Menopausal brain fog is real

It happens to everyone throughout their life: You’re trying to find a certain word — and you definitely know it — but you can’t for the life of you remember what it is. Or you completely flub an acquaintance’s name when you run into them at the supermarket. But with menopause, this kind of forgetfulness can become more and more frequent. Here, experts share the link between menopause and brain fog, how long it may last, and how to keep your mind sharp.

There’s no strict definition, but menopause brain fog refers to issues with verbal learning, memory, and focus. “It’s essentially not feeling confident that you're going to remember stuff,” explains Dr. Sally MacPhedran, M.D., director of the Midlife Women's Centre at University Hospitals Cleveland Medical Center. Common examples include forgetting words, misplacing items, or feeling mentally slower. Fortunately, this typically doesn't affect your ability to learn new skills — just short-term recall.

Brain fog is surprisingly common: about 75% of women experience cognitive issues during menopause. It can begin even before periods become irregular, during perimenopause, and may continue postmenopause. “We know it starts before the final menstrual period,” says Dr. Stephanie Faubion, director for the Centre for Women's Health at the Mayo Clinic, medical director for The Menopause Society, and member of the WeightWatchers Scientific Advisory Board. It’s likely to improve over time, but how long it lasts can vary.

Several interconnected factors contribute:

• Hormonal shifts: As estrogen declines in perimenopause, so can mental sharpness. Estrogen plays a role in brain function, so its drop may disrupt cognitive processes. While menopause brain fog isn’t linked to long-term dementia risk, estrogen’s influence on cognition is well-documented.

• Stress: Menopause often coincides with major life pressures — raising children, aging parents, career demands — and rising stress can impact memory and focus by affecting the brain’s working memory centres.

• Poor sleep: About half of menopausal women struggle with sleep, often due to night sweats. Sleep deprivation compounds irritability, low energy, and forgetfulness. “All of that just worsens the memory issues,” says MacPhedran.

Experts recommend a holistic approach:

• Eat for brain health: A Mediterranean-style diet, rich in vegetables, fish, and healthy fats, supports cognitive function and lowers the risk of memory decline. It’s anti-inflammatory and provides essential nutrients like antioxidants and omega-3s that protect brain tissue.

Learn more about nutrition during menopause

• Stay active: Regular exercise boosts blood flow to the brain, improving mental clarity. It also supports better sleep, which may reduce fog caused by night sweats or stress.

Learn more about strength training during menopause

• Stimulate your mind: Challenge your brain with new activities, like puzzles, games, or social experiences. Novelty helps activate areas of the brain tied to memory and learning. Even casual games like Wordle can offer helpful mental practice.

• Improve sleep: Since exhaustion exacerbates brain fog, prioritise sleep. Identify and treat the cause of disruptions — whether it’s night sweats, anxiety, or something else — and consider working with a healthcare provider to find solutions.

Learn more about sleep during menopause

• Learn about medication: Menopause hormone therapy (MHT), more commonly known as hormone replacement therapy (HRT), may not directly reverse brain fog, but it can alleviate symptoms like night sweats and insomnia, indirectly improving cognitive function for some women. Talk to your doctor or healthcare provider to see if it's a good option for you.

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