Hands-up if you frequently walk into a room and forget why you’re there? Or get halfway through a sentence before your train of thought leaves the station? Welcome to menopausal ‘brain fog’ where mental cloudiness and confusion become the norm and your ability to focus, process information, and remember basic things (like where you left your children…more on this below) take an extended holiday. Menopause brain drain is real ladies– with an estimated 40-60% of women experiencing some form of brain fog during perimenopause, ranging from mild forgetfulness to more severe memory loss.
Not remembering where you left the keys is one thing, but let me tell you about last week. I forgot to put bread in one side of my sister-in-law’s toaster and set it on fire, I left my 7-year-old in the bathroom of a trampoline park as I forgot I’d walked in there with him, and Ieft my suitcase in an airport café, only remembering just as I was jumping onboard a car park shuttle bus. To put this into context – I ran a company of over 20 people until December last year. Fast forward 4 months and it’s a win for the family if I navigate us through our daily lives without losing someone …. How has this happened so quickly?
Jokes aside. I would still consider myself early perimenopause and don’t have the anxiety and mood changes experienced by many but the now continuous brain fart that rumbles on in my mind is far from funny. It is making me question my abilities and competence, which if I am really honest is beginning to chip away at my confidence. My brain has always been active and creative. It’s had to be for a career as a health professional and educator. So to feel like it is failing me is demoralising and frankly a little frightening.
And I am not alone, Reports suggest that one in four women consider leaving their jobs during perimenopause due to the associated symptoms (with brain fog cited as a common reason). One in ten of these women do turn their back on their career, often due to the stress caused by constant worry about their ability to do a job they may have been excelling at for years. It’s time to take this seriously ladies!
Brain Fog Symptoms
The symptoms of menopausal brain fog can vary from woman to woman, but some common ones include:
- Difficulty concentrating
- Slower thinking
- Difficulty finding words
- Mental fatigue
- Decreased productivity
Causes of Menopausal Brain Fog
Women going through menopause may experience brain fog as a result of hormonal fluctuations that can affect the brain’s chemistry. The hormone oestrogen plays a critical role in cognitive function. It helps to regulate neurotransmitters, chemicals that transmit signals between brain cells. Common neurotransmitters include serotonin, dopamine, and acetylcholine, and declining levels of oestrogen can lead to subsequently reduced levels of these essential communication chemicals.
- Serotonin: involved in regulating mood, sleep, and appetite. Decreases in serotonin can contribute to mood swings, anxiety, and depression.
- Dopamine: involved in motivation, reward, and pleasure. Decreases in dopamine may contribute to a lack of motivation and decreased pleasure in activities.
- Acetylcholine: involved in memory and attention. Decreases in acetylcholine can contribute to forgetfulness and decreased ability to concentrate.
Declines in oestrogen have also been associated with other changes in brain structure and function, including decreased blood flow to some areas of the brain and a reduction in the number of brain cells. I will be keeping this to myself as it just feels like a stick my children would enjoy beating me with!
But the upshot is, fluctuations in oestrogen during perimenopause, and the general decline in this hormone moving towards menopause, can lead to an upheaval in the brain, which can contribute to hormone-related brain fog…..as well as anxiety, depression, and mood swings but that’s a whole other blog!
Brain Fog After Menopause
The good news is that many women report improvements in cognitive function after menopause, although the reasons for this are not entirely clear. Let’s just hope my household appliances and family members last long enough to benefit!
One possible explanation is that once the body adjusts to the new hormonal environment after menopause, the brain can compensate for these changes, which can lead to a reduction in brain fog. Additionally, women may be more likely to adopt healthier lifestyle habits, which can also help reduce symptoms.
However, it’s important to note that not all women experience improvements in cognitive funcion after menopause. If you are at all concerned, it’s important to speak with your healthcare provider to help determine other possible underlying causes.
In better news, whilst there is no miracle cure for menopausal brain fog, by understanding the relationship between our hormones, neurotransmitters, and cognitive function, there are many steps you can take to manage your symptoms and improve your quality of life.
Managing Brain Fog in Menopause
Here are some tips for improving mental clarity and boosting brain performance during menopause:
- Prioritise sleep: During sleep, the brain goes through a process of repair and restoration, where it removes toxins and consolidates memories. This allows it to function more effectively when we wake, reducing the feeling of brain fog. Lack of sleep, on the other hand, can lead to increased inflammation and stress, impairing cognitive function and exacerbating brain fog symptoms. Aim for 7-9 hours of sleep per night.
- Manage stress: Stress can contribute to brain fog by increasing the stress hormone cortisol. Elevated cortisol can impair cognitive function, leading to symptoms such as forgetfulness, confusion, and difficulty concentrating. Chronic stress can also lead to inflammation and oxidative stress, which can cause damage to brain cells. Additionally, stress can disrupt sleep, leading to fatigue and further exacerbating brain fog symptoms. Managing stress through practices such as meditation, exercise, and breathing exercises can help reduce the risk of brain fog and improve overall cognitive function.
- Enjoy regular exercise: When we exercise, heart rate and blood flow to the brain increase, delivering more nutrients and oxygen to brain cells. This can improve cognitive function, including memory, attention, and focus, and reduce feelings of mental fatigue and fog. Exercise also stimulates the release of endorphins, which are natural feel-good chemicals that can boost mood and reduce stress, both of which can contribute to cognitive impairment. Aim for at least 30 minutes of moderate exercise most days of the week.
