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Brain Fog

Forgetting why you walked into a room, losing your train of thought or quite frequently searching for that word that is just on the tip of your tongue. Sound familiar? This confusing feeling is often referred to as “brain fog.” It's a very common symptom during peri-menopause with 60% of women between the ages of 40 – 60 report difficulty in concentration and general cognitive decline.  Although cognitive decline is generally considered to be a result of aging, in reality there is actually a very strong connection to hormonal aging as well. For many women Brain Fog has a significant impact on both their personal and professional life, and can have a comprehensive effect on their overall wellbeing. 

60% of women report experiencing Brain Fog during the menopausal transition years

The good news is that treatment is available, and normally the symptoms fade as a woman enters post-menopause and her hormone levels stabilise.

The Lowdown on Brain Fog

Why it happens and the science behind it, how it may impact your life, how you and your doctor can diagnose it and common triggers or risk factors.

Women have reported several cognitive problems during menopause: a change in the ability to think daily activities through clearly, difficulty making decisions, a feeling of mental dysfunction, or difficulty incorporating new information into daily interactions. Medical researchers feel the large proportion of women self-questioning their cognition on anecdotal assessment criteria may also be suffering from negative mood disorders resulting from menopause at the same time.

‍As estrogen levels drop, changes in the body occur, and there is a drop in the metabolism of glucose in the brain. Brain function may be affected by the change in metabolism, as it requires estrogen, progesterone, follicle stimulating, and luteinizing hormones to work together. During menopause, hormone levels are fluctuating and, post-menopause, their production is reduced. However, the body adjusts to stable post-menopausal levels and symptoms of brain fog are considered temporary, not progressive.

‍Brain fog is considered to be a temporary symptom

If you are noticing an increase in forgetfulness or your brain function has deteriorated in ways that you feel are negatively impacting your daily life, it is important to speak to a medical professional to determine the cause and appropriate treatments.

Research has indicated that premature peri-menopause onset may be correlated to later risk for dementia, including Alzheimers. If a woman enters menopause before 40 years of age, she is thought to be 35% more likely to receive a subsequent diagnosis of dementia than a woman who enters menopause later. It is unclear why this correlation occurs, however it is presumed that prolonged lowered levels of estrogen plays a factor in the onset of dementia. If this is something that concerns you, please speak to our doctors or another medical professional specialized in Menopause that can answer your questions or refer you to someone who can.

Diagnosis of Brain Fog is performed through patient self-reporting. As it is a common symptom for many women during menopause, it is easily diagnosed through a tele-medicine consult without the need for an in-person doctor’s visit.

Brain fog may be positively correlated to other peri-menopausal symptoms such as sleep disturbances, higher perceptions of stress, depression, and excessive fatigue. To eliminate causes of brain fog unrelated to hormonal levels, it is wise to stay well rested and to keep work/life balance and associated stresses in check. The strong inter-relationship between brain fog and a wide variety of physiological conditions means that decreased mental performance may be related to more than one cause, including dipping levels of estrogen and progesterone.

Mental Health

Premature Menopause and Dementia

Research has indicated that premature peri-menopause onset may be correlated to later risk for dementia, including Alzheimers. If a woman enters menopause before 40 years of age, she is thought to be 35% more likely to receive a subsequent diagnosis of dementia than a woman who enters menopause later. It is unclear why this correlation occurs, however it is presumed that prolonged lowered levels of estrogen plays a factor in the onset of dementia. 

If this is something that concerns you, please speak to our doctors or another medical professional specialized in Menopause that can answer your questions or refer you to someone who can. 

Prevention and Treatment

Learn more about your options for prevention, management and treatment of Brain Fog. This is not an exhaustive list of the treatment options available, but a good start.


There are few direct interventions available to dissipate or relieve brain fog, however there are many interconnected factors that lead some women to find relief through pharmacological and non-prescriptive alternatives. Let’s look at some of the most common treatments available today and whether they are reliable for brain fog reduction.

Nutrition (and even a daily dose of caffeine stimulation) can affect brain activity positively. Think about the following recommendations:

  • Excellent hydration
  • 1 – 2 cups of coffee (200 mg of caffeine) daily was proven to improve memory consolidation for 24 hours after consumption
  • The Mediterranean Diet (MIND diet) has been found to slow cognitive decline
  • Brain boosting foods found to be effective for overall cognitive function include: caviar, dark leafy greens, berries, olive oil, cacao (over 80% dark chocolate works!)

