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Menopause Brain Fog Is Real — But It Doesn’t Have to Derail Your Life

There’s a lot going on when you reach middle age. You might have young kids at home who demand your attention all day, every day. Maybe you’ve moved up the corporate ladder and are piled up with work. This is also a time when your parents are getting older and might need a little more help if they’re sick. 

At this stage of life, you’re Superwoman running at 200 miles an hour and the last thing you need is life throwing you a curveball. Cue menopause

You may not notice it at first. It could start with forgetting to take out the trash or misplacing your keys. But for 60 percent of women transitioning to menopause, the forgetfulness and lack of focus can’t be chalked up to a bad day.

Menopausal brain fog is when people experience changes in their memory and cognition. The condition varies by individual. Some people might have lapses of confusion that lasts only a few months. Others might feel like their brain is stuffed with cotton wool that never seems to go away. “It’s a terrible feeling. You literally don’t understand what’s happening,” explains Heidi Flagg, MD, an OB-GYN at NYU Langone Health. “These are women in their 40s and 50s, who have many responsibilities and, in some cases, are at the height of their careers. Now, all of a sudden, your brain is not how it used to function.”

Brain fog shouldn’t stop you from living life. If anything, it’s a reminder to take time out to care for your own needs. And even if you are going through menopausal brain fog right now, keeping your mind sharp can clear up some of the haziness and confusion. 

What does menopause brain fog feel like?

Women might mistake it as stress from their everyday lives. It can start with simple forgetfulness from walking into a room and not remembering why you went there. But over time, the confusion gets worse. People have trouble remembering names, dates, and stringing words together. 

For some, the constant mental fuzziness interferes with their ability to work and could lead to a loss of confidence in their job. On top of that, you’re working against all the other things menopause does to your body. “It’s a constellation of things that are occurring,” explains Stephanie Faubion, MD, director of the Mayo Clinic’s Center for Women’s Health and medical director for The North American Menopause Society. “You’re in a work meeting and thinking about how much you’re sweating. You can’t remember what you were going to say or feel tired from not being able to sleep last night.”

Essentially, it can feel like your brain is running on fumes, and that’s exactly what’s happening.

What causes menopause brain fog?

Estrogen deprivation 

The human brain does not have any energy reserves, so it needs to constantly convert glucose into energy to keep operating. There are multiple processes involved and estrogen lends a hand in controlling the energy balance and helping your brain cells to fire. So when our estrogen levels drop in perimenopause, our brain loses its main energy source. “Your brain is literally in starvation mode,” describes Flagg.

Perimenopause lasts an average of four years, but for some women, this stage might extend as long as 12 years. In the meantime, your brain is scrambling to find another energy source to fuel its cognitive needs.

Poor sleep

Faubion says there are other factors that can cause lapses in memory. The fluctuating hormones during menopause can change how you sleep. Estrogen and progesterone levels sharply plummet and cause hot flashes and night sweats. The sleep hormone melatonin also decreases but in a more gradual manner, which explains insomnia and daytime grogginess. “Women can also have mood disorders such as anxiety and depression that can also keep them up at night,” she notes.

Is there any way to prevent brain fog?

Since your brain is reliant on glucose, it’s important to maintain a diet that optimizes brain health. Flagg says this means eating foods rich in proteins, vitamins, and eating a mix of vegetables. You’ll want to stay away from processed foods that can cause inflammation and foods that spike up your blood sugar too much. Exercise is another important activity to prioritize because it gives your brain the oxygen it needs to stay active. 

Faubion can’t emphasize enough the importance of sleep hygiene. “Set a sleep routine, focus on keeping the room cool and dark, reduce screen time and watch your caffeine and alcohol intake before bed.” Learning healthy ways of coping with stress such as mindfulness breathing practices would also help avoid a downward spiral of stress eating and worrying at night.

While more research is needed, Flagg says hormone replacement therapy could help ease menopausal brain fog symptoms. Adding some estrogen back to your body may restore glucose metabolism and give the brain back its source of energy. “The sooner you start it in perimenopause, the greater the chance of it being protective over a long period.”

Before you go, check out our slideshow featuring products that can help you maintain good sleep hygiene.


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