What causes menopause brain fog and what can you do about it?

Menopause ‘brain fog’ is the common name for trouble with thinking, concentrating and short-term memory during the menopause transition.

Some women worry that these cognitive symptoms are signs of dementia but if they’ve appeared relatively quickly, especially during perimenopause, there’s a good chance they are related to the hormonal changes your body is going through.

While menopause brain fog does generally go away, it can last for some time. Certain supplements, and other treatments such as HRT, may help to reduce symptoms for some women.

Getting regular exercise, improving your sleep routine and eating a balanced plant-based diet that limits refined carbs and sugar could also help to manage your brain fog.

If you’re unsure what’s causing your brain fog or cognitive issues, talk to your doctor.

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How does menopause cause brain fog?

There's no doubt that brain fog is a real and very common symptom of the menopause transition – and it's not just to do with getting older.

Surveys suggest that over 70% of UK women experience brain fog during this time and that trouble with concentration, tiredness and memory are the menopause symptoms that cause them most difficulty at work.

Although women do experience cognitive decline as they age, this is different to menopause brain fog, which is actually more common during perimenopause – the time leading up to menopause – and tends to improve once you've passed menopause.

Oestrogen and brain fog

During perimenopause, levels of reproductive hormones including oestrogen fluctuate, gradually lowering as you head towards menopause. These changes are at least partly responsible for brain fog.

Oestrogen regulates the way your brain uses glucose as fuel. Reduced oestrogen during the menopause transition means your brain is actually getting less energy.

Oestrogen also plays key roles in memory, brain function and brain health, as well as protecting your brain cells from harmful molecules called free radicals.

So it's no surprise that lower levels of oestrogen could cause symptoms like those of brain fog. What scientists still don't fully understand is why these symptoms often disappear after menopause, despite the fact that oestrogen levels stay low.

As with some other perimenopause symptoms, it may be that it's the changes in levels – rather than low oestrogen itself – that are the cause, but more research is needed to confirm this.

Testosterone and brain fog

Testosterone is another reproductive hormone that may be involved in some of the symptoms of brain fog. Although it's often seen as a 'male' hormone, it's important for women too.

Scientists are increasingly identifying links between low testosterone and changes in cognitive abilities, memory and sleep problems in women.

Testosterone levels are not tied directly to menopause – they gradually drop as you get older. But lower levels could coincide with perimenopause or menopause and may make brain fog symptoms worse.

What are the symptoms of menopause brain fog?

Brain fog is a very good description of how this collection of menopause symptoms can feel. Some women also describe it as like having a head full of cotton wool. It can make thinking difficult and you could find yourself losing your train of thought or forgetting words or names.

Symptoms of menopause brain fog include:

• difficulty thinking or concentrating
• problems with short term memory
• problems with recall
• feeling mentally drained

Brain fog can also be accompanied by related menopause symptoms, like:

• loss of self-confidence
• anxiety
• mood swings / irritability
• low mood

How long does menopause brain fog last?

Brain fog is actually most common during perimenopause and tends to go away after menopause, or even before. For most women, perimenopause lasts between 4 and 8 years, but symptoms often start to improve in the later stages.

A large-scale women's health study found that participants' performances in cognitive tests involving memory, learning and mental agility tended to get worse during perimenopause and return to their original levels after menopause.

Although there may be some comfort in knowing that brain fog doesn't last for ever, it's not much help if you're dealing with symptoms now.

Below, we'll look at treatments, supplements and lifestyle changes that could improve things.

Can HRT help with brain fog?

Hormone replacement therapy (HRT) uses tablets, gels or skin patches to top up the oestrogen and other hormones lost due to menopause.

For many women, it can be an effective treatment for a range of common perimenopause and menopause symptoms. According to both the NHS and the UK's Menopause Charity, that includes brain fog.

However, some experts say there is a lack of clinical trials looking specifically at how HRT affects these kinds of cognitive issues.

If you're thinking of trying HRT, your doctor can help you to decide whether it's right for you.

Supplements and remedies for menopause brain fog

Some supplements made from plant extracts have shown promise in helping with symptoms of menopause brain fog.

Two of those we’ll look at below contain high levels of phytoestrogens, plant compounds that mimic some of the effects of oestrogen in your body.

You can find out more about supplements for menopause brain fog in our dedicated article.

