The Menopause

Brain fog and the menopause – why it happens, symptoms and real life experience

Feeling like your brain has turned into a big ball of fluffy cotton wool? Brain fog is a common symptom during perimenopause and menopause.

Brain fog can manifest in a number of ways. For instance, you may be increasingly aware that you’re becoming more forgetful, or perhaps are misplacing items around your home (where on earth are your keys?!). Getting names of family and friends muddled up, or struggling to concentrate are also signs that you’re experiencing a loss of mental clarity.

Such changes can have a direct impact on our self-esteem and can affect our relationships or performance at work. Perhaps even more worrying is that these changes can sometimes be wrongly confused with signs of dementia.

Here, we delve into brain fog and menopause. We explain what you can do to ease things and share one woman’s experience of dealing with this symptom.

Why does brain fog occur during the menopause?

As with most menopause symptoms, changing hormone levels in the body are to blame for brain fog.

According to The Menopause Charity, estrogen and testosterone play an important role in cognition and memory. Dropping levels of these hormones can cause symptoms such as memory loss, having trouble concentrating and losing your train of thought.

Can you ease symptoms?

A HRT prescription can help to ease the symptoms of menopause, including brain fog. That’s because HRT replaces the hormones that have dropped during this time.

Sleep is also really important in helping to ease brain fog. It’s important for our brain health, so prioritise good quality slumber.

Avoid caffeine, leave screens out of your bedroom, and opt for blackout blinds. Ear plugs and an eye mask may also be helpful for avoiding extra disturbances. Maintaining a healthy diet can also help, as can regular exercise.

“Concentrating became tricky, I lost focus easily and, worryingly for a professional writer, I began to struggle to find the right words.”

We spoke to 49-year-old Kate Lucas, a copywriter from Warwickshire, who experienced brain fog when she hit the menopause.

After a “lifetime of being a good sleeper”, Kate first noticed signs of the menopause when she began to wake in the night.

“About two years ago – during Covid times – I first started noticing some changes,” she explains. “I was 47 and had begun waking at 3 or 4am, not able to get back to sleep after a lifetime of being a good sleeper.

“It wasn’t every night, just the two or three days before my period was due. Then it increased to the week before. At the same time my periods were getting much heavier.”

As for her brain fog, Kate says it “crept up” on her and it was hard to pinpoint the cause at the time. Looking back now, she realises she was perimenopausal.

“At the time it was hard to know if it was just general lockdown/Covid blah-ness, home-school fatigue or something else, but concentrating became tricky, I lost focus easily and, worryingly for a professional writer, I began to struggle to find the right words,” Kate recalls. “I also felt unmotivated and generally flat. But then didn’t everyone during Covid times?”

While some may find these changes alarming and worry they may be indicative of another health condition, Kate began researching her symptoms.

“I had been researching perimenopause and regularly listened to podcasts (including Liz Earle Wellbeing’s),” she says. “The more I read, the more I wondered if it was hormonal.”

Seeking help

Kate then made an appointment with her doctor, and she was tested for anaemia. The results showed she was anaemic as a result of the heavy periods.

“Extra iron helped the fatigue, but not the brain fog,” she says. “[The doctor] had also suggested a Merina coil as a first-stage HRT treatment but I really didn’t want a coil. I wasn’t able to have the medication usually prescribed for heavy periods due to contraindications. I left the GP [appointment] thinking I’d have to do more of my own research.

“Around that time I heard Dr Louise Newson talking about the menopause on Radio 4. I couldn’t believe it when I realised her Menopause Clinic was local to me. So I made an appointment.”

Finding the right treatment

Kate explains: “The doctor I saw at Newson Health was extremely thorough and gave me a range of options including a gradual HRT plan. She suggested starting on progesterone tablets only first, and then adding Oestrogel gradually to see if the symptoms resolved.

“I took her letter to my GP, who wasn’t familiar with my (fairly basic) treatment plan. There was some back and forth between the clinic and my GP, but eventually the GP was happy to follow the plan suggested by the Newson Health doctor.”

While her treatment plan resolved her other symptoms after several months, Kate says her brain fog and “flatness” remained.

“I was so happy to be sleeping again and no longer house-bound for a few days each month by heavy periods,” Kate shares. “But the loss of mental acuity remained so, as per my plan, I went to a new GP and asked for a blood test to check my testosterone levels.”

She continues: “They came back as really low, so my GP was happy to prescribe it off-licence, based on the Newson Clinic doctor’s recommendations and my test results.

“I know many GPs aren’t able or willing to do that, but I got lucky. After several weeks of titrating the dose, I began to feel the benefit.

“My word power – and general motivation for life – had come back!”

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