Brain Fog During Menopause: Understanding What's Going On
Brain fog is a common symptom of perimenopause and menopause, but it isn’t formally diagnosed by a doctor. Brain fog might look like difficulty focusing, experiencing forgetfulness, or thoughts that are slower or unclear (Cleveland Clinic, 2024). An estimated 44%-62% of women experience subjective or self-reported cognitive decline in perimenopause, which is the scientific term for brain fog (El Khoudary et al., 2019; Sullivan et al., 2001). While brain fog can be a difficult symptom to identify, understanding how menopause affects cognition can help to identify it when it’s happening to you.
How does menopause affect thinking and memory?
Brain fog during perimenopause is thought to be caused by changes in estrogen (Evernow, 2025) and progesterone (Guennoun, 2020). Estrogen helps with things such as heart health, bone health, and brain health, among other things (Cleveland Clinic, 2022a). Progesterone is estrogen’s best friend and has a lot of similarly helpful functions (Cleveland Clinic, 2022b).
Estrogen and progesterone fluctuate during perimenopause and decreases during menopause. Because of these hormone changes, many people experience brain fog such as memory or concentration problems. Because menopause experiences and symptoms vary greatly across people, how long brain fog lasts may be different for everyone. More generally, brain fog is said to last at least a year but may last as long as 3 years. Brain fog is reported to often stop either at menopause or after menopause ends (Brighten, 2025; Olsson & Molloy, 2025).
What can be done to manage brain fog?
While hormone changes play a major role in brain fog during menopause, sleep, stress, mood, and physical health can also influence how noticeable symptoms feel. The good news is that there are ways to help manage brain fog and support your brain health through daily habits. Some of the most important habits to create or maintain include:
- Get more sleep. You can do this by having a consistent schedule and establish a wind-down routine (Johnson & Ogden, 2025).
- Work physical activity into your routine. This should include strength training and aerobic exercise (Maki & Jaff, 2022; Stewart, 2003).
- Eat a balanced diet. The Mediterranean-type diet is ideal which includes eating regular meals with balanced protein, healthy fats, fruits, and vegetables. This can help slow mid-life weight gain (Maki & Jaff, 2022; Stewart, 2003).
- Stress management. Use healthy coping strategies such as deep breathing or mindfulness exercises, spending time in nature, take short walks or breaks, or reading (Johnson & Ogden, 2025).
When should I talk to my healthcare provider?
Healthcare providers are an important resource and should be a key source of information during this transitional phase. This is especially important if you have symptoms that are concerning or disruptive to your daily life, and if you have other underlying health conditions as managing those during this phase is invaluable (Maki & Jaff, 2022). If your personality or mood is changing in concerning ways or you are experiencing cognitive symptoms like getting lost and that are not fluctuating but are steadily getting worse it is a good time to see a provider.
Summary
Brain fog is a temporary symptom experienced by many women in perimenopause and sometimes lasts up to 3 years as a result of fluctuating estrogen and progesterone hormones. There are ways to manage the severity of these symptoms like getting enough sleep, maintaining physical activity and a balanced diet, staying hydrated, and managing stress. If your symptoms feel like they are getting in the way of daily life, you should reach out to your healthcare provider to discuss your concerns. Additional resources and tools to help manage brain fog can be found below.
Resources:
- Let’s Talk Menopause! