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Brain fog

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Brain fog

Many of us experience “brain fog” during the menopausal journey. This not-so-scientific term references difficulties with concentration and memory loss. It manifests differently but can include everything from forgetfulness to taking longer to find the right word. If it feels like you’re not as “sharp” as you once were, you’re not alone.

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    The science

    To start, we’re going to go ahead and address the elephant in the room. Yes, menopause brain fog IS a very real thing. No, you’re not imagining it or “going crazy.”

    Small decreases in cognitive abilities begin as early as your 30s (surprising, right?), with evidence showing small changes in memory performance across the menopause transition that aren’t accounted for by age or other factors. Several studies have found that different aspects of cognition, including verbal learning, attention, and memory performance decline as we shift from pre-menopause into perimenopause. These continue into menopause, with small but statistically significant decreases in attention, processing speed, and other cognitive problems — confirming that, for some of us, cognitive decline is indeed attributable to the menopause transition.

    Why does brain fog happen?

    As more and more research emerges, we’re getting a better grasp on just how important a role hormone levels play in cognition-related conditions, such as brain fog. As estrogen levels drop, changes occur including a drop in the metabolism of glucose in the brain (glucose being the brain’s primary fuel), and this may well be why you may feel “off your game.” Additionally, cognitive function is related to other common symptoms experienced by women in this age group: sleep disturbances, high stress levels, depression, fatigue, and night sweats – all of which may affect our mental performance.

    The experience of brain fog, including the occasional need to search for words or forgetting something that seemed at the tip of your tongue just yesterday, can be very unsettling. In fact, one of the fears of midlife women is that their “foggy brain” is an early sign of dementia and especially Alzheimer’s disease. Here is the good news, though: although these symptoms can be similar, the brain fog of menopause is usually temporary and things get “back to normal” once the hormonal upheaval of this transition has settled.

    But what about the link between estrogen and actual dementia, and more specifically, Alzheimer’s disease?

    We do know that a younger age at menopause is associated with an increased risk of Alzheimer’s. In one study, women who went into menopause between ages 41-46 had a 29% higher chance of developing Alzheimer’s than women who hit menopause between 51-55.

    To be clear, menopause itself does not cause Alzheimers. Estrogen may be just one link in the complex nature of dementia, and studies are ongoing to further elucidate genetic, gender, hormonal, and metabolic risk factors that contribute to this disease.

    There’s no way to sugarcoat the fact that upwards of 60% of women report difficulty concentrating during menopause, but we CAN take comfort in knowing that these changes are temporary, and the majority will NOT develop dementia.

    Cognitive evaluation

    Neurologists and neuropsychiatrists, doctors who specialize in diagnosing and treating brain disorders, can perform evaluations to test for cognitive defects (for example, problems with executive functions, like abstraction, conceptualization, attention, memory and more — these tests are usually done with paper & pencil). More often than not, women in menopause will score normally — in which case attention, focus, sleep issues, and stress may be contributing to brain fog. Humans aren’t hardwired to excel at multitasking, and we don’t know about you, but these days it feels like everything and everyone is demanding our attention.

    Although brain fog of menopause and early dementia symptoms overlap in some aspects, there are some clear cut differences between the two. Getting lost in familiar places, difficulty performing daily tasks, difficulty making decisions or handling finances, and repeating statements over and over are more worrisome and warrant a cognitive evaluation.

    Fortunately, brain health is not out of our control, and there’s much we can do to nourish that noggin as we age. As Richard Isaacson, founder of the Alzheimer’s Prevention Clinic at Weill Cornell Medicine and NewYork-Presbyterian Hospital states:

    “Just like you can’t prevent a heart attack or a stroke definitively, you can’t prevent Alzheimer’s definitively. But one in three cases can be either preventable or delayed.”

    And remember…

    As Dr. Jen Gunter states, “Girls have amazing, capable brains before they enter puberty and many women who never take estrogen continue to achieve great things after their final menstrual period.” Our worth does not depending on the amount of circulating estrogen in our bodies.


    “I’ve found that the less I stressed about my brain fog, and the more I tried to visualize what I was thinking or wanting to say, the more I was able to explain or remember a simple task or conversation.”

    Read Liz's story

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    What you can do

    We’re all about equipping you with the know-how to understand your symptoms, and we especially emphasize the specific, tangible ways to manage them. Our goal is to empower YOU to take charge of your menopause journey, starting today.

    A quick note about product recommendations…Elektra Health is not paid to feature any products. We just like them and think you might too, though we can’t guarantee any results.


    Brain health is dictated by many lifestyle behaviors such as sleep, nutrition, exercise, and stress management — and no, it’s never too late to start making changes! In addition to directly benefiting brain health, lifestyle can also indirectly benefit us by impacting cardiovascular factors (e.g., hypertension, diabetes, and high cholesterol), which scientists believe are also linked to cognition.

    Nutrition & Diet

    Diet plays a clear and integral role in every aspect of brain function. And although there’s no one best diet for everyone, the Mediterranean diet has been associated (correlation, not causation) with better cognition, as well as better sleep and cardiovascular health. It’s low in saturated fats and animal proteins, rich in antioxidants and fiber, and loaded with B vitamins. It’s also anti-inflammatory, low-carb, and low-sugar. And because it kicks most refined and concentrated sugars to the curb and focuses instead on non-starchy veggies, beans, fruits, and whole grains, it’s considered a “low-glycemic index” diet — meaning it won’t dramatically spike your blood sugar. This is what you want!

