Approximately 1.3 million women in the United States reach menopause every year. Menopause, marked by the absence of menstrual periods between the ages of 45 and 51, is preceded by perimenopause. Perimenopause typically begins in the mid-40s and lasts around 5 to 15 years. During this time, women experience significant hormonal changes in their bodies, which can lead to a range of common symptoms caused by an imbalance of hormone levels, particularly estrogen. These symptoms include hot flashes, insomnia, night sweats, low mood, and difficulty concentrating, referred to as “brain fog.”

What is perimenopausal brain fog?

Brain fog is the inability to concentrate, think, or reason. Perimenopausal women experience feelings of mental confusion, uneasiness, and sadness.

Cognitive research indicates that perimenopausal women experience brain fog more frequently (around 60%) than menopausal women (11-13%), who may experience significant mental problems.

What are the signs of perimenopausal brain fog?

These are the foremost common signs of brain fog that perimenopausal women may experience:

1. Low verbal memory, which can cause temporary memory loss. This can manifest as difficulty recalling words, numbers, stories, or names.
2. Short-term working memory can lead to an inability to focus or complete multiple tasks simultaneously. For example, you might have difficulty remembering a new email address while typing or writing the email.
3. Poor attention, which means trouble concentrating. This can result in forgetting items like keys or appointments.

Why does brain fog appear around perimenopause?

The imbalance of sex steroid hormones such as estrogen and progesterone can disrupt brain functions and cognition, leading to brain fog during perimenopause. This is due to the interference with brain neurotransmitters such as serotonin, dopamine, and cortisol.

How does the hormone estrogen affect brain functions?

Estrogen has an impact on brain functions and memory. When estrogen declines at perimenopause, specific parts of the brain are affected, which modifies several aspects of the brain. This results in poor sleep, mood change, depression, and anxiety.

What are some practical ways to alleviate brain fog?

Studies have shown that estrogen therapy may have positive effects on cognitive function. However, there have been inconsistent outcomes in perimenopausal women. If you do not wish to undergo hormone therapy, you can still make lifestyle changes to prevent brain fog. Let’s consider some of these possibilities:

1. Estrogen therapy

Estrogen therapy through oral pills may positively impact the memory of menopausal women. However, it is still unclear whether perimenopausal women will benefit from estrogen therapy as the evidence is insufficient. Studies on estrogen therapy have been conducted on menopausal women and have not shown any significant effects. However, some studies suggest that estrogen therapy may improve memory in women undergoing severe menopausal symptoms.

2. Physical activity

Regular physical activity has been shown to have numerous benefits, including enhancing cognition and potentially preventing memory loss later in life. Engaging in moderate to high-intensity exercises, such as running, jumping, cycling, or swimming, can increase blood flow to the brain, which in turn can stimulate the growth of neuron cells.

The World Health Organization (WHO) recommends that individuals engage in at least 150 minutes of moderate-intensity or 75 minutes of high-intensity aerobic exercise per week to boost brain health. However, even walking can positively impact your overall health and well-being if you cannot engage in high-intensity activities. So, take small steps towards a more active lifestyle and reap the benefits!

3. Mediterranean diet

Maintaining a balanced diet can help to reduce the risks of heart disease, diabetes, and obesity, which are all associated with a decline in brain function. When you eat healthily, you care for your heart and brain, which is a win-win situation!

Several studies suggest that adhering to a Mediterranean diet (MedDiet) could improve cognition and delay brain dysfunction. The MedDiet comprises plant-based foods, whole grains, healthy fats, plenty of fruits and vegetables, seafood, and nuts.

A study conducted on perimenopausal women indicates that following the MedDiet is linked to a lower incidence of brain fog and better cognition than the group that follows a diet primarily reliant on meats.

4. L-theanine supplement (green tea)

L-theanine, an amino acid found in green tea, particularly matcha, has been shown to improve brain function and reduce symptoms of depression. A small study conducted among middle-aged men and women who had difficulties with cognition showed that taking L-theanine supplements can significantly improve working memory and attention. So, stocking up your shelf with green tea is a good idea.

5. Brain activities

Engaging in mental exercises is just as vital as physical activity. You can improve your cognitive and memory functions by participating in activities such as playing memory games, reading, writing, solving puzzles, learning a new language or skill, playing games, or volunteering. Keeping your brain cells busy can significantly enhance your mental abilities. So, don’t forget to exercise your mind!

6. Social engagement

It is essential to stay connected with others as social and leisure activities can protect the brain. On the other hand, social isolation and loneliness can increase the risk of depression and cognitive decline. Recent studies suggest that employed women during perimenopause have better cognitive performance than those not, highlighting the importance of mental, physical, and social lifestyles.