What is brain fog?
Brain fog is that time you walked into the kitchen to get a pen and ended up staring into the freezer.
It can include everything from trouble with memory and concentration to difficulty processing information, solving problems or coming up with words. Women who have had children report that it’s similar to baby brain. It’s frustrating and disorienting, and can make you want to go out and take action–if only you could remember why!
Because the symptoms of brain fog are so general, it can sometimes be misdiagnosed as mild cognitive impairment–which is linked to early onset dementia or Alzheimer’s disease–and this can be scary. But dementia and Alzheimer’s are progressive conditions that get worse over time, whereas brain fog should clear up in the years after menopause (when your period finally stops) as your brain adjusts to lower estrogen levels.
What’s the cause?
Brain fog is caused by the fluctuation and decline of your hormones, mainly estrogen. Certain other factors can contribute to how it feels, including those that disrupt your sleep (damn you, hot flashes!) or those that cause stress, anxiety and depression.
What’s happening inside your body?
The areas of your brain that are associated with memory are also rich in estrogen receptors, specifically those for estradiol, a type of estrogen produced by your ovaries. This means that when estrogen starts to drop during perimenopause and menopause, these memory regions can be under-stimulated, which can lead to the feeling of “brain fog” and other cognitive problems.
How is brain fog diagnosed?
A doctor can diagnose you based on your description of your symptoms and health history.
What does the research say?
- The American Journal of Epidemiology published a study showing that perimenopausal women were 1.4 times more likely to self-report forgetfulness than pre-menopausal women.
- Follow-up research on the Study of Women’s Health Across Nations (SWAN) discovered that there was a decline in cognitive performance in perimenopausal women that rebounded post-menopause.
- A 2016 study in the Journal of Neuroscience found that lower concentrations of 17β-estradiol (a type of estrogen produced in your ovaries and also used in estradiol therapy) were related to poorer performance on memory retrieval tasks.
What are effective treatments?
- Estradiol: Estradiol replenishes the exact form of estrogen that your ovaries are no longer producing as you approach menopause. (Remember, it’s your decreasing levels of estrogen that are causing the feeling of “brain fog” in the first place.) There are many recent studies that show that taking hormonal therapies such as estradiol in the perimenopausal/menopausal years may have some cognitive benefits. However, they are not yet conclusive and further research is needed.
What are some non-medical treatments?
While less effective than the medical treatments, some women find that these help:
- Nutrition: Several studies have shown that people who consume a Mediterannian diet–low in sugar and carbohydrates, and high in healthy fats, produce and protein–have a lower risk of cognitive decline. The diet features foods rich in omega 3s, antioxidants and spices that may help fight inflammation.
- Supplements: Certain nutrients such as vitamin D, vitamin B12 and fats such as omega-3s have been associated with cognitive benefits.
- Physical exercise: Exercise has been linked to improved function of the hippocampal area (responsible for verbal memory and learning).
- Meditation: Studies on meditation have tied it to benefits in memory, attention and verbal fluency (goodbye words on the tip of your tongue!). It may also help prevent cognitive decline.
- Memory exercises: Similar to other non-medical treatments on this list, some studies and many articles promote the benefit of memory exercises like Sudoku and crossword puzzles.
What to do next:
- Connect with an OBGYN who treats menopause: Many doctors will list their specialties/areas-of-interest on their website, or you can ask when making your appointment.
- Determine your options: Collaborate with your doctor to identify and understand the treatment options available to you given your medical history.
- Decide what works for you: You know your body best. Select your treatment and keep communicating with your doctor to make sure it’s working optimally for you.
Are you experiencing other symptoms that you want to better understand and learn how to treat and manage them? Check out our following guides:
This article was reviewed by Emily Hu, MD