Hardcover

ISBN 10: 0684854562 ISBN 13: 9780684854564

Publisher: Free Press, 1999

"Menopause and the Mind" gives every woman the survival kit she needs to manage the thinking and memory symptoms -- long overlooked by the medical establishment -- that accompany the onset of perimenopause and menopause. As early as their late thirties, many women begin to experience a range of startling changes in the way they speak, remember, drink, and navigate. Sometimes, these changes begin with occasional "slips of the tongue." Other times, a former champion speller realizes that she's isn't so sure how to spell "potato" or "forty," or an organization maven loses track of her appointments. Some women find they can't remember the name of their oldest friend, or how to turn on the computer. Others put the shampoo bottle in the refrigerator instead of the shower caddy, or forget where they are going "en route" to the supermarket they've shopped at for years. These symptoms occur with greater frequency as women enter their forties, fifties, and beyond, but often they are chalked up to stress or age. However, repeated lapses in memory and recurrences of foggy thinking can be terrifying, causing some women to wonder, "What's happening to me? Could this be early Alzheimer's Disease?" Neuropsychologist Claire Warga provides the first scientific explanation for this common "hormonal misconnection" syndrome. Drawing upon recent brain and clinical research, she shows that forgetfulness, malapropisms, and lost concentration are not manifestations of dementia or senility; instead, they result from the depletion of estrogen in the brain cells of women as they enter perimenopause and menopause. Armed with this knowledge, Warga offers women a breakthrough plan for regaining control andconfidence in their minds. Warga explains in clear, simple language the cutting-edge science that underlies the "hormonal misconnection" syndrome. Research shows that a decrease in estrogen -- which begins with the onset of perimenopause at about age 35 -- produces detectable changes in the parts of the brain having to do with memory and attention, and can affect multiple neurotransmitter systems. There is also evidence that estrogen loss impacts verbal memory and learning. Yet remarkably, the medical establishment has failed tot use this research to help the millions of perimenopausal and menopausal women who suffer from speech, memory, attention, or cognitive/behavioral symptoms. Most doctors know a good deal about the physical and emotional symptoms of menopause, but little about how it affects the brain. Claire Warga fills this vacuum and provides every woman with the information she needs to take care of herself on her own and in consultation with her doctor. "Menopause and the Mind" includes a wide range of real-life stories -- such as the menopausal woman who was misdiagnosed as a paranoid schizophrenic -- that illustrate how different women have coped with their "hormonal misconnection" symptoms. Warga explains the full range of thinking, speech, short- and long-term memory, behavior, spatial, and time sense symptoms in extensive detail, complete with an array of examples. Most important are a self-screening test and symptom chart that every woman can use to understand the extent of her symptoms and accurately assess her condition, with or without her ob/gyn. Women can also make practical use of Warga's detailed guide to treatment options, which include estrogen therapy,dietary and behavioral changes, and techniques for improving memory. Women today live longer and are more active than ever before. "Menopause and the Mind" ensures that every woman can live without embarrassment or fear that she is "losing it" as she grows older. With Claire Warga's roadmap of the relationship between estrogen and the brain, women can develop the practical coping tools they need to lead happy and productive lives.

Review:

Has this happened to you? A name that was on the tip of your tongue suddenly disappears from memory. You mean to say one word, and another pops out. You put your car keys down and have no idea where they are a minute later. You search for something and discover it's in plain sight in front of you. Your mind feels foggy. If you're approaching menopause, your brain may be reacting normally to estrogen loss, according to neuropsychologist and researcher Claire Warga in Menopause and the Mind. She immodestly names this condition WHMS: Warga's Hormonal Misconnection Syndrome. Warga gives tools for assessing, understanding, speaking about, and getting competent help for your symptoms. She presents case studies, discusses why this condition is often overlooked, explains the research on estrogen and the brain, and presents options for improving your brain power and reversing WHMS using hormone replacement therapy or nonhormonal approaches. She includes a comprehensive screening test and recommends that you take the results to your doctor. In fact, you might want to take the whole book to your doctor, because a recurring theme in this book is that medical professionals tend to miss, disregard, or misdiagnose these symptoms. --Joan Price

Excerpt. © Reprinted by permission. All rights reserved.:

Chapter 1

What Are These Strange Symptoms I'm Experiencing in the Middle of My Life?

Mrs. Malaprop: a character in Richard Brinsley Sheridan's 1775 play The Rivals. "A...woman of almost fifty [emphasis added] who...is famous for misusing...long words that sound similar to the correct words."
-- Larousse Dictionary of Literary Characters

Malapropisms: the type of verbal errors made by the character Mrs. Malaprop.

There are some topics almost no one talks about till you do first. The stampede for the male impotence drug Viagra unveiled one such topic. This book is about another one: the previously unrecognized cognitive symptoms that are caused by the effects of perimenopause and menopause on the mind.

Sometimes it begins out of the blue with occasional slips of the tongue, meaning to say one word and unexpectedly hearing another pop out. Or when you realize that you, once a champion speller, aren't so sure anymore how to spell "potato" or "forty." Sometimes it begins with uncharacteristically forgetting important appointments or drawing unexpected momentary blanks -- total blanks -- when it comes to remembering your only child's or best friend's name, or how to turn on the computer you've been using for years. Sometimes with feeling mentally "hazy" "foggy," or "spacey" and not being able to clear things up though you need to be "sharp" at that moment. "What's happening to me" you wonder. "Could this be early, early, early Alzheimer's disease or a brain tumor?"

