Brain Fog at Menopause

What is menopause brain fog, can you do anything about it? This highly incapacitating menopausal symptom is not emphasised and contributes to the appalling mental health aspects of menopause and potentially brain health in later life. It is known that menopause brain fog affects about two-thirds of menopausal and perimenopausal women.

What is menopause brain fog?

The menopause brings hormonal changes and its debilitating symptoms that often clash with our busy lives. On top of hot flushes, night sweats poor sleep, weight gain and a host of other symptoms women can experience brain fog too.

Brain-fog is an apt name because this is how it feels. It is difficult to explain; a fuzzy head that makes it hard to think and plan, lack of focus and concentration forgetfulness. Cognitive impairment is the ‘proper’ term referring to difficulty remembering, learning new things, concentrating, or making decisions that affects everyday life and ranges from mild to severe. Brain fog can occur at any time in our lives, due to lack of sleep, stress, food intolerances and even medication or a medical condition. However, foggy brain dramatically increases around menopause.

What causes menopause brain 

Women often need reassurance that they are not going mad when ‘menopause brain’ kicks in. Firstly, they often don’t realise they are in perimenopause, the transition time before actual menopause when monthly cycle ceases. Secondly because they didn’t know it was a menopause symptom. Research is only just discovering all the factors that explain a lack of mental clarity at menopause and beyond. Menopause brain is recognised by scientists as a very real problem.  Understanding what is really going on can motivate lifestyle changes to reduce your brain fog.

Hormonal changes

It occurs due to changing hormone levels on the female brain. Progesterone is often the first hormone level to drop and can be associated to irritability, mood swings and brain fog it can also cause sleep disruption which may impact the brain’s capacity to function. This is similar to premenstrual syndrome.

Oestrogen fluctuates and lowers throughout the menopause transition and ‘Brain-fog’ including memory loss is also caused by low levels. This hormonal change affect the hippocampus region of the brain that is critical for memory processing. Brain fog is often worse when we are feeling stressed, busy, and overwhelmed. This region also controls motivation and emotion which may explain why this happens. Oestrogen directly targets the brain and is protective. It also influences brain function through effects on the blood vessels and the immune system.

Hot flushes and night sweats

The link between these Vasomotor symptoms (VMS) and cardiovascular (heart) and brain health is a relatively new discovery. There is a correlation between the severity of hot flushes and verbal memory skills and brain health. With 70% of women experiencing VMS it raises questions about the continuity of VMS post menopause and later life cognition and brain health

Other risk factors from VMS include raised cortisol, the stress hormone that released by the adrenal glands in response to stress, this increases inflammation and health risks like cardiovascular disease or diabetes. Any menopausal woman knows that night sweats and flushes impact on sleep. Poor or interrupted sleep has implications for brain health as it raises inflammation.

The happy hormone serotonin

Serotonin is a powerful mood boosting hormone and brain chemical which decreases at menopause. Highly likely the reason women get placed on anti-depressants in menopause. If you have poor gut health this can exacerbate the problem as these brain chemicals are made in in the gut!  Supporting gut health, aerobic exercise, regular sleep are all serotonin boosting strategies

Dementia or Brain Fog

Dementia is a growing health problem largely due to inflammation in the brain often resulting from cardiovascular problems. Nevertheless, in menopause forgetfulness and lack of focus is more likely due to hormones.  Brain fog often improves post menopause and is not linked to any increased risk of dementia or Alzheimer’s disease. Cloudy thinking is also very different from cognitive problems associated with dementia or Alzheimer’s disease. They affect more than memory and change your ability to function in your daily life.

What to do about Brain Fog 

It is important to rule out the general causes of brain fog plus increase brain and nerve supporting nutrients.  

Get sleep!

The brain and body heal when you sleep, a lack of sleep will jeopardise our memory and immunity. As we get more exhausted serotonin levels drop and melatonin (our sleep hormone) stops rising high enough in the evening to make us sleepy. Bear in mind serotonin makes melatonin too and is reduced by low oestrogen. Between 2 and 4am our memory is consolidated, so waking up affects the quality of our sleep. Our memory bank is not restoring properly.

Regulate Blood sugar

Our brain needs glucose to function it is one of the few nutrients that crosses the blood-brain barrier and is the brains main source of energy. Your brain is so rich in nerve cells, or neurons, that it is the most energy-demanding organ, using one-half of all the glucose energy in the body. Regulating blood sugar means eating regular meals with protein and fibre from whole foods.


