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Menopause Brain Fog – What It Is, Why It Happens, and What to Do About It

Dr. Rebecca Levy-Gantt

Written by Dr. Rebecca Levy-Gantt, DO

Dr. Rebecca Levy-Gantt

Written by Dr. Rebecca Levy-Gantt, DO

Have you ever misplaced your car keys? Forgotten the name of your neighbor, possibly in the middle of your afternoon conversation with her? Had difficulty staying focused on the task at hand? We’ve all had moments when we feel our memory or ability to focus may be failing us. But how many times does this have to happen before we begin to wonder whether these lapses are something more? Turns out there’s a phrase that sums up this set of cognitive symptoms: brain fog. And brain fog is more common than you might think—especially among women approaching or experiencing menopause.

Brain Fog During Perimenopause and Menopause  

Women often report feeling forgetful or having difficulty concentrating as they age.  This is particularly common for those in their 40s and 50s: studies have shown that women in the early stages of menopause may experience more noticeable issues with cognition, especially with memory, verbal learning and motor function skills.

But what exactly causes this brain fog during menopause? What are the changes that are happening in the body, and how do those changes affect the mind?

What Causes Brain Fog in Menopause?

Many scientists believe that brain fog has something to do with the hormonal changes experienced during perimenopause and menopause. In the years leading up to menopause, sometimes in women as young as age 35, the ovaries no longer function as they used to. Women may not ovulate every month, and when they don’t, they produce much less of the hormone progesterone. Progesterone is the main hormone responsible for sleep, stable moods and regular menstrual cycles. As a woman reaches the age of menopause, her ovaries also slow down and then cease to produce estrogen, the main hormone responsible for maintaining energy, cognitive function, efficient metabolism and a sense of well-being. When hormone levels decrease, the protections and benefits associated with those hormones are most often diminished, resulting in poor sleep, mood changes, weight gain, and a notable decrease in cognitive function. 

Surprisingly, many studies have shown that the years of fluctuating hormones in perimenopause are actually worse for some women as far as mental function, and that memory improves over time as they move further into menopause and post-menopause.

It is not only lower levels of hormones that may directly cause brain fog during menopause. Low hormone levels can cause night sweats and hot flashes, which can wake women up during the night. Interrupted sleep can be a significant cause of cognitive decline, as most sleep experts suggest that adults over age 50 need seven to nine hours of uninterrupted sleep for optimal daily function. Hot flashes, which many menopausal women experience due to a lack of estrogen, can also signal that there may be problems with the narrowing of certain blood vessels in the body. If these include the vessels carrying essential blood flow to the brain, this can result in difficulty with learning, decreased memory and other issues with higher-level cognitive functions.

Other Factors That Can Cause Brain Fog

Of course, menopause isn’t always to blame when it comes to brain fog. Blood vessel and vascular health is an important part of overall health, including brain health. Certain medical conditions, especially if they have been chronic and on-going, can cause blood vessel damage and may affect the amount of blood that regularly flows to the brain. Diabetes, high blood pressure, autoimmune diseases, and elevated cholesterol levels are all health conditions that can have a detrimental effect on the body’s vasculature, and over time, decrease the blood flow to the brain. This will eventually result in poorer cognitive function, with decreases in verbal memory, attention and mental acuity also experienced.

Medical conditions such as anemia, thyroid abnormalities and dehydration can all contribute to brain fog. Mental illnesses like depression and anxiety can also cause a decline in mental clarity and cognition. Even something as common as stress can overload the brain and worsen brain fog if the reaction becomes prolonged.

If you notice an increase in brain fog while taking a particular medication (especially a new medication) this may be a side effect of the drug. It’s important to discuss this with your doctor so they can determine if a change in treatment is needed.

How to Treat Brain Fog

So, what can you do if you’re a woman experiencing brain fog? An evaluation by a menopause specialist can help determine whether hormonal changes are a contributing factor. Medical conditions can easily be ruled out by some simple tests that a primary care doctor can run, as well. Beyond talking to your healthcare providers, there are lifestyle changes you can make to help improve your symptoms.

Reduce Stress

When people are living in chronic stressful situations (and who hasn’t been in the past year?) finding relief can be difficult, but it is critical. When stress hormones in the body are chronically elevated, many bodily functions are at risk, including the ability to think, reason and focus. Yoga, deep breathing, or meditation and relaxation apps are great ways to help reduce stress.

Improve Sleep

Sleep hygiene is imperative to help us regenerate and recharge for the next day’s activities. There are many ways to get a better night’s sleep but watching our consumption of stimulants is a good place to start. Skipping stimulants like caffeine and nicotine before bed may help. Alcohol can also disrupt sleep, and may trigger hot flashes and night sweats in some menopausal women, so watch how much you drink.

Focus on Diet and Exercise

Diet and exercise are tied to improving brain function. Some studies report that the number one method of improving cognitive function, far into old age, is continued, regular cardiovascular exercise five days a week.

Certain studies have shown limited benefits to adding certain foods to your diet. One is fatty fish, which contains EPA and DHA, omega-3 fatty acids that are vital for normal brain function. Another is foods that are high in vitamin B. In particular, vitamin B-12 has been shown to help support healthy brain function and may assist in decreasing the severity of menopausal brain fog.

The brain needs regular workouts as we age, too. Puzzles, learning a new language or a musical instrument forces the brain to work in new ways and can lessen the feeling of brain fog.

When Symptoms Are a Sign of More Serious Cognitive Issues

Women seem most worried that brain fog is a sign of dementia, or Alzheimer’s disease. Unlike brain fog, Alzheimer’s is a progressive disease that gets worse over time. If changes in mood, trouble finding words, and difficulty performing daily tasks are part of your brain fog complaints, please consider being evaluated by your primary doctor to be sure that these cognitive issues are not something more.

The feeling that your brain is just not working as well as it used to is a common one, especially for menopausal women. But rest assured, there are lifestyle changes that can help address the many possible causes, ease the symptoms and help the fog to lift. 


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A great read with lots of information that I really needed to know about!!
I’m going to make an appointment with my Dr tomorrow..
Thank you..

Amy Gallagher on

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