• Curcumin: Curcumin is the active ingredient in turmeric root, but is only present in relatively small amounts. While their hasn't been much research looking specifically at its effects on menopause brain fog, high-dose curcumin supplements have been shown to improve measures of memory, focus and overall cognitive performance in women with pre-menstrual symptoms.
• Soya isoflavones: Soyabeans contain high levels of phytoestrogens called isoflavones. A review of multiple studies found that postmenopausal women who took a daily soya isoflavone supplement saw improvements in their memory, planning and organisational skills after as little as a week.
• Resveratrol: The phytoestrogen resveratrol is found in grapes and red wine. Research suggests it could boost cognitive performance by increasing blood flow to your brain. One 14-week study involving postmenopausal women found that taking a daily resveratrol supplement improved working memory, planning and organisation.

Are any vitamins good for menopause brain fog?

While there hasn't been much research looking at whether vitamin supplements can help with menopause brain fog, it's possible you could benefit from taking vitamin D.

Vitamin D deficiency is very common in menopausal women. And people with low vitamin D levels tend to perform worse on brain function tests and have a greater risk of cognitive decline.

Studies looking at the effect of vitamin D supplements on cognitive symptoms have had mixed results – some have suggested they can lead to improvements, while in others they didn't appear to make a significant difference.

However, vitamin D supplements can help with a range of other menopause symptoms – including reduced bone density, low mood and vaginal and urinary tract problems – and the NHS says most people could benefit from taking them, so it could be worth trying them to see if they work for you.

Dietary changes to help with menopause brain fog

If you regularly find yourself struggling to concentrate or feeling mentally tired after a meal, it could be the foods you’re eating.

Refined carbohydrates like processed breakfast cereals, white rice, bread and pasta – and sugary foods like soft drinks, fruit juices, cakes and sweets – may cause your blood sugar to spike and then crash, contributing to some of the symptoms of brain fog.

Try switching to whole foods that contain more fibre, like vegetables, beans and pulses, and including some protein, which will also help to flatten your blood sugar response.

Extending this focus on whole plant foods to your wider diet can have other benefits for your brain too. The Mediterranean diet is a healthy eating pattern that includes a wide variety of fruits, vegetables, beans and pulses, whole grains, nuts and seeds, as well as plenty of extra virgin olive, and some fish and seafood.

Large-scale studies have shown that sticking more closely to the Mediterranean diet has a protective effect on brain health, and can even reduce the risk of developing Alzheimer's disease in later life.

Following this kind of eating pattern will also ensure you get plenty of phytoestrogens in your diet, which could be helpful as your natural oestrogen levels drop.

Exercise

Studies have shown that regular physical activity can improve memory, concentration and brain processing speed.

Strength work in particular – such as weight training, body weight exercises or using resistance bands – has been directly linked to long-term cognitive benefits.

If possible, try to work each of your major muscle groups at least twice a week and include some aerobic exercise that raises your heart rate too.

If you're new to exercise, start slowly and remember that any physical activity is better than none.

Sleep

Insomnia and other sleep problems are common symptoms of perimenopause and menopause, and it goes without saying that a lack of sleep can contribute to aspects of brain fog, including difficulty concentrating.

While improving your sleep is easier said than done, there are some changes you can make to your bedtime routine that could increase your chances of getting a good night's rest.

Try to go to bed and get up at the same time each day. Avoid caffeine, especially later in the day. Don't use your phone in bed. And keep your room dark, quiet and at a comfortable temperature.

Summary

Menopause brain fog involves difficulty with thinking, concentrating and short-term memory.

Changes to your oestrogen levels during perimenopause are likely to be one of the main causes. Reduced levels of testosterone as you get older could also contribute to symptoms.  

Brain fog that begins during perimenopause tends to go away as you approach menopause.

Hormone replacement therapy may improve menopause brain fog. Supplements containing plant extracts like curcumin, soya isoflavones and resveratrol could also help to manage your symptoms.

Eating less refined carbohydrates and sugary foods could reduce the blood sugar crashes that can lead to mental fatigue or trouble concentrating. A diet focused on whole plant foods can have wider benefits for your brain health too.

Regular exercise – particularly resistance training – can improve concentration and speed of thought. Adjusting your bedtime routine to improve your sleep quality can make you feel less tired.

For help with a whole range of menopause symptoms, including brain fog, poor sleep, hot flushes, low mood and anxiety, try The Better Gut probiotic supplements.

Use the discount code WELCOME10 to get 10% off your first order.