Struggling to focus, losing your train of thought, or not able to remember a word on the tip of your tongue? You’re not alone. For women going through menopause, these moments of brain fog are a common and frustrating symptom of this transition.
“Brain fog is definitely one of the most common complaints that I hear in clinic for my perimenopausal and menopausal patients,” said Ana B. Mosquera Pelegrina, MD, a gynecologist at UT Physicians Multispecialty — Sienna. “It’s verbal memory that gets affected during this transition.”
Decoding brain fog
Brain fog during menopause typically presents as difficulty recalling words or names or forgetting your purpose mid-task. According to Mosquera, a menopause certified practitioner (MSCP) by The Menopause Society, this isn’t just anecdotal. Researchers have found that certain cognitive functions are more commonly affected during the perimenopausal and menopausal changes.
The good news? Mosquera said for the great majority of women, it’s something that will get better over time. The challenge is that the timeline varies and is unknown. In the meantime, brain fog can significantly affect quality of life, work performance, and self-confidence.
Looking beyond hormones
With estrogen receptors located throughout the brain, estrogen certainly plays a direct role, but brain fog during menopause can be tied to a number of factors.
“Hormonal changes affect your sleep. If you don’t sleep well, your brain won’t function well,” Mosquera said. “There are many things that can cause brain fog, as well as improve it.”
Night sweats, anxiety, and sleep disruption all contribute to cognitive difficulties. For women with a history of depression, symptoms may get worse during this transition, which impacts mental sharpness even more. Sometimes, women are diagnosed with ADHD for the first time during perimenopause, as existing symptoms become exacerbated.
Worrying about dementia?
Some women fear these memory lapses are an early sign of dementia. Mosquera said it’s extremely rare to have dementia in your 40s to early 50s, the time frame of typical perimenopause. Unless there is a significant family history of early-onset Alzheimer’s or dementia under age 60, it’s not likely.
For women who do have this family history and significant brain fog or cognitive changes, Mosquera recommends seeing a neurologist for a neuropsychological evaluation to establish a baseline.
Focusing on positive lifestyle factors
Heart health is brain health. Mosquera recommends six lifestyle factors that make a big impact:
- Eat a Mediterranean-style diet: Avoid ultra-processed foods and added sugar.
- Exercise regularly: Combine both cardio and strength training.
- Prioritize sleep: Sleep is central to everything, Mosquera said.
- Reduce stress: Practice meditation or take time for yourself.
- Participate in cognitive exercises and brain games: Keep your mind engaged.
- Maintain social relationships: These create feelings of belonging and being loved and valued, as well as help reduce the risk of chronic disease and serious illness.
Relying on supplements or HRT?
While Mosquera doesn’t generally advocate for supplements due to limited regulation and research, she said some women find magnesium and Omega-3 fatty acids helpful for brain health.
Hormone therapy can also make a significant difference.
“Even though it’s not an indication for hormone therapy, anecdotally we do see a significant improvement,” she said. While it may not completely resolve brain fog, it can help substantially, since hormonal changes are part of the underlying cause.
Mosquera also recommends keeping up with your primary care doctor to manage other medical conditions. Hypertension, diabetes, and obesity all affect both heart and brain health.
Don’t settle for dismissal
For women feeling frustrated or anxious about brain fog, Mosquera recommends talking to your OB-GYN or primary care provider. Seek out a menopause-certified practitioner if you feel dismissed or unsatisfied with the response. The Menopause Society maintains a list of certified menopause practitioners who specialize in these conversations.
One of the biggest challenges Mosquera faces in diagnosing and treating brain fog is the time it takes to gather the symptoms, lifestyle factors, medical history, and medications to learn the contributing factors.
“Look for a provider who’s willing to take the time to discuss this a little bit more,” Mosquera said. “I do ask a lot of detailed questions when I do my menopause consult. It’s just teasing out those little details to create a big picture.”
Brain fog during menopause is real, it’s common, and it’s temporary for most women. With the right support and strategies, you can navigate this transition with your cognitive function intact.