    According to Dr. Lisa Mosconi, MD author of Brain Food, the five top brain-boosting foods are:

    1. Caviar
      That caught up by surprise too! Caviar contains a beneficial blend of nutrients, including omega-3 fats, choline (a B vitamin used to make memories), vitamins B6 and B12 (to support the nervous system), minerals such as iron and magnesium (for healthy blood and tissues), protein, and antioxidants such as vitamin A, vitamin C, and selenium.
    2. Dark leafy greens
      Greens such as spinach, Swiss chard, dandelion greens, and kale are chock-full of minerals, fiber, and vitamins to support the nervous system.
    3. Berries
      Including antioxidant-rich blackberries, blueberries, strawberries, and raspberries, as well as less-common goji berries and mulberries that have a low glycemic index (to regulate sugar levels) and keep your memory sharp as you age.
    4. Extra virgin olive oil or flaxseed oil
      Both of which contain omega-3s and vitamin E to support the heart and, in turn, the brain.
    5. Raw cacao
      Cacao in its raw form, available at Whole Foods or most places selling organic food, is rich in theobromine, an antioxidant that supports cellular aging and reduces the risk of heart disease.

    READ MORE: 8 Foods (& Drinks) That Help With Menopausal Brain Fog

    Holistic Practices


    Sleep promotes the consolidation of experiences and ideas, as well as the enhancement of memory, attention, problem-solving, and creativity. Sleep disorders have been recognized as a clinical symptom of concern for neurodegenerative disorders. For example, sleep apnea increases production of amyloid, a protein associated with Alzheimer’s disease. Here’s a handy guide with behavioral, nutritional, and supplemental solutions for better sleep.

    Stress reduction

    Cultivating a meditation practice is a great way to reduce stress. Over time, you’ll condition yourself to be more present while letting thoughts come and go. We recommend guided meditations on apps such as Headspace, Insight Timer, and Calm.

    Tai chi

    Research suggests that tai chi — a mind-body movement practice that incorporates mild to moderate-intensity aerobic activity — can have a positive effect on cognitive function.


    Although we may be conditioned to multi-task, as humans, we’re not actually hardwired to excel at this. Contrary to popular belief, it’s actually been shown to take longer, as well as result in more errors. Research also indicates that “media multitasking” (watching TV while scrolling through your emails, for example) affects memory. Instead, prioritize doing one thing at a time.

    According to Daniel Levitin, neuroscientist and author of The Organized Mind, the reason we think we’re capable multitaskers “is just self-delusion. The brain is a very good deceiver.” He explains:

    “We now know that the brain doesn’t multitask. Rather, the brain shifts rapidly from one thing to the next. That causes us to not be able to focus attention on any one thing, and this dividing of our attention makes us less efficient.”

    Keep learning (and playing)

    Research shows that learning new things or tasks can improve brain function by building new neural connections. There’s also evidence pointing to the power of regularly engaging in mentally stimulating activities. A perfect reason to try to learn (or re-learn) a foreign language or, for a less involved activity, pick up the crossword (or Spelling Bee) or get a Sudoku book.


    Aerobic exercise maintains brain health indirectly (by supporting the heart) and directly (by affecting cerebral flow and neurogenesis), with two studies showing strong associations between physical activity (walking included) and cognitive function for women in particular.

    Supplements & Over-the-Counter Solutions

    Although we are on team fish oil and turmeric, or its active ingredient curcumin, for their supposed brain health benefits (due to omega-3 fatty acids, which are anti-inflammatory), there isn’t hard evidence to support this. So while it can’t hurt, we don’t know yet for certain that it helps. We also believe that our nutrition should be the primary source of brain healthy ingredients, so before reaching for that bottle, we would recommend some real salmon or sardines on your plate (with a side of veggies!).

    If you do opt to try fish oil, we recommend Nordic Naturals

    Hormone Replacement Therapy

    Unfortunately, current data does not show that the use of hormone replacement therapy (HRT) clears brain fog. Results are mixed, and the reassuring thing is that while hormone therapy may not directly HELP with brain fog, it will not worsen it either. Therefore, if you are considering HRT for other reasons such as hot flashes / night sweats or osteoporosis prevention, and do not have contraindications to it, there is no reason to worry that it will make things worse, especially if you start in the right timeframe – no later than 10 years from your last period.

    A related (and exciting!) area of research is currently examining HRT as a way to stave off future cognitive changes. At present, it is still unclear whether hormone therapy use around the time of menopause will prevent dementia. Because of that, hormone therapy is not recommended at this point solely for preservation of cognitive function and Alzheimer’s prevention.

    Like we mentioned, we’re always keeping an eye out for emerging research and the latest clinical studies, so be sure to subscribe to our weekly digest for the latest, science-based info sent straight to your inbox. And if something worked well for you, we want to hear it! Shoot us a note at [email protected]. (We’re human, promise.)

    Disclaimer: This information is for general educational purposes, and should not be used as a substitute for medical advice, diagnosis, or treatment of any health condition or problem.

    As with anything you put into your body, taking dietary supplements can also involve health risks. You should consult a medical professional before taking supplements and inform your doctor about any supplements, as well as any medications you already take, since there may be interactions.


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