Positive mental health lifestyle choices may include:

  • Reducing multi-tasking to promote working memory attention requirements
  • Participation in brain strengthening games such as puzzles
  • Using written lists for complicated activities or busy times

Exercise is essential for effective brain operation and blood flow.

  • Maintain a healthy weight
  • 45 – 60 minutes of moderate exercise is ideal
  • Aerobic and resistance training are associated with increased brain function
  • Tai chi exercise, specifically, has been proven to help stave off the effects of aging and to improve cognitive functions in adults over 50 experiencing brain dysfunction.

Even though there are many OTC products such as supplements out there claiming to improve brain function, there is actually no definitive scientific proof supporting these claims.

Fish oil and curcumin (turmeric) are two of the most frequently named (and used) supplements to improve brain function. It can’t hurt to take either of these in the recommended doses, and if you think it can be beneficial it is safe to take. However, having a healthy diet (incl dark chocolate!) may actually work just as well, if not better. So it might be a good idea to give that a try first.

Over-the-counter treatments for memory lapses and feelings of foggy brain are not available.

There are no effective non-hormonal treatments available for cognition problems that are caused by menopause.  However it is important to receive an accurate diagnosis, because if cognition changes are related to non-menopausal medical issues, such as thyroid malfunction or cerebrovascular disease, other treatment options may actually be available.

Systemic Estrogen Therapy (progestin and/or estrogen) is a prescription treatment available under a doctor’s supervision. Although some peri-menopausal symptoms have been found to respond well to Hormone Replacement Therapy (HRT), there is unfortunetly no scientific evidence that it clears Brain Fog or reduces the risk of dementia in later life. Having said that, there is also no evidence that it will make it worse - so if you are taking HRT for other symptom management you have nothing to worry about.

FAQs

What is Brain Fog?

Brain Fog is an umbrella term used for symptoms that can affect concentration and memory loss issues, which can range from feeling confused or disorganized, finding it difficult to concentrate and/or taking longer to find the right word. Examples are forgetting why you walked into a room, losing your train of thought or quite frequently searching for that word that is just on the tip of your tongue. It is very common Menopause but can also happen during pregnancy (often referred to as Pregnancy Brain) or caused by certain types of medication.

Is brain fog common during Menopause?

Brain fog and irregular cognition concerns are expressed by 60% of women during the menopausal transition years.

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Sources used

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Harvard Health Publishing. (2018, November 16). A sharper mind: tai chi can improve cognitive function. Harvard Health.

Thurston, R. C. (2013). Cognition and the menopausal transition. Menopause, 20(12), 1231–1232.

Weber, M. T., Rubin, L. H., & Maki, P. M. (2013). Cognition in perimenopause. Menopause: The Journal of The North American Menopause Society, 1

Weber M, Mapstone M. Memory complaints and memory performance in the menopausal transition. Menopause. 2009 Jul-Aug;16(4):694-700. doi: 10.1097/gme.0b013e318196a0c9. PMID: 19276998.

Greendale, G. A., Derby, C. A., & Maki, P. M. (2011). Perimenopause and Cognition. Obstetrics and Gynecology Clinics of North America, 38(3), 519–535

Cording, J. (2018, March 12). The Top 5 Brain-Boosting Foods You Should Be Eating. Forbes.

Copaken, D. (2019, November 8). How Menopause Could Lead to Alzheimer’s. The Atlantic.

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Gava G, Orsili I, Alvisi S, Mancini I, Seracchioli R, Meriggiola MC. Cognition, Mood and Sleep in Menopausal Transition: The Role of Menopause Hormone Therapy. Medicina (Kaunas). 2019 Oct 1;55(10):668. doi: 10.3390/medicina55100668. PMID: 31581598; PMCID: PMC6843314.

‍American Heart Association. "Early menopause may raise risk of dementia later in life." ScienceDaily. ScienceDaily, 2 March 2022. <www.sciencedaily.com/releases/2022/03/220302131326.htm>.

Online sources

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