Brain Fog during Perimenopause and Menopause - What causes it?

Brain fog during perimenopause and menopause is super common, and it’s mostly driven by hormonal changes, especially the fluctuating and eventually declining levels of oestrogen and progesterone. Here's a breakdown of what’s going on under the hood:

🧠 1. Oestrogen’s Role in Brain Function

Oestrogen isn’t just for reproductive health — it also plays a big role in:

• Cognitive function (especially memory and focus)

• Neurotransmitter regulation (like serotonin, dopamine, and acetylcholine)

• Blood flow to the brain

So, when oestrogen levels drop or fluctuate wildly, it can mess with your:

• Memory (hello, “Where are my keys?” moments)

• Concentration

• Verbal recall (like forgetting a word mid-sentence)

😴 2. Sleep Disruption

• Hot flashes, night sweats, and anxiety can all mess up your sleep.

• Poor sleep = poor cognitive function = more brain fog.

🧬 3. Stress & Cortisol

• Midlife often brings more stress (career, kids, aging parents).

• Chronic stress increases cortisol, which interferes with memory and focus.

• Plus, the hormonal changes make your brain more sensitive to stress.

🩸 4. Blood Sugar and Metabolic Changes

• Hormonal shifts can impact insulin sensitivity.

• Blood sugar highs and lows affect energy levels and focus.

🧠 5. Neurotransmitter Imbalance

• Oestrogen affects serotonin and dopamine levels.

• Less oestrogen = potential dips in mood, motivation, and mental clarity.

🧂 Bonus: Nutrient Absorption Changes

• As you age, your body might not absorb certain nutrients (like B12, magnesium, or omega-3s) as well — all of which are important for brain health.

Treatment:

🌿 Lifestyle & Natural Approaches

These are often the first line of defence.

1. Sleep

Poor sleep is a big contributor. Aim for 7–9 hours and stick to a consistent sleep schedule. If insomnia is an issue (common during menopause), you might try:

• Magnesium glycinate before bed

• Sleep hygiene strategies

• Cognitive Behavioural Therapy for Insomnia (CBT-I)

2. Exercise

Regular aerobic + resistance training helps clear brain fog and boosts mood:

• Aim for 30 mins, 4–5 days a week

• Yoga and walking also help reduce stress

3. Nutrition

• Focus on omega-3s (e.g. fish, flax)

• Eat more leafy greens, berries, and whole grains

• Reduce sugar and processed food

• Stay hydrated

4. Supplements (talk to a doctor first)

• Omega-3 fatty acids: Brain health

• Magnesium: Supports sleep and stress reduction

• B Vitamins (esp. B6, B12, folate): Vital for cognitive function

• Vitamin D: Often low in midlife and affects mood/cognition

• Lion’s Mane mushroom or Rhodiola: Brain-boosting adaptogens (evidence is still emerging)

🧠 Mindfulness & Cognitive Strategies

• Mindfulness meditation improves memory and reduces stress

• Journaling or using memory tools like notes, lists, and reminders helps structure thinking

• Try brain-training apps like Lumosity or Elevate

🩺 Medical Options

1. Hormone Replacement Therapy (HRT)

• Oestrogen can help with brain fog for some women (especially if started early in menopause transition)

• Progesterone or combined HRT may also improve sleep and mood

• It’s not for everyone, so weigh pros/cons with a menopause specialist

2. Non-Hormonal Medications

Sometimes SSRIs or SNRIs (often prescribed for hot flashes or mood) can also improve mental clarity.