Around a woman's fortieth birthday she starts hearing jokes and innuendoes- or making them herself- about mood swings, depression, and memory loss. It's not that long ago that the "change of life" was believed to turn women into nasty old crones or dimly aware, befuddled old ladies.

In reality, many of us finally hot our strides I our forties. We advance inour careers, start won businesses, make a difference in our communities, and usually act as the anchor for our families. All of our talent, skill, and good intentions not withstanding we also can find ourselves unexpectedly sidelined by seemingly mysterious changes in our memory, moods, and energy levels. These changes are of varying intensity: for some of us, occasional forgetfulness, transient fatigue, or a "blue" day now and then will be minimally disruptive. But frequent memory lapses, chronic fatigue, and volatile mood changes not only make our days less productive but rack our self-confidence and leave us feeling like we don't recognize ourselves.

For many of us, the timing of these mood changes, memory gaps, and energy shortages couldn't be worse. Of course, there wouldn't be a favorable time to blank out in a meeting or squint uncomprehendingly at a spreadsheet as Janice did, but in the midst of a career that is really taking off, sudden holes in memory or difficulty concentrating can threaten the gains you've worked so hard to achieve. Just when you need more energy than ever to move through your busy days, finding that simple tasks require monumental effort is discouraging. Moods that careen from anxiety to tearfulness to irritability, often without warning, can rattle your view of yourself and cause your family to tiptoe around you, wondering what's wrong.

Making the connection....
Many women in their forties don't connect their experiences with a possible hormonal change. Many worry secretly that they just aren't as sharp as they used to be, or that they just can't cope with life's pressures as effectively anymore. These symptoms- depression, anxiety, irritability, fatigue, mental fuzziness- can be particularly hard to sort out because they feed on each other. The more tired we are, the harder it is to concentrate during the day, or the more likely it is that we will feel irritable and down. "Am I tired because I lay awake worrying last night? Or am I irritable because I had no sleep? Do I have trouble focusing because I've been feeling depressed?" I talk with many women whose perimenopausal anxiety or depression seems to produce still more worry: "What's going on?
Is there something wrong with me?
Why am I feeling this way?"

In this chapter I want to unravel the mystery surrounding perimenopausal memory changes, mood swings, and fatigue. We'll take a look at hormonal influences on memory, mood, and productivity, then examine ways to sort out recall, outlook, and energy. Most important, we'll look t ways of managing these changes so you can get on with your life with your customary energy, determination, and enthusiasm.

Desperately Seeking Sleep
"I don't have time to be tired," Colleen burst out in frustration one day in my office. "For me, absolutely the worst part of this time in my life has been the loss of energy. I never wake up feeling like I'm ready to go. I'm in a fog. Then, even though I go to bed early, I don't sleep well. I'm exhausted many days by three in the afternoon. Being tired so much of the time really get in the way of doing what I want to do."

During perimenopause, sleep, or lack of it, is a big part of the mood swings, mental blurriness, or absentmindedness that can disconcert us. If you lie awake listening to the clock tick or sit in front of the television, bleary-eyed , watching your third infomercial at three thirty A.M., you're not alone. Chances are thousands of women in their forties are also lying awake, wondering how in the world they're going to think straight, function, and have energy when their day starts in three short hours.

Sleep deprivation caused by perimenopausal insomnia can shorten your temper, drain your energy, and trigger a flood of tears because you're just too tire to deal with anything, from a small inconvenience to a major problem. Night after sleepless night takes it toll, physically and emotionally, leaving you longing for a good night's sleep much as a starving person yearns for food. The relationship between loss of sleep and feeling short tempered , out of it, or anxious during the day is complex-sleeplessness doesn't directly cause your wavering moods, but it certainly is a major contributing factor.

Humans spend more time sleeping than any other species on earth, yet sleep researchers still don't know exactly why we sleep. While most sleep research has been done on men, one European study revealed that women actually need more sleep than men, up to an hour and a half more per night. Why, then, when we're in our forties, do so many of us have trouble getting a decent night's rest?

The reasons, are varied, complex, and interrelated. Some women's sleep is disturbed by hotflashes at night, called night sweats. We can wake up soaking and have to change our nightclothes and bedding. By the time we've done, we're wide awake.

Comments:
From: Jana (Long) Leeney
I just wanted to let everybody know that Stephanie Bender's book would be a great investment in your life if you have PMS or Menopause. Back in 1991 I started under her council and I believe she saved my life. She helped me understand what was and is going on inside my body. She taught me how to chart, keep my journal and basically read my body. Thank you, Stephanie!

Natural vs. Synthetic Hormones

HotFlash FAQ:
Estrogen & the Mind
Many women taking estrogen report a feeling of well being while taking their estrogen. There is research to suggest a link between hormone use and Alzheimer prevention. In fact perimenopausal women find that in a short time after starting an estrogen product they feel better- emotionally. See an excerpt from an interview with Dr. Goldstein as well as other facts on estrogen and the mind.

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