signs.
Write them down. That method, if you’re feeling foggy or apprehensive all the way through your appointment, you’ll lean for your notes.
This knowledge too can let you pass judgement on whether or not MHT or any other drugs is operating. In line with your symptom information, you and your healthcare skilled might make a decision to modify to another drugs or alternate your dose.
Believe monitoring:
How frequently you get scorching flashes
The selection of hours in a normal day you end up fighting mind fog
How frequently you enjoy fatigue, nervousness, rage, or every other symptom
How frequently you get up at evening
▶ Be as particular as you’ll all the way through your appointment.
Pronouncing one thing like “I don’t sleep smartly,” is much less prone to get you the proper of assist than announcing, “All over the previous seven days, I’ve best gotten 4 uninterrupted hours as soon as. I wake, on reasonable, 5 occasions an evening. On a normal evening, my longest stretch of sleep is 3 hours.”
If you happen to use a smartwatch, come in a position to stir up your well being app, so your healthcare skilled can see the information.
▶ Communicate concerning the execs and cons of remedy.
There’s an idea in drugs referred to as “shared decision-making.” A part of that procedure comes to frank discussions about the advantages and dangers of a given remedy. Then, sufferers and clinicians paintings in combination to make choices in line with the ones advantages and dangers.
Many healthcare networks inspire clinicians to make use of shared decision-making, as it kind of feels to cut back affected person lawsuits in addition to malpractice proceedings.29 30
Because of this, shared decision-making can assist shift a healthcare skilled out of the “defensive drugs” mindset.
You could ask questions like:
“I’m concerned with seeing if menopausal hormone remedy could be useful. May we speak about if I’m a just right candidate?”
“I’ve learn that menopausal hormone remedy may relatively building up my possibility of breast most cancers. May you assist me perceive my non-public breast most cancers possibility in line with my circle of relatives historical past, age, physique weight, and way of life?”
“Osteoporosis runs in my circle of relatives, as does dementia. I’ve heard that menopausal hormone remedy may assist to cut back the danger for each, along with serving to me sleep. May you assist me weigh the professionals and cons?”
Tips on how to enhance psychological and emotional well being all the way through menopause: 9 way of life methods
The way of living behavior that enhance psychological and emotional well being all the way through menopause aren’t extraordinarily other from the way of life behavior that enhance general well being—for somebody, at any degree of lifestyles.
Instead of averting caffeine, alcohol, and highly spiced or scorching meals, there’s no particular nutrition for other folks with vasomotor signs. (And via the way in which, tofu and different soy merchandise don’t appear to assist with vasomotor signs up to as soon as thought30—despite the fact that they’re nonetheless nutritious.)
Technique #1: Lean into elementary well being methods.
Wholesome behaviors don’t essentially alternate all the way through center age.
Diet, bodily task, tension control, sleep, social connectedness, and a way of function subject simply as a lot all the way through the menopausal transition as they do after we’re more youthful. On the other hand, those basics are much more vital to dial in as lifestyles progresses.
So believe:
Are you environment apart sufficient time for sleep and leisure?
Are you bodily lively?
Are you consuming a nutrition that’s most commonly minimally processed and filled with brightly coloured produce, wholesome fat, lean protein, fibrous greens, and legumes?
Do you steadily hook up with different people in ways in which let you buffer tension and really feel supported?
Do you to find techniques to enjoy awe, pleasure, interest, peace, and function?
If you happen to replied “no” to a few or all of the ones questions, believe why this is. What’s preventing you? How may you take away obstacles or shore up reinforce to make the ones basics more straightforward?
Technique #2: Experiment with creatine.
Along with serving to to blunt age- and hormone-related losses in muscle and bone mass, creatine may additionally assist bolster temper and mind serve as whilst decreasing psychological fatigue.
It additionally turns out to counter one of the vital side effects of sleep deprivation. 32 33 Analysis displays a day by day dose of five to 7 grams of creatine monohydrate is efficacious.
Technique #3: Get common about mild publicity.
Along with serving to you’re feeling alert, daylight is helping to set the interior clock on your mind that makes you sleepy at evening and spunky within the morning. Morning and past due afternoon mild publicity appear in particular potent.
