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Everything You Need To Know About Brain Fog During Menopause

Brain fog is “a constellation of symptoms,” most often taking the form of forgetting words, absentmindedness and distractibility.
Illustration of a woman looking off to her right, with her right hand resting on her chin. She is surrounded by clouds, representing brain fog during menopause. (Illustration: Nicole Rifkin)

Shirley Weir was 41 when her brain started feeling “spent, at capacity, overflowing.” The entrepreneur began missing deadlines, and her work stress led to her being irritable with her family. Afraid she was developing dementia, Weir saw her doctor, who said she was too young for menopause. Instead, she was offered birth control pills, sleeping pills and an antidepressant to cope with the brain fog as well as the anxiety and insomnia she was also experiencing. But none of these addressed the root cause of her symptoms.

Weir began looking for support online and, finding few options, she created Menopause Chicks, an online community for sharing evidence-based information. Brain fog is a common discussion topic.

The International Menopause Society defines brain fog as “a constellation of symptoms,” most often taking the form of forgetting words, absentmindedness and distractibility. Forty to 60 percent of people in menopause experience it, with one in 10 having severe symptoms.

Related: Setting The Record Straight On Menopause Hormone Therapy 

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A “storm of hormones” is to blame, says Dr. Nathalie Gamache, a Vancouver-based gynecologist who has completed a fellowship in menopause. Other symptoms, such as sleep disturbances, hot flashes and anxiety, can deepen the fog.

Now, some good news. First of all, not everyone develops brain fog; genetics, lifestyle and stress are also factors. Secondly, most perimenopausal women continue to score within normal ranges on memory and thinking tests. (One study even found that they outperformed men of the same age.) Finally, the fog will eventually clear for many people, says Gamache. And she says it’s almost never an early sign of dementia, though it’s important to rule out other medical conditions such as low iron, thyroid problems and ADHD.

On her quest for relief, Weir realized she needed to focus on her overall well-being. Healthy eating, exercise and sleep became priorities, followed by stress management. She also ruled out nutritional deficiencies and thyroid problems. She eventually started menopause hormone therapy (MHT) after deciding that for her, the benefits outweighed the risks.

Related: How To Get More Sleep During Menopause

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While there haven’t been significant trials to prove that MHT directly alleviates brain fog, it often relieves other meno symptoms, such as hot flashes, which can have a positive impact on brain fog. (Non-hormonal meds that reduce other meno symptoms can also help.) ADHD medication and testosterone supplements are other potential treatment options that are currently being researched.

Above all, Weir wants people to know that solutions exist. “You deserve to feel amazing,” she says.

Read more: Everything You Need To Know About Menopause

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Liana Hwang is a family doctor based in Alberta and a certified Tea Association of Canada tea sommelier.

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