Menopause and brain fog

Brain fog is exactly how it sounds. It’s a term used to describe any, usually temporary, changes in cognitive function you might get with certain medical conditions and in some life stages, like menopause. It can include anything from difficulty concentrating and slower processing to forgetting things that you’d usually remember which might cause you to miss appointments, lose your train of thought mid-conversation, or forget where you’ve put your keys and phone. For some conditions, it can be a permanent symptom that comes and goes, but if you’re going through menopause, it’s a common, temporary symptom—even though it might feel frustrating and never-ending. You might notice it appearing alongside other symptoms, like poor sleep, stress, and hot flushes.

Hormonal shifts such as declining oestrogen and progesterone levels during perimenopause, menopause, and post‑menopause, can lead to temporary changes in how your brain functions, disrupt your sleep, and increase stress levels. This happens because falling oestrogen affects key neurotransmitters in the brain, like: 

• Serotonin is a messenger chemical in the brain which regulates mood, sleep, digestion and even body temperature. These things can all impact your focus and ability to concentrate if disrupted by causing fatigue and forgetfulness. If you’re struggling with low mood and menopause, your GP might prescribe you an SSRI (Selective Serotonin Reuptake Inhibitors). ^{Footnote [1]}
• Dopamine in decline can make you feel sluggish and less motivated, with a noticeable decrease in something called ‘executive function’. Executive function is understood to be your working memory, cognitive flexibility, and self-control. ^{Footnote [2]} When this vital neurological process is disrupted during menopause, it can cause brain fog. 

Yes, memory loss can be a part of brain fog, but it’s usually intermittent. Verbal memory loss and problems with verbal fluency is a common symptom. It might be the most noticeable at work when you’re presenting or during meetings, so it’s a good idea to let your manager know if it’s something you’re struggling with. It can appear even if you’ve never had problems before and can worsen for anyone who may already struggle with brain fog or other conditions. ^{Footnote [3]} Symptoms like this can cause concerns around dementia, but brain fog caused by menopause improves over time, unlike dementia which progressively worsens.

Any memory loss you may experience typically improves post-menopause as your hormone levels stabilise. Brain fog will often peak in perimenopause and early menopause but will ease with time. It can take a few years for things to stabilise, but this will vary based on your medical history, lifestyle, and stress levels. If you experience persistent or worrying symptoms of memory loss, you should book an appointment with your GP. Taking HRT treatment can also significantly improve this symptom, which we’ll talk more about below.

There is no official brain fog treatment, but there are plenty of different ways you might be able to improve the intensity of brain fog. 

• CBT (Cognitive Behavioural Therapy or ‘Talking therapy’) can be helpful if your brain fog symptoms are causing you a lot of distress and frustration. CBT can be especially helpful if you’re also experiencing low moods and problems sleeping, which can also worsen cognitive function.  
• A diet rich in omega-3s, leafy greens, and antioxidants can help support brain health and reduces any inflammation triggered by hormonal changes. 
• Keeping physical, visible notes around for things you might be struggling to remember, like appointments, or tasks you need to complete. Keeping notes away in a folder on your phone isn’t always as helpful as having something right in front of you. 
• Regular physical activity if you’re able can boost blood flow to your brain and help balance hormones by releasing more feel-good hormones as you exercise. It can also help reduce stress, anxiety and can even increase your motivation and concentration levels. Low-impact activities like certain types of yoga and Pilates are a good option for those going through menopause. ^{Footnote [4]}  
• HRT (Hormone replacement therapy) is a common treatment used to treat menopause and perimenopause symptoms. It uses oestrogen and progesterone to replace the levels you lose. HRT can relieve most menopause symptoms simply by re-balancing your hormones, including relieving the effects of brain fog.^{Footnote [5]}