Author: Dr. Bonnie Brock, NMD, MPH, RD
As a practitioner helping women navigate menopause, the number one symptom that seems most frustrating and frightening is “brain fog”. I’ve had women tell me they would trade a lifetime of hot flashes just to be rid of this feeling of losing their mind, memory and in some cases, even losing “themselves”. As someone who has started menopause herself, I can say it sometimes feels like a slow dulling of your once sharp self. And it can be terrifying to wonder where that dulling ends. While “brain fog” isn’t a technical medical diagnosis; it’s a common way people describe a range of cognitive symptoms like mental fatigue or fuzziness, trouble focusing or concentrating, memory lapses or forgetfulness, feeling detached and slower thinking or processing speed.
Brain fog is commonly the first symptom of perimenopause and is largely due to the drop in estrogen. As menopause progresses and the ovaries “retire from service”, the task of making estrogen shifts primarily to the adrenal gland. The adrenal gland does not make estrogen in the same robust quantity as the ovary, and that drop in estrogen can be experienced as hot flashes, night sweats, vaginal dryness, loss of libido and brain fog. Estrogen plays a big role in cognitive processes like memory and attention, so when levels decline, you might notice your brain not firing on all cylinders as it once had. In addition to hormone fluctuations, brain fog during menopause can be the result of newly poor sleep, exacerbating anxiety or depression, increased stress and co-occurring thyroid dysfunction.
So, what can be done to break through this fog? Certainly, bio-identical hormone replacement therapy is an effective way to maintain hormone levels and soften that sudden estrogen drop. There are many hormone delivery choices for women, including patches, troches, creams, pellets, pills and injections. Find a practitioner who will work with you to find the best delivery system for you. In addition to BHRT, women should start or maintain a regular exercise regimen to boost blood flow to the brain. Finding a way to sleep soundly and consistently is critical for memory. Be careful of some prescription and OTC sleep medications, as they can make fogginess worse the next morning or some studies reveal they even contribute to dementia. Challenging the intellect with daily puzzles, games, reading and new learning is also important to keep the mind sharp. And a nutrient-dense diet can help with not only mental clarity but also the midriff weight gain that menopause sometimes brings. Focus on dark greens, fatty fish, berries, nuts, seeds, avocado and olives.
If brain fog is affecting your daily life or seems worse than it should be, it’s a good idea to talk to a menopause-aware healthcare provider to help navigate the changes ahead. Other, more serious, conditions can share symptoms with menopause, so it is important to see a menopause specialist to rule out a condition that may need more specific attention.