But it is usually not early Alzheimer's disease or a brain tumor. It is something else, a particular set of symptoms -- a syndrome -- that can occur in women beginning in their mid to late thirties or in their forties or fifties that more than likely can be halted and even largely reversed according to the best evidence available today. It is a syndrome associated with estrogen loss that is mainly experienced from within, and that until now, amazingly, no one has recognized as common among women or has linked to the wealth of post-1990s research evidence revealing the many important newly discovered roles estrogen plays in the remembering, naming, and attending parts of the brain. This is research that helps explain why the symptoms occur and why they can often be reversed.

"I'm losing it," women say. "I'm going out of my mind," "I'm falling apart at the seams." "I'm flipping out." "I'm cracking up." "I'm having a nervous breakdown," "I'm just not myself." "I don't know what's wrong with me." "I do the strangest things." "I think I'm getting early Alzheimer's."

These are not the hysterical rantings of women with vague psychosomatic complaints but rather the blanket descriptions frequently used by perimenopausal (women experiencing or undergoing changes associated with the shifting hormonal functioning of the ovaries that precedes the last period. Symptoms can begin four to fifteen years before menopause.) and menopausal (women who have had their last period twelve months ago) women to describe the dislocating experience of confronting an assortment of unpredictable mind, speech, and behavioral "flash" symptoms. These are surprising symptoms no one has ever prepared them for. Physicians hearing these dramatic statements over the years have simply had no basis in training for understanding what they were hearing and as a result have been able to offer no, or minimally constructive, help to women who dared to mention them.

THE SYMPTOMS OF PERIMENOPAUSE AND MENOPAUSE CAN BE VERY STRANGE BUT NORMAL

Before describing the specific symptoms I am referring to it makes sense first to agree about certain realities of a perimenopausal/menopausal symptom you already do know something about. Hot flashes. Consider this: If we on earth had never heard of hot flashes as a "normal" midlife symptom associated with ovarian and hormonal changes, and a returning astronaut-discoverer of a twin planet to ours reported drenching, unpredictable, overheating episodes as normal in otherwise healthy midlife-and-older women, we would likely say in quick dismissal, "Go away! You must have gotten something wrong there. The women were probably fooling with you in some way. You couldn't be right. That symptom is just too weird to be true of normal people."

And yet the reality is hot flashes are definitely normal but strange symptoms for healthy women to have. The fact that they are so common makes them seem normal to us. What makes them believable apart from their strangeness is the fact that they are also sometimes observable to others, leaving "tracks" of the internal experience visible to those who don't have them and who might otherwise be inclined to dismiss them as "too crazy" to credit as real.

PERIMENOPAUSAL AND MENOPAUSAL SYMPTOMS CAN OFTEN BE CURED EVEN WHEN NOT FULLY UNDERSTOOD

It's also useful to point out that though science does not yet have a clear consensus on what specific sequence of events produces hot flashes in women -- beyond the bigger picture of changing ovary and estrogen function during perimenopause and menopause -- nevertheless medicine has developed at least one quite effective empirical treatment for hot flashes based on trial-and-error experience, even in the absence of a clear scientific understanding of their basis. Namely, estrogen replacement. (Other remedies that apparently work for some proportion of women have been considerably less tested and proven.) Successful treatment therefore of a symptom associated with ovarian/hormonal changes can precede biological understanding of the full complexity of the symptom.

The broad array of symptoms I have named the WHM Syndrome -- for Warga's Hormonal Misconnection Syndrome -- may at first, I suspect, appear as strange and bizarre as hot flashes do to those unfamiliar with them. But in the years to come, I believe, it will seem one of the great mysteries of our time that such a common, unusual, but apparently typical set of biologically based symptoms could have been overlooked for so long. Cultural and medical historians of the future, I predict, will long ponder the great divide of female patient/doctor non-communication that is implicit in physicians not having "heard" and detected this set of symptoms and its cause in women for so many years.

What WHMS Is Like

The list of possible symptoms I am specifically referring to is presented in Table 1 to help you better understand the cases you will shortly be reading about. (A fuller description of possible WHMS symptoms with examples of how they actually occur in women's lives follows in chapter 7.) In Table 1, however, I list only the mind/speech/attention/ behavioral symptoms to which I have given the name "WHM Syndrome," or "WHMS." This table does not include any of the mood or physical symptoms that are also frequently but not inevitably associated with menopause and the years preceding menopause. (These are more fully described in Appendix I.)

TABLE 1
The WHM Syndrome: Warga's Hormonal Misconnection Syndrome

As you examine the following chart keep in mind that the symptoms below typically occur as brief come-and-go episodes within the context of a functional ongoing nondisabled life, not unlike the manner of hot flashes. Women who experience some of the symptoms need not experience all of the symptoms or even many of the symptoms. Some symptoms may appear similar but are experienced by women as different from each other and are thus listed as distinct, pending additional research. Implied in each symptom is the sense that it occurs with a greater frequency than it did in the past. The symptoms most typically do not occur continuously but in erratic on-and-off intermittent episodes, in the pattern of occurrence of "hot flashes," so eac