In a find out about of 103 other folks, publicity to morning daylight predicted higher sleep high quality the next evening. When other folks hung out open air within the mornings, they fell asleep extra briefly, slept longer, and skilled fewer awakenings the next night time.34
Daylight may additionally enhance temper and focus.35
Technique #4: Cross more straightforward on the gymnasium.
If you happen to’re already wiped out, lengthy, intense workout periods will most probably make you’re feeling worse.
For one, accidents crop up a lot more simply at center age than all the way through our 20s and 30s. As well as, it takes longer to get well between periods.36
String too many overly zealous workout routines too shut in combination, and also you’ll no longer best most probably begin to really feel achy but additionally extra irritable, worrying, and drained.
On the other hand, similar to a chilly bathe, quick bursts of workout might let you to really feel alert all the way through the day.
If you happen to’re falling asleep at your table, inspire your self to take quick motion breaks reminiscent of a 5- or 10-minute stroll open air or a snappy set of pushups or squats.
As well as, chances are you’ll to find mild workout—reminiscent of yoga or stretching—is helping you loosen up sooner than mattress. Simply don’t make it too intense, otherwise you’ll cause a unencumber of adrenaline.
On every occasion you workout, music into how your physique feels, particularly after a in particular unhealthy evening of sleep.
We’re no longer announcing you will have to by no means workout vigorously or attempt to beat your lifting PRs. On the other hand, relying for your sleep and restoration, you could wish to pare issues again, particularly should you’ve historically hit the gymnasium exhausting.
You’ll nonetheless do intense periods—simply stability them out with extra reasonable periods, in addition to proportionate restoration.
Relying on how you’re feeling, you could make a decision to head all out, as same old.
On the other hand, you may additionally make a decision to do a zone 2 coaching consultation as a substitute of an intense run. Or, should you’re resistance coaching, you could nonetheless do your deliberate consultation, however cut back the selection of units, reps, or quantity lifted.
Technique #5: Examine Cognitive Conduct Remedy for Insomnia (CBT-I).
This research-based remedy for insomnia mean you can expand talents and psychological reframes that inspire sound sleep.
For instance, a CBT-I therapist will let you expand the ability of having up on the identical time on a daily basis, irrespective of how badly you slept (or didn’t sleep) the evening sooner than.
(Learn extra: 3 CBT-I talents that may develop into the way you sleep.)
Technique #6: Get actual about tension.
You won’t have the power (or need) to do the whole lot you probably did whilst you had been more youthful. (Whilst you had been 36, your day by day tick list defied time and house.)
In consequence, you could get pleasure from having a look seriously at your present obligations to peer which of them you’ll shrink or downsize. For a number of days, monitor the way you spend your time and bandwidth. Then, analyze your information.
Ask your self:
Is that this the way you actually wish to spend your time and effort?
Does your present agenda mean you can leisure, get well, and have a tendency in your personal wishes? Or, do you spend just about your whole time and effort taking care of and offering for others?
What adjustments may you’re making to prioritize leisure and restoration?
If you happen to’re a trainer, use the Wheel of Stress Assessment to assist shoppers establish other dimensions in their lifestyles that could be draining their psychological and emotional capability. (Whilst you know in particular the place your tension is coming from, you’ve gotten a greater likelihood of resolving it.)
If it’s calls for from different those that save you you from prioritizing self-care and restoration, you could love to learn: How announcing “no” can radically change your lifestyles.
Technique #7: Experiment with cooling generation.
You could to find you sleep higher and enjoy fewer evening sweats should you sleep in a cooler atmosphere.
Check out turning down the thermostat a few levels, the usage of a fan, or making an investment in an electrical cooling bed pad.
Technique #8: Take common breaks.
When you’re feeling the fog take over your mind, it’s probably not you’ll be doing “your very best paintings” anyway.
So, for a block of time—say, 20 mins—allow your self to do not anything. You could:
Calm down with a chilly beverage
Cuddle with a puppy
Gaze out a window
Take a seat open air whilst taking note of the birds
Name a pal
If you want a snappy “refresh,” you’ll additionally take a look at a 5-minute mind-body scan.
Get your physique right into a at ease place. For instance, you could use the yoga “legs up the wall” pose or lie down and position a pillow below your knees.
