For some women, perimenopausal forgetfulness or changes in their ability to concentrate are extremely troubling, especially when we don’t connect these changes to hormonal fluctuations. Sometimes these symptoms of impaired concentration come at the same time we are observing age-related changes in our elderly parents, and we can wonder if we are prematurely losing our edge or suddenly becoming less sharp. Many women have confided in me that they were worried they were developing Alzheimer’s disease.

When Janice found herself sometimes going over and over the numbers that she was responsible for crunching at her firm, losing track of where she was and having to start over again in preparing the complicated reports that she regularly produced as part of her job, she decided to try ginkgo biloba to improve her mental concentration. She also took black cohosh to help with perimenopausal hot flashes.

The leaves of this ancient decorative tree, ginkgo biloba, have a rich history of medicinal use. In China ginkgo leaves have been used for literally thousands of years to increase blood flow to the brain. Today ginkgo biloba leaf extracts are very commonly prescribed in Germany and France.

What we know about ginkgo’s workings in the body is largely based on animal research. Clinical trials with humans have examined ginkgo’s effects on a variety of symptoms and conditions, including memory loss, depression, macular degeneration (a cause of blindness in adults), certain hearing problems, and tinnitus (ringing of the ears), among others.

In animals, it has been shown that ginkgo biloba extract affects the lining of the blood vessels, and in humans, researchers believe it improves cerebral blood flow. In a very simplified summary, it could be said that by boosting the flow of blood and oxygen to the brain, ginkgo stimulates and improves certain brain functions, some of which are related to our ability to recall certain facts.

In his book The Healing Power of Herbs, naturopathic doctor Michael T. Murray states that clinical research indicates that ginkgo should be taken consistently for at least twelve weeks to be effective. After taking 120 mg of ginkgo daily (three 40 mg capsules), for eight weeks, Janice said she felt some improvement in her ability to concentrate: “Let’s just say I haven’t hit the wall at three o’clock recently. For a while, by late afternoon, I would be in my office with the door closed, taking twice as long as usual to do one small task and sometimes sitting there for a good two or three minutes trying to remember what I was supposed to do next.”

Janice acknowledged that along with taking ginkgo, she had also made a serious effort in the previous month to reorganize and reprioritize her workload, delegating certain responsibilities and asking her assistant to step up her share of the duties. “It’s been great for both of us,” she told me. “I’ve realized that I don’t have to do everything, and she seems to appreciate the trust I have in her.”

It’s not clear which helped Janice’s ability to concentrate more: ginkgo or reordering some of her work. She did point out, however, that reorganizing her workload and providing explicit instructions to her assistant “took a lot of clear thinking.” Looking at me over the top of her glasses, Janice said, “Maybe the ginkgo helped me think all that through. Once I had a picture in my mind of how I wanted things done, I had to be able to write some of it down and explain the rest articulately. Fm not sure I could have done that two or three months ago, I felt so muddled at times.”

If you try ginkgo, look for an extract that contains 24 percent ginkgo flavones glycosides. Few side effects are associated with ginkgo, and these occur only infrequently (gastric upset, headache, and dizziness). One of my patients did report headaches when she took ginkgo, but she switched to a different brand and took it without any side effect.

In relation to improving memory and concentration, I also want to talk briefly about DHEA (dehydroepiandrosterone). Like melatonin, DHEA is not an herb but a hormone, and it is widely available as an over-the-counter preparation. It is called a precursor or foundation hormone because in the body it “cascades” or turns into other hormones, including testosterone and estrogen. In adults, DHEA levels begin dropping at about age twenty. Some researchers believe that restoring DHEA to youthful levels can delay the effects of aging, notably memory loss and impaired concentration. Some scientific data also found that DHEA lowered the death rate from cardiovascular disease in men (results that have not yet been repeated in women).

DHEA is sometimes discussed as a preparation that can minimize several perimenopausal symptoms in addition to memory loss: bone loss, fatigue, vaginal dryness, sleeplessness, and dry skin. Using DHEA for perimenopausal symptoms is sometimes based on the theory that this precursor hormone will cascade into estrogen and thus alleviate symptoms produced by estrogen deficiency. It’s not that simple, however. First of all, not all scientists agree that taking DHEA as a supplement will produce the same cascade effects. Assuming that DHEA supplements will cascade into other hormones also assumes that all the other chemicals and enzymes needed are present in the body, and we can’t know this.

If you’re thinking about trying DHEA, I have two recommendations:

- Have your DHEA levels measured first in blood or saliva to determine how much of the hormone your body is currently producing. As is true with any hormone, you wouldn’t want to take more if your body is still producing a normal level.

- Work with a health care professional who is knowledgeable about DHEA supplementation so you can arrive at the dosage appropriate for you. Recommended DHEA dosages for women range from 5 to 50 mg daily.

Related posts:

1. The Basics of Signs of Perimenopause – Depression and Loss of Libido

2. The Basics of How Perimenopause Affects Our Memory Bank

3. The Basics of More PMS During Perimenopause

4. The Basics of Sex Drive Hormones During Perimenopause

5. The Basics of Perimenopause’s Effects on Your Memory, Moods, and Productivity

6. The Basics of Refeathering Our Nests During Our Perimenopause

7. The Basics of Perimenopause – New Hormone Test Options

8. The Basics of Herbs for Hot Flashes During Perimenopause

9. The Basics of Hormones For Perimenopause – Natural versus Synthetic

10. The Basics of HRT alternative perimenopause treatment – black cohosh