As busy women, we are often multi-tasking juggling demanding work and family. Our brains are working hard when this is constant and the nerves in the brain become hyper-excitable. This increases stress hormones, anxiety, forgetfulness and potentially inflammation when chronic. This is what can cause long term problems in our brains.

What to eat for menopause brain fog

An anti-inflammatory diet like the traditional Mediterranean one really supports our brain! The Brain health thrives on healthy fats, proteins, and whole foods just like our bodies. The brains energy requirement is greater, and it needs some specific nutrients for this energy production. Additionally our brains perform a huge amount of neuron communication which requires neuro transmitters (brain chemicals). Certain nutrients can support and enhance this.


Obvious but often neglected drinking 2 litre of filtered water daily works wonders for out brain.  Since 75% of the brain is made of water any level of dehydration can compromise cognitive functions, like forgetfulness and poor concentration.

Omega 3 fats

The brain is nearly 60% fat, so fatty acids shape your brain’s structure and ability to perform. Essential fats are crucial part of cell membranes supporting this. This can improve mood and cognitive functions.  They are also key for menopause supporting vaginal dryness, joint pain, skin and hot flushes by their anti-inflammatory effect. They have a natural triglyceride-lowering effect, important as post menopause this tends to be higher.

Sources Oily fish, salmon, mackerel, anchovies, sardines. Vegetable sources flax, walnuts, and almonds contain alpha linolenic acid that can be converted to omega 3 but a better vegetarian’s source is sea algae.

Soy isoflavones

Phytoestrogens or dietary oestrogens are naturally occurring in plants. They imitate oestrogen because of their similar chemical structure. The oestrogen receptors treat them as if they were oestrogen they do not bind to receptors as firmly as oestrogen produced by the body, so their effects are weaker and safe. There is good evidence for improving overall menopause symptoms and brain function throughout menopause.

Sources Flax seeds, almonds, soy beans and products like tofu , apples, carrots, alfalfa sprouts, lentils.

B vitamins 

The whole range of B vitamins engage in cellular function and subsequently mood, anxiety, and stress. Several are key for the brain and nervous system. They include Folate, choline, inositol, B2, B6, B5 and B12.

Sources Easily found in many foods, dairy, eggs, meat, fish, dark green vegetables, whole grains, beans, nuts. Vegans may lack vitamin B12 and folate essential for neurotransmitters that support the feelings of wellbeing.


This is an essential nutrient for normal function and required to produce acetylcholine, a key brain chemical for memory and learning and problem solving.  Choline is needed for the fats that make up cell wall structure, involved in cell communication, and DNA synthesis. Deficiency is rare but post-menopausal women in studies seemed more at risk of liver or muscle damage on a choline deficient diet.

Sources egg yolks, red meat, cod, tilapia, chicken breast, and legumes.


Known as the ‘spark of life’ because of its effect to lift mood, support energy and promote relaxation and sleep. This makes it important at menopause. Additionally older adults and women are more likely to be deficient. Magnesium may alleviate depression at perimenopause and post menopause. It has a key role in brain function, mood and stress response that can lead to depression. It affects several areas crucial for menopause.

Brain function 

Magnesium acts as the gatekeeper for receptors, found on nerve cells that support healthy brain development, memory, and learning. It prevents the over stimulation by weak signals. Low magnesium leads to less receptors blocked and more stimulated regularly. This overstimulation can kill nerve cells and may cause brain damage.


Menopause is physically and psychologically stressful. Magnesium has a significant role regulating our stress response. Chronic physical or mental stress depletes your body of magnesium, which increases stress creating a vicious cycle. Studies suggest increasing magnesium intake may lower anxiety, relieve stress and decrease response to fear.

I have a blog all about this favourite mineral

Sources Different coloured veggies, beans and lentils and nuts and seeds.

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Bromberger, J. T., & Kravitz, H. M. (2011). Mood and Menopause: Findings from the Study of Women’s Health Across the Nation (SWAN) over ten years. Obstetrics and Gynecology Clinics of North America, 38(3), 609.

Fischer, L. M., da Costa, K. A., Kwock, L., Galanko, J., & Zeisel, S. H. (2010). Dietary choline requirements of women: effects of estrogen and genetic variation. The American Journal of Clinical Nutrition, 92(5), 1113.

Newcomer, J. W., Farber, N. B., & Olney, J. W. (2000). NMDA receptor function, memory, and brain aging. Dialogues in Clinical Neuroscience, 2(3), 219.

Thurston, R. C. (2013). Cognition and the menopausal transition: Is perception reality? Menopause, 20(12), 1231–1232.