I’m losing my memory. Is it menopause?

Q: I’m 41 and I’ve noticed a severe drop in my mental acuity since I was 39. I now have extreme difficulty with short-term memory. It’s hard to articulate my thoughts and to recall words. Are these symptoms of menopause, or is this just aging suddenly (and less than gracefully)?

A: It’s possible, but unlikely, that this memory problem is a sign of early menopause.

The average age of menopause is 51. Symptoms can appear in the perimenopause — the time leading up to menopause — three or four years earlier, and may include a decline in short-term memory. But only one percent of women undergo premature menopause, before age 40.

If you’ve had a hysterectomy or your period has always been irregular, you may not be aware of your hormonal status. You can get a blood test for FSH (follicular stimulating hormone), to see whether ovarian failure is imminent and/or you are in early menopause.

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But it’s also time to take a thorough medical history to check for other causes of memory lapse. Here are some questions you doctor may ask:

• Are you on any new medications that could affect your memory — antidepressents, antihistamines, painkillers, hypertension drugs, tranquilizers or sleeping pills?
• Have you increased your consumption of alcohol?
• Are you depressed or suffering from sleep deprivation?
• Have you been diagnosed with diabetes, high cholesterol, hypertension, thyroid or endocrine disorders, or a chronic infection?
• Have you had a head injury that has made you black out for an hour or more?
• And, more ominously, is there a family history of early Alzheimer’s or dementia?

One way to assess your risk for Alzheimer’s is through a blood test for the ApoE gene. There are four common variations of this gene. Individuals with one particular mutation have a 27 percent lifetime risk of developing Alzheimer’s. Those without this mutation have a 9 percent lifetime risk.

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Still, many people with one or even two copies of this mutation won’t get Alzheimer’s and many without it will. So the test is not totally adequate or prophetic.

You might want to be tested at a memory clinic at a hospital or university near you. They will put you through standard written and oral tests for memory and thought processing. They may suggest an MRI, which could detect a silent stroke or changes in critical memory areas of the brain. And new types of PET scans show promise in detecting early-stage Alzheimer's disease.

If you do get a test that tells you something is neurologically wrong, it gives you the chance to change your lifestyle and start medications that have in some studies been shown to diminish the severity of Alzheimer’s.

Dr. Reichman’s Bottom Line: Memory problems can result from many conditions. They all need to be checked out before we blame hormones, aging or Alzheimer’s.

Dr. Judith Reichman, the “Today” show's medical contributor on women's health, has practiced obstetrics and gynecology for more than 20 years. You will find many answers to your questions in her latest book, "Slow Your Clock Down: The Complete Guide to a Healthy, Younger You," published by William Morrow, a division of HarperCollins.

PLEASE NOTE: With this column, Health TUESDAY is going on vacation. Look for Dr. Reichman’s next column on Tuesday, August 17.

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