- Eat brain-supporting foods: Certain nutrients, such as vitamins B6, B12, folate, magnesium and omega 3 fats have been linked to improved cognitive function. These nutrients are found in foods such as leafy greens, nuts, seeds, whole grains, and protein sources like fish and poultry. Foods rich in antioxidants, such as highly coloured fruits and vegetables, have been shown to protect against oxidative stress, which can contribute to cognitive decline. For more information on essential nutrients for menopausal women head to my blogs ‘Ten Important nutrients for Menopause’ and ‘The Magic of Magnesium for Menopause’.
- Keep blood sugar balanced: Blood sugar imbalances can lead to brain fog because the brain relies on a steady supply of glucose to function optimally. When blood sugar levels fluctuate, it can cause the brain to struggle to maintain a consistent source of fuel. High blood sugar levels can impair cognitive function, leading to symptoms such as confusion, difficulty concentrating, and memory problems. Conversely, low blood sugar levels can lead to fatigue, dizziness, and brain fog, as the brain is not receiving enough glucose to function properly. Therefore, maintaining stable blood sugar levels through a balanced diet and regular meals is essential for optimal brain function and reducing the risk of brain fog. Focus on a nutrient-dense, high-protein diet including plenty of fibre and essential fats. To find out how much protein is required in midlife head to my blog ‘How Important is Protein for Midlife Women?’ (I’ll give you a clue….very!
- Feed your microbiome: Recent research has shown that the gut microbiome, the collection of bacteria and other microorganisms in the digestive system, can have a significant impact on brain function. Imbalances in the gut microbiome can lead to inflammation and oxidative stress, which can contribute to brain fog. Additionally, the gut-brain axis, a network of communication between the gut and the brain, plays a critical role in regulating mood and cognitive function. Changes in the gut microbiome can disrupt this communication, leading to brain fog, anxiety, and depression. A diet that is rich in fibre and fermented foods can help to support a healthy gut and promote cognitive health.
- Stay hydrated: When the body is dehydrated, it reduces blood flow to the brain, resulting in reduced delivery of oxygen and nutrients to brain cells. This can cause symptoms such as confusion, difficulty concentrating, and fatigue. Additionally, dehydration can lead to a decrease in the production of neurotransmitters. Ensuring proper hydration by drinking enough water throughout the day can help prevent brain fog and boost brain performance.
- Consider hormone replacement therapy (HRT): HRT can help to alleviate menopause symptoms, including brain fog by topping up the body’s hormone levels, particularly oestrogen. However, HRT’s effectiveness in reducing brain fog may vary depending on individual factors. It is important to consult with a healthcare provider to determine if HRT is an appropriate option for you.
Coping Strategies for Managing Brain Fog
Whilst nutrition and lifestyle strategies can help minimise cognitive decline, if you are experiencing it either frequently or infrequently there are strategies that can be effective in managing the impact.
- Cognitive-behavioral therapy (CBT): CBT can be an effective treatment for brain fog, particularly when related to anxiety or depression. CBT focuses on identifying and changing negative thought patterns and behaviours that can contribute to symptoms. By addressing the underlying psychological factors, CBT can help individuals learn coping strategies and improve cognitive function.
- Organisation and memory aids: These can be helpful for managing brain fog symptoms. Strategies such as using a planner or calendar, making to-do lists, and setting reminders can help individuals with brain fog stay organised and remember important tasks. Memory aids such as sticky notes, voice memos, and smartphone apps can also be useful for keeping track of important information. Additionally, simplifying the environment by reducing clutter and eliminating distractions can help individuals with brain fog stay focused and improve cognitive function.
But is Brain Fog Normal?
Whilst all of the above are important factors in maintaining cognitive function, it is also important to keep things in perspective and not stress unnecessarily (mainly because that plays havoc with your memory!). Consider what your ‘normal’ looks like in terms of brain function. If I’m honest – I’ve always had a tendency to leave behind keys / phones/ jackets etc (not my children until this point!) – I can be scatty as my brain has normally moved on before the job at hand has finished. I am more aware of it now as I am worrying about it and am therefore probably noticing and focusing on these things more.
It is also perfectly normal for women to experience brain fog and associated symptoms during their cycle, particularly in the luteal phase just before our period. But we tend to try and just power through, expecting our brain to be sharp and creative when normal hormone fluctuations (a decrease in oestrogen and an increase in progesterone) are trying to get us to rest and recharge. There is a reason the couch comes a calling….go sit on it for a bit!
What I am saying is, it’s important to keep things in perspective and try to determine what is menopausal brain fog and what might be the impact of your normal menstrual cycle or perhaps you just pushing yourself too hard and not prioritising downtime.
On a personal level, Whilst my tendency to lose things is not new I know the time has come to take action and consider what additional support I need – given that my A-game currently looks like a C+ at best! There is no point in suffering on when I can be proactive and add other tools to my ever-growing armoury of strategies to maintain my wellbeing through menopause.
A final word – menopausal brain fog is a common symptom that many of us will experience. But by understanding the causes and symptoms and taking steps to manage it, most of us CAN improve our cognitive function and quality of life until a time when our brain has time to regroup after the hormonal landslide it has just succumbed to.
It might not feel as uncomfortable as hot flushes or be taken as seriously as anxiety or depression but if you are experiencing brain fog don’t suffer in silence. The struggle is real. Speak to a healthcare professional with expertise in this area to determine the best course of action for you. Midlife women deserve help but we have to get better at asking for it too. And remember – nutrition and lifestyle absolutely 100% make a difference. So prioritise your wellness and put yourself first. That Netflix show will still be there tomorrow….tonight, hit the sack early and give your poor overworked midlife brain as a bit of respite….it deserves it.
Let me know in the comments if you’ve experienced menopausal brain fog, how it impacted you and what strategies helped you.
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