Then, shut your eyes and produce your consideration to bodily sensations on your physique. Get started at your head, and paintings your method down in your feet.
Don’t pass judgement on or rush to switch anything else. Simply practice, like a scientist. You’ll additionally scan your intellect, as an example, via noticing ideas.
Whilst you’ve finished the scan, believe:
What are you feeling bodily?
What are you feeling emotionally?
What are you pondering?
You don’t need to “do” anything else with the ideas you discover, simply realize.
Technique #9: Apply a nutrition that promotes wholesome flow.
The meals that give protection to the blood vessels round your middle too can give protection to the blood vessels on your mind.
For instance, each the MIND and Mediterranean diets are related to a discounted possibility of Alzheimer’s illness and despair.37 38 Those consuming patterns are wealthy in greens, fruit, total grains, olives, beans, fish, and different minimally-processed total meals.
As well as, nitrate-rich meals like beets and darkish, leafy vegetables might assist to dilate blood vessels, briefly making improvements to reminiscence via serving to extra blood to succeed in the mind.39 40
(For extra on how our nutrition can reinforce mind serve as and emotional law, learn: Diet and psychological well being: What (and the way) to consume)
The upside of menopause
It’s irritating when you’re feeling like you’ll’t do all of it.
Imagine me. I do know.
On the other hand, this degree of lifestyles gifts a hidden alternative, forcing you to re-examine what’s maximum vital.
Sooner than occurring hormones, as my skill to sort coherent phrases and words decreased, I used to be compelled to invite the most important query:
Do I truly want to be doing this?
It used to be extra of an existential query than a career-related one, and it allowed me to re-examine how I sought after to spend my restricted psychological assets.
For the reason that I used to be self-employed, I didn’t in fact want to be operating 8 hours an afternoon. That used to be a present, wasn’t it?
Perhaps I additionally didn’t want to prepare dinner dinner six nights out of 7. Perhaps the recipes I selected might be simplified, too.
After all, possibly announcing “no” much more frequently and with out be apologetic about would permit me to proceed to mention sure to the issues that mattered maximum.
Such things as visiting my ageing oldsters.
And selecting up the telephone every time my child referred to as from faculty.
Or assembly a pal for a meandering stroll round the town.
Because of the hormones and lifestyles tweaks, I now have power once more. I’m additionally clear-headed more often than not. On the other hand, I nonetheless have a tendency to finish my paintings day round 3 p.m.
Why?
As a result of I will, and I wish to.
References
Click on right here to view the ideas resources referenced on this article.
Temper Adjustments All over Perimenopause Are Actual. Right here’s What to Know [Internet]. [cited 2024 Nov 1]. To be had from: https://www.acog.org/womens-health/experts-and-stories/the-latest/mood-changes-during-perimenopause-are-real-heres-what-to-know
Gordon JL, Eisenlohr-Moul TA, Rubinow DR, Schrubbe L, Girdler SS. Naturally occurring changes in estradiol concentrations in the menopause transition predict morning cortisol and negative mood in perimenopausal depression. Clin Psychol Sci. 2016 Sep;4(5):919–35.
N.d. Accessed November 20, 2024. https://nap.nationalacademies.org/read/27757/chapter/8.
Lugo T, Tetrokalashvili M. Scorching flashes. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024.
Andrews R, Lacey A, Bache Okay, Kidd EJ. The role of menopausal symptoms on future health and longevity: A systematic scoping review of longitudinal evidence. Maturitas. 2024 Sep 30;190(108130):108130.
Thurston RC, Chang Y, Wu M, Harrison EM, Aizenstein HJ, Derby CA, et al. Reproductive hormones in relation to white matter hyperintensity volumes among midlife women. Alzheimers Dement. 2024 Sep;20(9):6161–9.
Thurston RC, Maki P, Chang Y, Wu M, Aizenstein HJ, Derby CA, et al. Menopausal vasomotor symptoms and plasma Alzheimer disease biomarkers. Am J Obstet Gynecol. 2024 Mar 1;230(3):342.e1-342.e8.
Thurston RC, Wu M, Barinas-Mitchell E, Chang Y, Aizenstein H, Derby CA, et al. Carotid intima media thickness and white matter hyperintensity volume among midlife women. Alzheimers Dement. 2023 Jul;19(7):3129–37.
