Menopausal brain fog: Is it real?

During perimenopause and menopause, you may experience a wide range of symptoms, from mood swings to hot flashes. Because your body goes through so many changes during the stages of menopause, it can be difficult to know what’s a symptom and what’s not.

Brain fog is one menopause symptom that many women aren’t prepared for. Understanding menopausal brain fog can help you know what to expect.

While not a medical diagnosis, brain fog is a commonly used term for a set of symptoms related to impaired focus and concentration. Brain fog symptoms may include:

• Inability to maintain sustained attention and concentration while performing a task or inability to multitask 
• Becoming easily distracted
• Thoughts drifting or jumping from one topic to another
• Forgetting things, such as details from a conversation or missing details, such as appointment times 
• Misplacing items
• Difficulty following what should be relatively easy directions and getting easily confused 

Although they can be troubling and may make it harder to complete daily activities, brain fog symptoms aren’t usually severe. Severe memory loss, lack of responsiveness or inability to speak or talk clearly aren’t considered brain fog and could be warning signs of serious medical conditions, particularly if they happen suddenly.

Menopause can have mental and emotional effects. Some people do describe feeling “foggy” or “out of it.” For some people, brain fog may begin years before menstrual periods stop during the phase called perimenopause. Other symptoms like hot flashes, irregular menstrual cycles, migraine headaches or changes in mood may also occur during perimenopause. However, it’s possible for brain fog to be the only noticeable symptom. 

Medical providers may not be able to pinpoint a single cause of your brain fog symptoms during menopause. However, certain factors may contribute to brain fog, including:

• Hormone changes: Levels of female sex hormones fluctuate during perimenopause and then fall when your menstrual periods stop and you reach menopause. These hormones play a role in brain function and may interfere with your ability to remember things or process information.
• Sleep problems: Many women have insomnia, or difficulty falling asleep or staying asleep during menopause. Over time, a lack of good quality sleep could interfere with your cognitive abilities.
• Stress: Stress over going through menopause, work, relationships, finances and other parts of life can be overwhelming, making it difficult to concentrate.

The good news is that menopausal brain fog is usually temporary. As you move into the final stage of postmenopause, symptoms typically resolve over a period of months or years. 

Self-care can potentially lessen brain fog during menopause. Follow these tips to help manage symptoms:

• Prioritize sleep: Strive to get seven to eight hours of sleep every night. Go to bed and get up at the same time every day and avoid blue light from screens, caffeine and alcohol close to bedtime
• Exercise regularly: Exercise can improve sleep and reduce stress, potentially improving brain fog
• Try relaxation techniques: Download a mindfulness meditation, visualization or deep breathing app and use it daily to help manage stress
• Follow a well-balanced diet: Choose foods like fruits, vegetables and whole grains
• Manage chronic health conditions: If you have a health condition like high blood pressure or diabetes, follow your treatment plan and keep all checkups and follow-up appointments with your healthcare provider

Menopause treatments like oral hormone replacement therapy and estrogen patches may also be beneficial for some people.

If brain fog symptoms come on suddenly and are severe, seek emergency medical care. For mild symptoms, talk to your healthcare provider if brain fog is making it difficult for you to complete tasks or if any other symptoms of menopause are interfering with your life. Your provider can discuss treatment options and lifestyle changes that may be helpful.

Published March 2023.