What causes brain fog during menopause?

If you’ve noticed that your brain doesn’t seem to be as sharp as it used to be prior to the transition into menopause, you’re not alone. 

Many women experience “brain fog” during the time leading to and during menopause, but why? What about menopause can lead to changes in cognitive abilities?

What Is Menopause Brain Fog? 

Menopause brain fog typically involves a decline in some cognitive functions, like recalling and retaining memories, as well as generally feeling groggy or unable to focus.

From a medical perspective, menopause brain fog can refer to changes in cognitive abilities that often stem from hormonal changes. [1] It tends to be distinct from other causes of memory loss or cognitive symptoms due to this connection to hormones and its generally temporary nature. 

It can be hard to ascertain how much of a person’s head fog is due to menopause and hormones and how much is due to aging. Still, in general, studies do support the notion that menopause can affect brain activity independently of aging, perhaps due to estrogen’s role in regulating it. [2]

Signs Of Brain Fog 

Common symptoms of perimenopause brain fog can include the following: [3]

• Frequently forgetting details like names, appointment times, addresses, etc.

• A general feeling of sluggishness or irritability

• Trouble concentrating for long periods

• Being frequently and easily distracted

• Misplacing items like keys, phones, etc.

• Having a hard time with verbal communication (difficulty recalling words or following conversations)

How Menopause Affects Cognitive Thinking 

As a person goes through menopause, estrogen production decreases significantly. However, estrogen in particular plays a key role in brain processes that aid in forming episodic memories, [4] which means that a reduction in estrogen may lead to an acute dip in a person’s ability to remember things clearly. Likewise, estrogen can influence several neurotransmitter systems, including some that are involved in memory processing. [4]

Overall, menopause brain fog describes the changes in cognitive performance that can stem from the hormonal fluctuations that accompany menopause. Experts also believe that increased stress levels and lowered amounts of quality sleep, which are frequently experienced during menopause, can also play a role. [1,3] These effects are normally temporary and do not pose long-term health risks, but they can be frustrating to manage.

It seems that the most significant impact on brain functioning occurs as a result of changes in hormone levels during perimenopause, or the period of time before menopause officially starts. [5] During perimenopause, menstrual periods may begin to slow or stop altogether, and hormones can fluctuate while continuing to decrease overall. The peak of cognitive symptoms generally falls within this timeframe. [3]

To further support this belief, researchers in one study examining the cognitive performance of women in late reproductive stages, perimenopause, and early postmenopause found that declines in cognitive ability were most significant in the first year after a woman’s last menstrual period. [6]

How To Ease Symptoms Of Brain Fog

Although brain fog during menopause may be unpleasant, it usually goes away over time and can be improved through some simple lifestyle changes. Below are a few easy suggestions for menopause brain fog treatment that can help you feel more alert: 

• Prioritize good sleep hygiene. Sleep problems during menopause aren’t uncommon, but they can make brain fog feel more intense; other symptoms like hot flashes or night sweats and insomnia can make it hard to get quality rest regularly. [7] Practicing a regular routine, making sure you get seven to eight hours of rest, and avoiding screens and other things that can stimulate your mind might help.

• Get moving in a way that’s enjoyable. Regular exercise can promote good cardiovascular functioning and stave off the signs of cognitive decline. [8] Finding a form of exercise that you enjoy and can commit to regularly may help you protect both your mind and body over time.

• Stay social. Keeping up with friends, family, and other loved ones can offer you a chance to share your feelings and experiences. Socialization is a form of stimulation that has been shown to be helpful for age-related cognitive decline, [9] so it may also offer some benefit to those experiencing perimenopause brain fog. 

Seeking Help For Brain Fog 

Menopause brain fog usually isn’t cause for concern, but if it comes on suddenly or begins to pose a risk to a person’s health or safety, it’s probably time to see a doctor. 

Mild brain fog or cognitive deficits may resolve on their own or respond to the treatment options mentioned above. If you’re concerned about your brain fog or feel that it’s interfering with daily life, it’s best to reach out to a professional.

References:

1. Thurston, Rebecca C. (2013, December). Cognition and the menopausal transition: is perception reality? Menopause 20(12):1231-1232. Retrieved February 15, 2023 from https://journals.lww.com/menopausejournal/Citation/2013/12000/Cognition_and_the_menopausal_transition___is.3.aspx 

2. Epperson, C.N. et al. (2013, September). Menopause Effects on Verbal Memory: Findings From a Longitudinal Community Cohort. The Journal of Clinical Endocrinology & Metabolism 98(9):3829–3838. Retrieved February 15, 2023 from https://doi.org/10.1210/jc.2013-1808

3. Maki, P.M. & Jaff, N.G. (2022). Brain fog in menopause: a health-care professional’s guide for decision-making and counseling on cognition. Climacteric. Retrieved February 15, 2023 from https://doi.org/10.1080/13697137.2022.2122792 

4. Henderson, V.W. (2008, September). Cognitive changes after menopause: influence of estrogen. Clin Obstet Gynecol 51(3):618-26. doi: 10.1097/GRF.0b013e318180ba10. PMID: 18677155; PMCID: PMC2637911. Retrieved February 15, 2023 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2637911/ 

5. Equelle. (2022, September). “Understanding the Changes In Hormone Levels During Perimenopause.” Retrieved February 15, 2023 from https://equelle.com/blogs/menopause-resources/understanding-the-changes-in-hormone-levels-during-perimenopause 

6. Weber M.T., Rubin L.H., & Maki PM. (2013, May). Cognition in perimenopause: the effect of transition stage. Menopause 20(5):511-7. doi: 10.1097/gme.0b013e31827655e5. PMID: 23615642; PMCID: PMC3620712. Retrieved February 15, 2023 from https://pubmed.ncbi.nlm.nih.gov/23615642/ 

7. National Institute on Aging. (n.d.) “Sleep Problems and Menopause: What Can I Do?” U.S. National Institute of Health. Retrieved February 15, 2023 from https://www.nia.nih.gov/health/sleep-problems-and-menopause-what-can-i-do 

8. Barnes, J.N. (2015, June 1). Exercise, cognitive function, and aging. Advances in Physiology Education 39(2). Retrieved February 15, 2023 from https://journals.physiology.org/doi/full/10.1152/advan.00101.2014 

9. Myuri Ruthirakuhan, M. et al. (2012). Use of Physical and Intellectual Activities and Socialization in the Management of Cognitive Decline of Aging and in Dementia: A Review. Journal of Aging Research 2012. Retrieved February 15, 2023 from https://doi.org/10.1155/2012/384875

DRA: 1398073026