Thurston RC, Wu M, Chang Y-F, Aizenstein HJ, Derby CA, Barinas-Mitchell EA, et al. Menopausal vasomotor symptoms and white matter hyperintensities in midlife women. Neurology. 2023 Jan 10;100(2):e133–41.
Wardlaw JM, Valdés Hernández MC, Muñoz-Maniega S. What are white matter hyperintensities made of? Relevance to vascular cognitive impairment: Relevance to vascular cognitive impairment. J Am Center Assoc. 2015 Jun 23;4(6):001140.
Thurston RC, Sutton-Tyrrell Okay, Everson-Rose SA, Hess R, Matthews KA. Hot flashes and subclinical cardiovascular disease: findings from the Study of Women’s Health Across the Nation Heart Study: Findings from the Study of women’s Health Across the Nation Heart Study. Flow. 2008 Sep 16;118(12):1234–40.
Thurston RC, Chang Y, Barinas-Mitchell E, Jennings JR, Landsittel DP, Santoro N, et al. Menopausal Hot Flashes and Carotid Intima Media Thickness Among Midlife Women. Stroke. 2016 Dec;47(12):2910–5.
Thurston RC, Sowers MR, Sternfeld B, Gold EB, Bromberger J, Chang Y, et al. Gains in body fat and vasomotor symptom reporting over the menopausal transition: the study of women’s health across the nation. Am J Epidemiol. 2009 Sep 15;170(6):766–74.
Thurston RC, El Khoudary SR, Sutton-Tyrrell Okay, Crandall CJ, Gold EB, Sternfeld B, et al. Vasomotor Symptoms and Lipid Profiles in Women Transitioning Through Menopause. Obstetrics & Gynecology. 2012 Apr;119(4):753–61.
Thurston RC, El Khoudary SR, Sutton-Tyrrell Okay, Crandall CJ, Sternfeld B, Joffe H, et al. Vasomotor Symptoms and Insulin Resistance in the Study of Women’s Health Across the Nation. The Magazine of Medical Endocrinology & Metabolism. 2012 Oct;97(10):3487–94.
Thurston RC, Chang Y, Barinas-Mitchell E, Jennings JR, von Känel R, Landsittel DP, et al. Physiologically assessed hot flashes and endothelial function among midlife women. Menopause. 2017 Aug;24(8):886–93.
Thurston RC, Chang Y, Buysse DJ, Corridor MH, Matthews KA. Scorching flashes and awakenings amongst midlife ladies. Sleep [Internet]. 2019 Sep 6 [cited 2024 Oct 31];42(9). To be had from: https://pubmed.ncbi.nlm.nih.gov/31152182/
Roy S. Sleep Deprivation Harms Reminiscence By way of Lack of Connectivity Between Hippocampus Neurons [Internet]. Sleep Evaluation. 2016 [cited 2024 Oct 31]. To be had from: https://sleepreviewmag.com/sleep-health/demographics/age/sleep-deprivation-harms-memory-via-loss-connectivity-hippocampus-neurons/
Minkel JD, Banks S, Htaik O, Moreta MC, Jones CW, McGlinchey EL, et al. Sleep deprivation and stressors: evidence for elevated negative affect in response to mild stressors when sleep deprived. Emotion. 2012 Oct;12(5):1015–20.
Dorr B. Contributor: Within the Misdiagnosis of Menopause, What Must Trade? [Internet]. AJMC. 2022 [cited 2024 Oct 31]. To be had from: https://www.ajmc.com/view/contributor-in-the-misdiagnosis-of-menopause-what-needs-to-change-
Allen JT, Laks S, Zahler-Miller C, Rungruang BJ, Braun Okay, Goldstein SR, et al. Needs assessment of menopause education in United States obstetrics and gynecology residency training programs. Menopause. 2023 Oct 1;30(10):1002–5.
Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML, et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women’s Health Initiative randomized controlled trial. JAMA. 2002 Jul 17;288(3):321–33.
Nerattini M, Jett S, Andy C, Carlton C, Zarate C, Boneu C, et al. Systematic review and meta-analysis of the effects of menopause hormone therapy on risk of Alzheimer’s disease and dementia. Entrance Growing older Neurosci. 2023 Oct 23;15:1260427.
