At some point in our lives, we have probably experienced mental exhaustion. Times where we are just unable to think clearly or focus. Kind of like when one is rowing a boat at night, in the middle of the ocean, surrounded by dense white fog. You know where you are, you know how to row, but you just can’t see straight ahead. Brain fog or also known as brain fatigue encompasses this feeling. Brain fog is when someone has trouble concentrating, remembering things, and focusing. Women more frequently experience this phenomenon because of its association with the female reproductive hormones oestrogen and progesterone.

Progesterone exposure during the luteal phase has been implicated in the premenstrual emotional disturbances, such as Premenstrual Syndrome and Premenstrual Dysphoric Disorder. A study found that during the luteal phase women experienced increased mental fatigue and were unable to regulate emotions. Because of this women were also more likely to develop psychiatric disorders. The Amygdala, which is a part of the limbic system of the brain is responsible for the perception of emotion and storage of memories and emotions. High progesterone levels during the luteal phase have been associated with an increase in amygdala reactivity and an increase in emotional memory. It has also been found that women are likely to experience spontaneous intrusive recollections and memories during this phase.

Brain fog is also commonly experienced by women transitioning through menopause. These women are at a higher risk of developing depression, anxiety, and stress. Increased estrogen activity has been found in the brain regions involved in mood and cognitive regulation (such as the prefrontal cortex, hippocampus). This provides evidence that estrogen may have some kind of mediating effects on mood. Estrogen also regulates the activity of the neurotransmitters implicated in depression. Despite the beneficial effects of estrogen on mood, further research, and data are required to approve the use of estrogen hormone as a treatment for cognitive and mood dysfunction.

So what can a woman do to maintain her mental health and prevent brain fog?

  • Take care of her physical health: Stop smoking, receive treatment for other medical issues, such as hypertension, diabetes mellitus.
  • Participate in physical activity such as walking, yoga, or aerobic exercises
  • Maintain a healthy and balanced diet: Mediterranean diet is known to decrease age-related cognitive decline and can be useful in postmenopausal women ○ Get adequate sleep along with good sleep hygiene

We usually have a tendency to dismiss our feelings. That the emotions we are experiencing are just part of the routine, part of our cycle. Changes in our emotional state can be subtle or perhaps sometimes explosive. Whichever the severity, it is crucial to be aware of changes in our emotional state and reach out when we need help.

Talking to your GP about what you are going through mentally is the key to getting the help you want and need. They are not only there to treat your physical ailments, but they are also there to listen to you when you are under emotional distress. We have both female and male GPs who can help you at Liverpool Plaza Medical Centre and can also provide you with a mental health care plan and refer you to a mental health specialist, such as a psychologist or psychiatrist.  


REFERENCES

1)    Inger Sundström-Poromaa, Chapter Thirteen - The Menstrual Cycle Influences Emotion but Has Limited Effect on Cognitive Function, Editor(s): Gerald Litwack, Vitamins, and Hormones, Academic Press, Volume 107, 2018, Pages 349-376, ISSN 0083-6729, ISBN 9780128143599, https://doi.org/10.1016/bs.vh.2018.01.016.

2)    Sophie H. Li, Andrew R. Lloyd, Bronwyn M. Graham, Physical and mental fatigue across the menstrual cycle in women with and without a generalised anxiety disorder, Hormones and Behavior, Volume 118, 2020, 104667, ISSN 0018-506X, https://doi.org/10.1016/j.yhbeh.2019.104667.

3)    Sundström Poromaa I, Gingnell M. Menstrual cycle influence on cognitive function and emotion processing-from a reproductive perspective. Front Neurosci   . 2014;8:380. Published 2014 Nov 24. doi:10.3389/fnins.2014.00380

4)    Maki PM, Henderson VW. Cognition and the menopause transition. Menopause. 2016;23(7):803-805. doi:10.1097/GME.0000000000000681