Menopause Brain: When Fog Meets Fierce

Let’s talk about a topic that’s often whispered but rarely spotlighted: menopause brain. If you've ever walked into a room and forgotten why, struggled to find the right word mid-sentence, or walked into a room and wonder why you went there—congratulations, you might be in the VIP club of hormonal brain haze. But before you panic, know this: it’s real, it's common, and most importantly, it's not forever.

What Is “Menopause Brain,” Anyway?

According to Dr. Brooke Halliwell, an OBGYN at Valley View’s Women’s Health, “Menopause brain” – also known as brain fog -- is a term often used to describe constellation of cognitive changes that some women experience during the menopausal transition. These may include:

• Memory lapses or attention difficulties
• Difficulty concentrating and distractibility
• Mental fog or sluggish thinking
• Word-finding problems (the tip-of-the-tongue phenomenon)

The Science Behind It

These symptoms can be unsettling, but there’s a biological reason behind the shift: the loss of estradiol, the primary form of estrogen produced by the ovaries during the reproductive years or estrogen—a broader hormone that plays a role in brain function. When the ovaries stop producing estradiol during perimenopause it affects the entire body and deeply impacts the receptors in a woman’s brain.

Estradiol/estrogen supports the brain in several ways:

• Boosts neurotransmitter activity (which helps with mood and cognition)
• Encourages blood flow to the brain
• Protects brain cells from aging

As estrogen levels plummet, the neural circuits responsible for memory and focus can glitch. Add in other common perimenopausal symptoms such as poor sleep, hot flashes, night sweats and mood swings, and you’ve got a perfect storm for brain fog.

It’s Not All Bad News

Here's the good part: menopause brain fog isn’t permanent. Studies show that cognitive symptoms often improve post-menopause, once the body adjusts to its new hormonal baseline. Even better, there are ways to manage and mitigate the fog:

• Exercise: Regular physical activity supports both brain and heart health. Dr. Halliwell recommends physical activity of 150 minutes or more per week of activity like brisk walking, gardening, tennis, even mowing the lawn.
• Sleep: Quality sleep can sharpen cognition and reduce forgetfulness.
• Nutrition: Foods rich in omega-3s, antioxidants, and lean meats or plant-based proteins fuel the brain. Eat less sugar and stop smoking if you do.
• Hormone Replacement Therapy (HRT) Support: Cognitive changes can often find some relief with the use of Hormone Replacement Therapy (HRT), which may not directly address brain fog, but are very helpful for other symptoms which may be contributing to fogginess.
• Cognitive Engagement: Play crossword puzzles, Wordle and stay connected with friends. Join a club!

“The good news,” says Dr. Halliwell, “The prognosis for brain fog is good. This is not associated with Alzheimer’s Disease. While it’s disconcerting to feel these symptoms, the cognitive symptoms of menopause most often resolve with time during the post-menopausal period.”

Dr. Halliwell encourages those who have these and other symptoms of menopause to discuss them with their provider and view menopause brain not as a decline, but a temporary recalibration. “We have to normalize this, not only to validate these symptoms, because this is normal and women don’t have to suffer through this without support.”

If you would like to schedule an appointment to discuss your menopause symptoms, Dr. Halliwell and all Valley View Women’s Health providers are welcoming new patients. Call 970.945.2238.