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Brain Fog: addressing this perimenopausal symptom head on!

Updated: 4 days ago

"Brain fog" refers to a state of mental confusion, haziness, or difficulty in maintaining clear and focused thinking.

Brain fog caused by hormonal changes during menopause is often a genuine concern for women. Many of the women I see in the clinic wonder if they might be developing dementia, which is undoubtedly a frightening notion.

I myself experienced reduced sharpness, increased forgetfulness, struggles with word retrieval, and difficulties in articulating my emotions and thoughts before commencing Hormone Replacement Therapy (HRT).


Ladies arm holding a brain. Brain fog symptoms of the menopause
Brain fog: cognitive symptoms in the menopause

Individuals grappling with brain fog frequently express sensations of sluggishness, disorganisation, or unclear thoughts. These sensations can significantly impact various cognitive functions, including memory, decision-making, problem-solving, and information processing. Consequently, these symptoms often become more noticeable in professional settings and social situations. Many of my patients have described feeling embarrassed about their lack of short-term memory, inability to construct coherent sentences with the right words, or difficulty in finding the appropriate terminology.

Brain fog can be attributed to various lifestyle factors, such as inadequate sleep, stress, medication, diet, and harmful substances. Nonetheless, certain underlying medical conditions can also induce brain fog symptoms. These conditions encompass hormonal fluctuations occurring during perimenopause, pregnancy, or thyroid hormone imbalances. Managing brain fog as a perimenopause or menopause symptom requires thoughtful approaches.


Can HRT treat brain fog symptoms?


While hormone replacement therapy (HRT) can notably improve brain fog symptoms, the inclusion of testosterone can sometimes be pivotal in addressing this issue. Nonetheless, other essential lifestyle factors merit consideration:

  1. Prioritise Quality Sleep: Ensure you consistently achieve restful sleep, aiming for 7-9 hours per night. Cultivate a calming bedtime routine to signal to your body that it's time to unwind.

  2. Reduce Stress: Engage in stress-reduction techniques, such as mindfulness, deep breathing exercises, meditation, or yoga. Effective stress management can considerably enhance mental clarity.

  3. Stay Hydrated and Maintain a Balanced Diet: Sustain adequate hydration throughout the day and follow a well-rounded diet rich in fruits, vegetables, lean proteins, and whole grains. Minimize excessive sugar and processed foods.

  4. Engage in Regular Exercise: Incorporate regular physical activity into your routine. Exercise bolsters blood flow to the brain and can contribute to improved cognitive function.

  5. Break Tasks into Manageable Steps: When facing cognitive challenges, break tasks into smaller, more manageable components. This strategy can avert overwhelm and facilitate better focus.

  6. Foster Organisation: Utilise tools such as calendars, planners, or digital apps to stay organised and monitor tasks and appointments. This practice reduces mental clutter and enhances clarity.

  7. Minimise Distractions: Curbing distractions during work or study sessions is essential. Identify a quiet, well-lit space where you can concentrate without interruption.

  8. Engage in Cognitive Exercises: Participate in activities that challenge your intellect, such as puzzles, crosswords, Sudoku, or acquiring new skills. These mental exercises can elevate cognitive function.

  9. Maintain Social Engagement: Sustain connections with friends and family. Engaging in conversations and social activities fosters mental stimulation.

Can HRT prevent dementia?


There is some evidence to suggest that Hormone Replacement Therapy (HRT) may have a role in reducing the risk of dementia. Particularly in women who initiate HRT around the time of menopause. There are more clinical trials demonstrating the positive effects for improving risk against cognitive decline in women who have a menopause before the age of 40, know as premature ovarian insufficiency (POI). However, it's important to note that the relationship between HRT and dementia risk is complex, and research findings can sometimes be nuanced.

Some studies have indicated that starting HRT, especially estrogen therapy, closer to the onset of menopause might have potential cognitive benefits. Estrogen is known to have effects on brain health, including promoting neuronal survival, enhancing blood flow to the brain, and influencing neurotransmitter systems. These effects could contribute to a reduced risk of cognitive decline and dementia.


Addressing brain fog symptoms can markedly improve your cognitive clarity and self-assurance. For further discussion, please don't hesitate to reach out to Kate or Katie at our menopause clinic.





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