Wondering why you have brain fog during perimenopause and what you can do about it? Read on for brain fog causes, solutions and strategies!

Complete Guide: Understanding Brain Fog in Perimenopause

Brain fog is a common symptom experienced by many women during perimenopause, i/e the 2-8 years before menopause. Perimenopause is characterized by hormonal fluctuations, particularly in estrogen and progesterone levels, which can impact cognitive (brain) function.

Brain fog refers to a range of cognitive symptoms, including forgetfulness, difficulty concentrating, mental fatigue, and confusion. It can interfere with daily life, relationships, and work performance to varying degrees.

Each woman has their own unique experience so symptoms can vary.  Sometimes, the symptoms can get better as women get closer to actual menopause (the day you go one year without a period) and sometimes they don’t.

Understanding the causes, duration, and treatment options for brain fog is helpful in trying to navigate this annoying perimenopause symptom so read on for more help!

Key Takeaways:

• Brain fog is a common symptom during perimenopause.
• Hormonal fluctuations, particularly estrogen and progesterone, contribute to brain fog.
• Symptoms of brain fog include forgetfulness, difficulty concentrating, mental fatigue, and confusion.
• Brain fog sometimes improves as women progress through perimenopause and get closer to actual menopause.
• Effective management strategies include lifestyle changes, natural remedies, and, in some cases, bioidentical hormone replacement therapy (HRT).

What causes brain fog in perimenopause?

Hormonal imbalance and disruption play a significant role in causing brain fog that starts in perimenopause.

Hormonal fluctuations and cognitive function

Fluctuations in estrogen, progesterone, and testosterone levels can significantly impact cognitive function.

Estrogen boosts learning and memory through the hippocampus, the brain’s memory center. It also helps emotional health and boosts mood when it is balanced. During perimenopause, estrogen can follow a roller coaster-type pattern, often spiking and creating a situation of estrogen dominance during the initial few years.  Conversely, it gradually drops during the last phase of perimenopause, i/e the time close to actual menopause.

Similarly, progesterone, which also affects the brain, drops during this transitional phase.  This can contribute to brain fog and poor sleep, which can make brain fog worse.  Estrogen also impacts sleep, demonstrating another way that estrogen can impact your brain.

Testosterone, although present in smaller amounts in females, can also influence cognitive function and contribute to brain fog during perimenopause.  Testosterone improves blood flow, nerve function, and energy levels in both men and women.

Additionally, increased levels of cortisol, a stress hormone, during perimenopause can further exacerbate brain fog.  Check out my blog on cortisol and estrogen dominance to find solutions to cortisol imbalance.

What does brain fog feel like in perimenopause?

Brain fog in perimenopause and menopause is characterized by a range of cognitive symptoms that can vary in severity and be different in each woman.

Symptoms of perimenopause mental changes

Common symptoms of brain fog include:

• Forgetfulness
• Difficulty remembering information
• Trouble focusing or concentrating
• Mental fatigue

Women may also experience lapses in memory, such as forgetting names, appointments, where they placed objects, or why they walked into a room (totally raising my hand on this one).

These symptoms can be frustrating and challenging to deal with, but they are a normal part of perimenopause.  Working on the changes noted here and in my other perimenopause blogs can help reduce the above symptoms and make life a bit easier.

How long does perimenopause brain fog last?

The duration of perimenopause brain fog can vary for each individual, depending on factors such as overall health, hormonal fluctuations, stress, diet, sleep, and overall lifestyle. Brain fog typically starts during the early stages of perimenopause and may continue for several years.

As women progress through perimenopause and estrogen levels drop, brain fog can get worse, get better, or stay the same.  Helpful, right? I know it’s tricky, but the recommendations below can help improve brain function.

How do you get rid of brain fog during perimenopause?

It’s not all doom and gloom; the purpose of this site is to support you during this crazy time. So, here are some ideas for support for your brain!

Strategies for managing brain fog in perimenopause and menopause

Fortunately, there are several strategies that can help alleviate and manage brain fogginess:

• Adopt a brain boosting lifestyle: Regular exercise, a balanced diet, and sufficient sleep can all contribute to improved cognitive function and mental clarity.
  • Exercise boosts blood flow to the brain.  Which type of exercise? Finding something you enjoy is the most important thing.  It’s also important to choose a type of exercise that’s not too stressful for your body.  If you feel good after you exercise, that’s a good sign.  If you feel depleted, that’s not.  Yoga and Pilates can pull double duty because of the focus on breath and movement, allowing a slower pace and helping to manage stress too. Avoid or limit alcohol as it impacts sleep, memory and brain health negatively.
  • Eat a supportive diet that provides essential nutrients for brain health.  Getting half of your lean body weight in protein grams is helpful, as is avoiding sugar, which tends to raise and crash your cortisol levels and damage your estrogen-to-progesterone ratio.  Try to get plenty of healthy fats too, like avocado, nuts, seeds, and olive oil.
  • Prioritize quality sleep.  What this means is trying to be consistent with your bedtimes and waketimes to help balance your cortisol. Ideally get to bed by around 10pm and wake up around 6am, and keep your room a cooler temperature, 68-70F.  Don’t watch TV, be on your phone or any device within 60 minutes of bedtime if possible.  Aim for 7 to 9 hours of sleep.  If you have trouble sleeping through the night, check out some of my other blogs and videos, and talk with your healthcare provider.
• Engage in mental stimulation: Keeping your brain active and engaged through activities like puzzles, reading, and learning new skills can help combat brain fog. These activities stimulate neural connections and promote cognitive agility, contributing to better mental clarity.
• Manage stress: Chronic and acute stress can both worsen brain fog symptoms. Implementing relaxation techniques such as meditation, deep breathing exercises, or yoga can help reduce cortisol levels, promote relaxation, and improve brain function.  I often find that word-finding problems are strongly correlated with stress levels in myself and my patients.  Other helpful stress-reducing steps include walking or hiking out in nature, even if it’s just in a local park or walking outside wherever you live, journaling, practicing gratitude, Epsom salt baths, and cognitive behavioral therapy.
• Prioritize self-care and seeking support: Taking care of your overall well-being is essential in managing brain fog during perimenopause. Prioritize self-care activities that bring you joy and relaxation, such as engaging in joyful and stimulating hobbies, spending time with friends and family that you actually enjoy hanging out with, or seeking support from healthcare professionals or support groups. These resources can provide guidance, support, and comfort, and help to reduce stress levels, cortisol levels, improve sleep, and reduce brain fog.

