Brain fog is an umbrella term for certain symptoms that affect your ability to think clearly, for example, memory loss or an inability to focus. But while forgetfulness and memory lapses are often conflated with ageing, they are also relatively common during menopause (1).
One study reported that around 60% of middle-aged women may suffer from cognitive difficulties and problems with concentration, with memory issues peaking during perimenopause, which can last between 4-12 years (2).
Like hot flushes, mood changes, and insomnia, brain fog is a symptom of menopause and should be treated as such, rather than belittled or dismissed. If you are experiencing menopausal brain fog, it is important to remember that you aren’t alone and that there is help available. Here, we explore some of the ways in which you can manage your symptoms.
What is menopausal brain fog?
Menopausal brain fog is best described as a ‘cotton wool’ feeling: you may find it hard to absorb and recall information or concentrate on simple tasks. Common complaints may include forgetting what you walked into a room to do or struggling to remember your neighbour’s name.
Some women may worry about developing dementia or Alzheimer’s after experiencing brain fog. However, evidence suggests that learning ability and memory returns during postmenopause: in 2009, researchers analysed more than 2,000 women over four years and found that cognitive issues improved after menopause (3).
When does menopausal brain fog start?
There is no definitive answer for when, and whether, you will experience menopausal brain fog, because every woman’s body will react differently to the unique ways her hormones fluctuate during perimenopause. However, research shows that certain decreases in cognitive function (attention/working memory, verbal learning, verbal memory, and fine motor skill) are more evident in the first year after the final menstrual period (postmenopause). (4)
What causes menopausal brain fog?
Since hormones oestrogen, progesterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) play a role in cognition, scientists hypothesise that fluctuating hormone levels during perimenopause are responsible for brain fog.
Though other menopausal symptoms, such as hot flushes, night sweats, sleep issues, anxiety, and depression, may contribute to memory problems, they don’t appear to be the primary cause of brain fog. Instead, evidence suggests that hormonal changes — in particular, those associated with oestrogen — are more likely to cause cognitive challenges in menopausal women (5).
How to manage menopausal brain fog
How to manage menopausal brain fog
Since 75% of the human brain is comprised of water, even negligible levels of dehydration may compromise cognitive functions, which can lead to memory-related issues and poor concentration (6).
Make a conscious effort to drink more water every day. Have two glasses of water as soon as you wake up in the morning or set an alarm every hour to get up from your desk and drink a glass of water. You could add lemon, mint, or cucumber for flavour to make your drink more flavoursome and refreshing.
Add more healthy fats
Maintaining a healthy diet is also hugely beneficial for cognition. The Mediterranean diet has been widely touted for its brain-protective properties, thanks to its inclusion of omega-3s and unsaturated fats. Empirical data reports that eating a mainly Mediterranean diet is linked to a slower rate of cognitive decline and a lower risk of cognitive impairment (7).
To support your cognitive health, add more vegetables, fruits, legumes, nuts, beans, grains, cereals, oily fish (salmon, herring, anchovies, mackerel), and unsaturated fats (olive oil, avocado, nuts), to your diet.
Perform regular exercise
Regular exercise is a useful way of managing many different symptoms of menopause, including cognition. One study suggests that moderate-intensity exercise may increase cognitive flexibility and working memory, while high-intensity activity may improve the speed of information processing (8).
Aim for 30 minutes of moderate-intensity cardiovascular exercise at least five days a week. Try to find something that you enjoy: jogging, cycling, powerwalking, swimming, or dancing.
You may also consider incorporating strength training into your exercise regime. Aim for two sessions of weightlifting or callisthenics (squats, lunges, or push-ups) every week.
Get sufficient rest
Getting enough quality sleep is also vitally important for overall cognitive function. During the latter stages of your sleep cycle — in rapid eye movement (REM) sleep — your brain stores memories, consolidates ideas, and processes information from the day (9).
Due to fluctuating hormones, however, many menopausal women also experience insomnia, which is yet another reason to prioritise your sleep hygiene.
Stress and anxiety can perpetuate sleep issues, so it’s important to give yourself time to unwind before you go to bed. You may consider meditation, deep breathing, yoga, or having a hot bath, for example.
To prevent night sweats from affecting your sleep, ensure your bedroom is between 16-18 degrees, dress lightly, and avoid heavy duvets or blankets.
Finally, avoid large meals, caffeine, nicotine, or alcohol before bed, as they can have a disruptive effect on how easily you’re able to get to sleep and the quality of your sleep.
Add soy isoflavones
Phytoestrogens, like soy, have demonstrated promise in improving overall health and brain function throughout menopause (10). If you aren’t a fan of soy-based foods, then consider adding soya isoflavone supplements to your diet.
Take ginkgo biloba
Ginkgo biloba is a popular herbal choice for managing symptoms of menopause. There’s some evidence to suggest ginkgo biloba may help to maintain normal cognitive function and support memory in the short-term (11).
We understand that memory issues and brain fog can be unsettling but rest assured that symptoms of menopause often improve with time — especially if you make an effort to support your overall cognitive health. If, however, your symptoms are affecting your quality of life or do not resolve, then it’s important to seek advice from your doctor.
Learn more about menopausal symptoms, treatments, and more via our educational Menopause hub.
References:
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Maki. P., Henderson V., Cognition and the menopause transition. Menopause. 2016;23:7.
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Thurston R. Cognition and the menopausal transition. Menopause. 2013;20(12):1231-123. Available online: https://www.nhs.uk/conditions/menopause/symptoms/
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Greendale G.A. et al., Effects of the menopause transition and hormone use on cognitive performance in midlife women. Neurology. 2009;72(21):1850-1857.
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Weber. MT, Rubin. LH, Maki. MP. Cognition in perimenopause: the effect of transition stage. Menopause. 2013;20(5):511-517.
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Shulman L. Menopause-associated Symptoms and Cognitive Performance: Results From the Study of Women's Health Across the Nation. Yearbook of Obstetrics, Gynecology and Women's Health. 2010;357-359.
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Adan A. Cognitive Performance and Dehydration. Journal of the American College of Nutrition. 2012;31(2):71-78.
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Lourida I. et al., Mediterranean diet, cognitive function, and dementia: a systematic review. Epidemiology. 2013;24(4):479-489.
Feart. C, Samieri. C, Barberger-Gateau. P.. Mediterranean diet and cognitive health: an update of available knowledge. Curr Opin Clin Nutr Metab Care. 2015;18(1):51-62.
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Chang. Y., Etnier J., Exploring the Dose-Response Relationship between Resistance Exercise Intensity and Cognitive Function. Journal of Sport and Exercise Psychology. 2009;31(5):640-656.
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Deak. MC., Stickgold R., Sleep and cognition. Wiley interdisciplinary reviews. Cognitive science. 2013;1514:123-127.
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Silberstein R. et al., Examining Brain-Cognition Effects of Ginkgo Biloba Extract: Brain Activation in the Left Temporal and Left Prefrontal Cortex in an Object Working Memory Task. Evidence-Based Complementary And Alternative Medicine. 2011;1-10.
Disclaimer: The information presented by Nature's Best is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.
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Olivia
Olivia Salter has always been an avid health nut. After graduating from the University of Bristol, she began working for a nutritional consultancy where she discovered her passion for all things wellness-related. There, she executed much of the company’s content marketing strategy and found her niche in health writing, publishing articles in Women’s Health, Mind Body Green, Thrive and Psychologies.
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