Why did I open this closet door?
How did I miss that meeting?
Why am I stumbling over my words?
Where are my keys?
If these are the sorts of questions you're asking yourself lately, does it help to know you're not alone? Scientific research clearly shows that women in perimenopause can have disruption in their learning and cognition during the menopause transition. Specifically, verbal learning and verbal memory take a hit in the transition years.
The Good News
So is this a problem? Well, if the change is only caused by perimenopause, probably not. There are three points of good news about brain fog I like to share:
Brain fog in perimenopause is not an early sign of dementia (such as Alzheimer's disease), and it doesn't raise your risk for dementia later in life.
Nearly all women who notice "brain fog" will continue to function in the normal range on cognitive tests throughout perimenopause. It's a decrease for the individual person, but not technically abnormal.
Brain fog in perimenopause is temporary for most women, and for menopausal women (a year or more after the last period for those who have periods) cognitive performance tends to return to normal levels.
Something to consider, though, is that other things can cause brain fog too. If you're worried that your brain fog is affecting your life significantly, or is caused by something other than perimenopause, your health care provider should be responsive.
What Your Provider Can Do
Nobody should shrug off your concerns just because you're in perimenopause; there can absolutely be medical reasons for brain fog too. Your provider can explore your diet, exercise, supplements and sleep. They might consider testing. For instance, someone with anemia, depression, or a thyroid problem might experience brain fog too. Someone who isn't getting restful sleep will obviously not be as clear headed as someone well-rested. Researchers are also aware that long-COVID symptoms can include brain fog, and that ADHD symptoms can be amplified in peri-menopause, which may require adjustments in therapy.
While some supplements have been found to improve cognition in placebo-controlled studies, these products (including resveratrol, curcumin, citicoline and blueberries) haven't been specifically studied in perimenopause. This leaves us uncertain about whether perimenopausal women could expect the same benefit from these supplements. However, you could ask your healthcare provider whether they would recommend trying one of these, and if so, at what dose.
What You Can Do
Remember that perimenopause is a time in life when self-care becomes non-negotiable. Our bodies will speak up if we aren't getting a healthy diet, restful sleep, and controlling stress! A lot of your daily routine sets up what tomorrow and next week and next month feel like for you.
If you feel comfortable that your brain fog doesn't require medical attention, consider your current habits and see whether there is something your inner wisdom suggests changing. Has physical activity fallen off the list? Does a dietary shift seem in order? You may appreciate knowing that people who follow the Mediterranean Diet tend to perform better in the long-term on cognitive tests. And this diet reduces risk of dementia too! However you care for yourself, I hope you find the support you need to thrive in your menopause transition.