By incorporating these strategies into your daily routine, you can help reduce brain fog and improve your overall cognitive function and mental clarity.

Natural Treatment for Perimenopause Brain Fog

Perimenopause brain fog can be managed with natural remedies and supplements in addition to lifestyle changes. These natural interventions can help improve cognitive function and alleviate these symptoms. Here are some effective options:

1. Omega-3 fatty acids: Found in fish oil, algae oil, chia, walnut, or flaxseed oil, omega-3 fatty acids have been linked to improved brain health and cognitive function. These supplements can support overall cognitive performance and may help alleviate brain fog symptoms.  When choosing an omega 3 it’s important to check the potency.  Unless you are on a blood thinner or have a clotting disorder (in which case you should talk with your doctor), a healthy goal for most people is 1000-2000 mg of EPA plus DHA.  Here’s one of my favorite options for a potent and well tolerated fish oil, and algae based (vegetarian) option.
2. Vitamin B complex: Specific B vitamins, such as B12 and B6, are crucial for brain health. Folate, in it’s natural form not synthetic folic acid, may also help prevent long term memory loss and dementia risk.  Taking a vitamin B complex supplement may help support brain function and alleviate symptoms of brain fog during perimenopause.  Here’s my favorite b- complex that I take myself!  I love it because it has the most active form of each b vitamin, including methylated folate and p-5-p for vitamin b6.
3. Adaptogenic herbs: Herbs like Rhodiola, ashwagandha, ginkgo biloba, sage, and holy basil are known as adaptogens. They can help the body adapt to stress and hormone imbalance and reduce its impact on cognitive function. These herbs may improve mental clarity and reduce the severity of brain fog. I have not found a great blend with all of these, but here is my favorite with ashwaganda, rhodiola, and holy basil.

Incorporating these natural herbs, oils, or vitamins into your daily routine can reduce the frequency and intensity of hormonal brain fog. However, it is important to consult with a healthcare professional before starting any new supplements or making significant changes to your regimen.

	Omega-3 Fatty Acids	Vitamin B Complex	Adaptogenic Herbs
	Fish oil or Algae/AhiFlower Oil	B12 and B6	Rhodiola and Holy Basil
	Flaxseed oil	Folate	Gingko Biloba
	Chia Seed and Walnuts		Ashwagandha and Sage

Bioidentical HRT: Can it help brain fog?

Bioidentical Hormone Replacement Therapy (HRT) may also offer a solution for perimenopause brain fog. By using hormones that are chemically identical to those naturally produced by the body, bioidentical HRT has the potential to address the above hormonal imbalances and therefore help reduce brain fog.

BioHRT works by restoring hormonal balance, including levels of estrogen, progesterone, and sometimes testosterone, which can alleviate brain fog and improve cognitive function. Replacing low hormones can also help sleep, which in turn helps brain fog.  Before even considering bioHRT you would need to have your hormone levels assessed.

It’s important to note that the decision to pursue bioidentical HRT should be made in consultation with a healthcare professional. They can evaluate an individual’s specific symptoms, medical history, family history, and overall health to determine the appropriate and safe course of treatment. While bioidentical HRT offers potential benefits, you need to weigh the potential risks and side effects associated with hormone therapy.

Conclusion

Brain fog is a common annoying symptom resulting from hormonal fluctuations and other factors. Take a look at the above causes for perimenopause cognitive changes and discuss them with your doctor. By implementing lifestyle changes, exploring natural remedies, and, in some cases, considering bioidentical hormone replacement therapy (HRT), women can feel better and have more mental clarity.

Each woman may experience brain fog differently, highlighting the importance of finding personalized and unique strategies for managing it. Seeking guidance from healthcare professionals and integrating self-care practices are key to navigating the challenges associated with brain fog during perimenopause.

Functional Medicine Practitioners and Integrative Medicine providers are uniquely trained to work with you on brain fog during perimenopause or at any other time of your life.  This approach looks at you as a whole person, assessing your complete lifestyle history before designing a plan uniquely made for you!

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• 5 Most Popular Perimenopause Test Online Kits- Honest Review!