What is Brain Fog and How Does it Relate to Menopause?

Can’t remember where you left your keys or where you parked the car? Having trouble with word retrieval or recalling names? Are you leaving yourself sticky notes to remind you of your other sticky notes? These incredibly common complaints often cause women to fear the worst; is this a serious neurologic condition, dementia or even early onset Alzheimer’s?    
 
It might be surprising to learn, however, that upwards of 40% of women transitioning through the hormonal changes of menopause complain of general forgetfulness, difficulty concentrating and other cognitive complaints, commonly referred to as “brain fog.”
 

What causes brain fog?

While advancing age is partially responsible, other influencing medical factors include hot flashes, untreated hypertension, high cholesterol and diabetes. Depression and anxiety along with the medications used to treat them might also be influences. Life circumstances, such as professional demands, financial stress, teenage or young children, the empty nest, marital discord and aging parents can burden the mind. Smoking and low physical activity are also responsible. Additionally, the constant need for multitasking is not helpful. 

What does menopause have to do with it?

Research suggests that decreases in attention span, processing speed, and other cognitive abilities through the menopause transition are influenced as estrogen levels decline. This is not surprising since there are hormone receptors in the brain. 

Will hormones help?

Studies do not support that hormone replacement therapy (HRT) positively influences cognitive function, however, this should be interpreted accordingly. Many peri-menopausal and menopausal women suffer with interrupted and poor quality sleep due to hot flashes and night sweats. HRT is an effective treatment for these disruptive symptoms, thus allowing for a better night’s sleep and improved mental acuity during awake hours.

How to avoid brain fog?

Aim for 7-8 hours of quality sleep each night. Turn off electronics before bed and ensure a comfortable sleep chamber. Treat sleep apnea, if needed, and use sleep aides wisely, if at all.  Be mindful of diet; I recommend the Mediterranean diet noted for its heart healthy and immune-protective properties. Moderate caffeine and sugar intake; while these each enhance energy and mental clarity initially, fatigue and decreased mental acuity quickly follow. Minimize alcohol use; alcohol can cause sleep interruption and mental cloudiness. Avoid MSG and artificial sweeteners if you are sensitive. Exercise! A regular regimen cardio (aim for 150 minutes/week) and weight training is recommended. And lastly, don’t smoke; smoking constricts blood vessels, including those in the brain. Minimize stress; consider meditation, yoga or mindfulness exercises.