Understanding Menopausal Brain Fog

Published

Oct 14, 2025

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Forgetfulness and memory lapse are often associated with ageing. However, they are also relatively common during menopause. Brain fog is one of the many symptoms of perimenopause and menopause and has been described as a ‘cotton wool’ feeling. This popular term describes cognitive symptoms which may include forgetfulness, difficulty concentrating, inability to think clearly or problem solve, confusion or even decreased ability to multi-task.  You may experience difficultly remembering or recalling names or words, writing endless to-do lists or find it hard to retain information, which, depending on the severity, can interfere with work and daily life.  If you are experiencing menopausal brain fog, it is important to know you are not alone, and support is available.

Why does menopausal brain fog happen?

The two main hormones, oestrogen and testosterone, both play an important role in cognition and memory.  When the levels of these hormones start to decline during perimenopause and menopause, this can lead to a range of cognitive symptoms such as memory loss, difficulty focussing, finding work difficult, losing train of thought, and getting easily confused.

Oestrogen stimulates the brain, keeping it firing, and supports the growth of new cells, helping existing cells to form new connections. Testosterone helps to strengthen the nerves in the brain and contributes to mental sharpness and clarity, and energy levels. Testosterone also strengthens the arteries that supply blood flow to the brain, which helps protects against loss of memory.

Managing menopausal brain fog

Taking hormone replacement therapy (HRT) may help, although this is an individual choice and a conversation to have with a medical practitioner to determine if suitable. However, we can also support brain health with lifestyle changes:

  1. Stay hydrated. The brain is comprised of 75% water and, when dehydrated, it influences our concentration and energy levels. Make sure you are staying hydrated throughout the day with non-caffeinated drinks. Consider adding fresh fruit to your water for some flavour and remember that herbal teas count towards your hydration.
  2. Get moving. Regular exercise is important for a healthy brain, as it improves the blood flow to the brain. Research suggests it may increase working memory and improve the speed of processing information.  Moving daily will also have positive benefits on mood, heart and bone health, and weight management.  It is important to keep active by doing an activity you enjoy.
  3. Balanced diet. A healthy diet is great for cognition, especially a diet rich in healthy fats (from oily fish, nuts and avocado) and high in fibre (from fresh vegetables, legumes and beans and fruit).
  4. Rest and deep sleep. Trouble sleeping is also common during perimenopause and menopause as the brain cannot regularly sleep well without oestrogen and progesterone. If you are having difficulty sleeping, or are waking frequently, you are missing deep sleep, a time that is restorative for the body and brain. Consider taking steps to improve your sleep, such as guided meditation, sleep stories or reducing screen time.
  5. Manage stress. High levels of stress may disrupt your sleep\. Therefore, putting into place helpful coping strategies, such as journaling or talking to someone about your stresses, can improve your sleep and mood.
  6. Exercise your mind. Your brain also needs a good workout. Therefore, learn something new; try a puzzle, read a book, listen to a podcast, or even try a new recipe.  Learning a new skill, or challenging your brain, helps to build new brain connections. Getting out socially may also help.