Gosset A, Pouillès J-M, Trémollieres F. Menopausal hormone therapy for the management of osteoporosis. Best possible Pract Res Clin Endocrinol Metab. 2021 Dec;35(6):101551.
Garrison JA. UpToDate. J Med Libr Assoc. 2003;91(1):97.
Newhouser LM, Maneval M, Rayalam Okay, Sabeeh G, Varela L. SSRIs vs. SNRIs for vasomotor symptoms of menopause. Am Fam Doctor. 2022 Apr;105(4):430–1.
Wu C-Okay, Tseng P-T, Wu M-Okay, Li D-J, Chen T-Y, Kuo F-C, et al. Antidepressants during and after menopausal transition: A systematic review and meta-analysis. Sci Rep. 2020 Might 15;10(1):8026.
Schoenfeld EM, Mader S, Houghton C, Wenger R, Probst MA, Schoenfeld DA, et al. The effect of shared decisionmaking on patients’ likelihood of filing a complaint or lawsuit: A simulation study. Ann Emerg Med. 2019 Jul 3;74(1):126–36.
US Preventive Services and products Job Drive, Davidson KW, Mangione CM, Barry MJ, Nicholson WK, Cabana MD, et al. Collaboration and shared decision-making between patients and clinicians in preventive health care decisions and US Preventive Services Task Force recommendations. JAMA. 2022 Mar 22;327(12):1171–6.
Gençtürk N, Bilgiç FŞ, Kaban HU. The effect of soy isoflavones given to women in the climacteric period on menopausal symptoms and quality of life: Systematic review and meta-analysis of randomized controlled trials. Discover (NY). 2024 Might 22;20(6):103012.
Smith-Ryan AE, Cabre HE, Eckerson JM, Candow DG. Creatine Supplementation in Women’s Health: A Lifespan Perspective. Vitamins [Internet]. 2021 Mar 8;13(3).
Gordji-Nejad A, Matusch A, Kleedörfer S, Jayeshkumar Patel H, Drzezga A, Elmenhorst D, et al. Single dose creatine improves cognitive performance and induces changes in cerebral high energy phosphates during sleep deprivation. Sci Rep. 2024 Feb 28;14(1):4937.
Anderson AR, Ostermiller L, Lastrapes M, Hales L. Does sunlight exposure predict next-night sleep? A daily diary study among U.S. adults. J Well being Psychol. 2024 Jul 30;13591053241262643.
Burns AC, Windred DP, Rutter MK, Olivier P, Vetter C, Saxena R, et al. Day and night light exposure are associated with psychiatric disorders: an objective light study in >85,000 people. Nat Ment Well being. 2023 Oct 9;1(11):853–62.
Li DCW, Rudloff S, Langer HT, Norman Okay, Herpich C. Age-Associated Differences in Recovery from Exercise-Induced Muscle Damage. Cells [Internet]. 2024 Jan 30;13(3).
Agarwal P, Leurgans SE, Agrawal S, Aggarwal NT, Cherian LJ, James BD, et al. Association of Mediterranean-DASH Intervention for Neurodegenerative Delay and Mediterranean diets with Alzheimer disease pathology. Neurology. 2023 Might 30;100(22):e2259–68.
Wightman EL, Haskell-Ramsay CF, Thompson KG, Blackwell JR, Winyard PG, Forster J, et al. Dietary nitrate modulates cerebral blood flow parameters and cognitive performance in humans: A double-blind, placebo-controlled, crossover investigation. Physiol Behav. 2015 Oct 1;149:149–58.
Ventriglio A, Sancassiani F, Contu MP, Latorre M, Di Salvatore M, Fornaro M, Bhugra D. Mediterranean Diet and its Benefits on Health and Mental Health: A Literature Review. Clin Pract Epidemiol Ment Well being. 2020 Jul 30;16(Suppl-1):156–164
Heiland EG, Lindh F, Regan C, Ekblom Ö, Kjellenberg Okay, Larsen FJ, et al. A randomised crossover trial of nitrate and breakfast on prefrontal cognitive and haemodynamic response functions. Npj Sci Meals. 2024 Sep 13;8(1):64.
