Is ‘Menopause Brain’ Real?

With all of the changes menopause brings, memory lapse or "brain fog" can be one of the most alarming. Maybe you find yourself forgetting a word here and there, or have trouble recalling why you walked into a room.

Brain fog during the menopausal transition is real, but in most cases isn't cause for concern. Many studies have found that due to a mix of hormonal shifts and everyday stressors, brain fog is a common menopause side effect. The good news is that it usually subsides after menopause.

This article will cover the latest learnings and solutions for navigating menopause brain fog.

Menopause Brain Fog

The average age a person reaches menopause (when they haven't had a period for one year) is 52. During the transition, your ovaries will stop producing the hormones that drive your menstrual cycle.

There is also a period leading up to menopause called perimenopause. For some people, perimenopause starts around 47. Others may notice changes earlier in their 40s. During perimenopause, the hormones that regulate menstruation begin to fluctuate.

In both phases, many people report brain fog. In fact, around 60% report difficulty concentrating and other issues with comprehension. So if you’re between 40-50 years old and feeling forgetful, you are not alone.

There is evidence that people in the early stages of perimenopause, especially the first year, show more cognitive disturbances than those further along. Most studies suggest that up to two-thirds of perimenopausal people report forgetfulness, memory decline, and concentration difficulties. Some studies suggest that the more intense brain fog will subside after menopause.

Since brain fog is neurological, it can lead to more worry that something is wrong. In most cases, it's totally normal. The hormonal shifts happening during menopause play a big role in brain fog, but there are a few lifestyle factors that may play a part as well.

Causes

Memory lapse during menopause is often a cumulative experience of the following three causes.

Hormones

During perimenopause, your ovaries start to slow the production of eggs. Levels of estrogen (the main female hormone) become more erratic.

Research shows that fluctuating estrogen can lead to brain fog or memory lapse. One study found that person’s ability to learn new information (processing speed and memory) declined during perimenopause. Another showed reduced memory, thinking skills, and concentration.

The link between estrogen and memory is still being researched, but it’s believed that the hormone may have a hand in the brain’s neurotransmitter system, specifically in sending signals to the areas involved in memory and information processing.

Sleep Disturbances

You may know this from experience: getting a bad night’s sleep can lead to foggy thinking during the day. Sleep disturbances can be classified into three groups: trouble falling asleep, waking up several times, and waking up earlier.

One large study found that waking during the night was the most common type of sleep problem for women during this transition. Causes vary, but 85% of menopausal people experience hot flashes, which often occur during the night.

Stress

It’s important to look at this life transition holistically. Many people in their 40s and 50s are experiencing a tremendous amount of stress. Work, finances, raising a family, or taking care of an older parent can cause stress and eventually impact concentration.

Stress often keeps you out of the present moment, taking your mind elsewhere to whatever is causing worry. This simple but meaningful distraction can cause forgetfulness or even a foggy daze. 

Treatments

Most treatments for brain fog are tried and true ways to support your body during menopause and everyday life. Implementing some of these lifestyle changes may improve your mood, physical health, and mental strength too.

Diet

Aim to fill your plate with foods that support brain health, like fruits, vegetables, legumes, and whole grains. Leafy greens, fatty fish (like salmon), blueberries, eggs, and walnuts are especially high in vitamins and minerals that support cognitive function.

Consider reducing saturated fat, trans fats, fried food, or foods high in sugar.

Exercise

Engaging in regular aerobic exercise, the kind that gets your heart pumping, stimulates the memory and thinking part of the brain. Aerobics have even been shown to boost the size of the hippocampus, the area of the brain involved in verbal memory and learning, and promotes the growth of new neurons. It can even be a buffer against stress and improve sleep quality.

The goal is to get your body moving for at least 150 minutes each week, or 30 minutes most days of the week.

Adequate Sleep

Maintaining smart sleep hygiene can lead to a full night’s rest. Here are a few tips to try.

• Consider turning the lights down one to two hours before bed. That includes regular overhead lights and blue lights from artificial lights. Switch your tablet with a book.
• Ensure your room is dark, cool, and comfortable.
• Dress in layers and wear loose, natural materials to bed.
• Lower caffeine and alcohol intake close to bedtime.

If you’re regularly waking up from hot flashes, and these holistic treatments aren’t helping, chat with your healthcare provider about prescriptions or hormone therapy.

Mindfulness

It is very important to take care of your mental health during menopause. Sometimes that can be accomplished by long walks or other stress-relievers, like meditation and creative outlets. 

But sometimes it takes more than that. If you're experiencing depression during menopause, seek out proven therapeutic options for treatment. These include treatment with antidepressants and/or psychotherapy (talk therapy). There are several forms of psychotherapy, but one in particular that has been proven successful in treating depression is cognitive behavioral therapy (CBT).

Memory Exercises

Working out doesn't just mean your body. Brain training activities, like crossword puzzles, sudoku, reading, or engaging discussion, have been shown to keep your cognition sharp. Consider including a few games per week to improve your attention, concentration, memory, and motor speed.

Hormone Therapy

Hormone therapy (HT) usually refers to a combination of the sex hormones estrogen and/or progesterone. It can help ease menopause symptoms, like hot flashes and bone loss, but it comes with its risks as well.

While some studies found that hormone therapy doesn’t prevent or improve cognition deficits in menopausal people, it's still worth speaking with your healthcare provider to see if HT is a good option for your symptoms overall.

Other Menopause Symptoms

Each person experiences menopause differently. Symptoms range based on your general health, weight, age, and lifestyle. Here are a few common ones:

• Hot flashes: The clinical term for a hot flash is a vasomotor symptom. Hot flashes occur from a decrease in estrogen levels, causing your glands to release a higher amount of other hormones that affect the brain's thermostat. The result is fluctuating body temperature. A typical hot flash lasts anywhere from one to five minutes, and most women will have at least one per day.
• Vaginal dryness: Without adequate amounts of estrogen, the walls of your vagina lose volume and moisture. This can lead to painful sex, an increase in vaginal infections, and chronic vaginal discomfort.
• Emotional symptoms: Some people also experience mood swings, anxiety, and depression.
• Weight gain: In menopause, the loss of estrogen shifts fat distribution to the waistline. This type of weight gain is particularly unhealthy and is associated with an increase in cardiovascular disease.

When to See a Healthcare Provider

If you’re experiencing severe symptoms that disrupt your daily routine, talk to your healthcare provider or gynecologist about hormone therapy or other options and the associated risks.

Keep tabs on all neurological symptoms. More serious memory dysfunction, like getting lost or repeating questions, may point to cognitive diseases such as dementia or Alzheimer’s.

Remember to take note of any signs of depression, such as lack of motivation, changes in appetite, or consistently low moods.

Summary

Many people experience brain fog or memory lapse during menopause due to the shift in hormones. The cause of brain fog during menopause can stem from stress, sleep disruptions, and hormones.

Getting adequate sleep, eating a diet with foods that support brain health, practicing mindfulness, and hormone therapy are just a few ways to treat brain fog during menopause. If your symptoms are interfering with your quality of life, see your healthcare provider, who can help find the best treatment for you.