It’s Not Just You: ‘Menopause Brain’ Is a Real Thing. Here’s How to Deal with It

From night sweats and vaginal dryness to sudden hormonal acne and Burning Mouth Syndrome (?!), menopause can usher in a whole host of symptoms, both well- and lesser-known. One that might fall into the latter category is menopause brain, which is brain fog—a non-medical term for symptoms like forgetfulness and difficulty focusing—that happens during perimenopause and menopause. We reached out to Dr. Kathleen Jordan, MD, NCMP, for more on what menopause brain fog is, what causes it and how to alleviate your symptoms.

Dr. Kathleen Jordan, MD, NCMP, is the Chief Medical Officer for Midi Health, a virtual care clinic created by specialists in perimenopause and menopause. Her career highlights include establishing telehealth services at Dignity Health; attaining the Health Equity Leadership Certification for the hospital and its programs; establishing a new trans health program in San Francisco for which she was awarded the Leadership in Innovation Award; and helping women’s health clinic Tia grow from one site to a multistate organization with leading healthcare system partnerships.

Menopause brain is a type of brain fog which, while not a recognized medical condition, generally refers to what professionals call a “constellation of symptoms” reported by patients that might indicate cognitive impairment. Much like the definition of brain fog, the symptoms are quite broad, but often include forgetfulness, difficulty concentrating and a decrease in language processing speed. Dr. Jordan tells us that many women going through menopause report brain fog symptoms like difficulty finding words, memory problems, difficulties concentrating or word recall.  Reiterating that it’s not a medical term, she explains, “These are symptoms triggered by organic changes in the brain that occur as our hormones fluctuate.  I want to be clear, though, that these are not signs of a decline in cognition or IQ or signs of overall brain function–rather a reactive change that occurs in response to hormonal changes in menopause and perimenopause.”

She also notes that these symptoms often begin during perimenopause, or the years that lead up to menopause (meaning they commonly affect women in their 40s and continue into the 50s, though some women may have symptoms even earlier. In her own experience at Midi Health, Dr. Jordan reports that about three quarters of midlife clients report some degree of changes that they categorize as brain fog.

Dr. Jordan admits that doctors and researchers still have much to learn about how menopause triggers brain fog symptoms, but that estrogen plays a significant role in the neuroendocrine system, and symptoms do happen in response to the estrogen decline that happens during menopause. She adds, “Perhaps the most studied and appreciated hormonal influence on brain fog has been looking at estrogen in menopause and noting that it is associated with changes in the brain metabolic function. We know that the brain has estrogen receptors—so it’s not surprising that we see changes in brain cell metabolic activities when estrogen levels begin to fall in perimenopause and menopause.” Furthermore, “Research demonstrates that estrogen depletion is associated with a change in activity of certain neurotransmitters such as dopamine, GABA and serotonin–neurotransmitters that have long been known to contribute to sleep, mood, executive functions and attention,” Dr. Jordan reveals.

OK, so brain fog during perimenopause and menopause is pretty common, but is there anything you can do to lessen symptoms? Absolutely. “There is plenty to do to help with symptoms,” Dr. Jordan tells us. “Understanding that it’s happening is often the first step and the solutions are best when tailored to your specific symptoms.”

While brain fog symptoms during menopause aren’t uncommon, and can be alleviated, Dr. Jordan does say that it’s important to make sure that these symptoms aren’t a sign of something else—like an early progressive Alzheimer’s dementia—but that in most cases brain fog is normal in perimenopausal and menopausal women. She says there are tests your doctor can administer to rule out more serious issues.

In most cases, though, you can work to lessen symptoms related to menopause brain by trying these doctor-approved methods:

1. Work on Your Sleep Health. Dr. Jordan shares that sleep disruption is hugely common in midlife, with almost two-thirds of women having some frequently disordered sleep. She explains, “Poor sleep then leads to a variety of symptoms that fall into the ‘brain fog category: daytime fatigue, mood lability [rapid changes in mood] and difficulty with attention and focus.” By trying to get your sleep hygiene in order, you might alleviate some of the sleep-related brain fog symptoms. Here are some tips for sleeping better during menopause, from setting your thermostat a little lower to skipping that evening glass of wine.
2. Consider Hormone Replacement Therapy. “This can improve brain fog symptoms, especially in women experiencing hot flashes and night sweats, as these are known to disrupt the sleep cycle and trigger daytime symptoms,” Dr. Jordan tells us, adding that estrogen replacement supports our normal brain cell function while progesterone replacement is associated with repleting serotonin—the calming neurotransmitter than can help both sleep and relax. Talk to your doctor if you’re interested in learning more about HRT.
3. Focus on Your Overall Health. “Diet, supplements and exercise can positively impact these changes and symptoms, too, as can the stress reducing practices of yoga and/or regular exercise,” Dr. Jordan says.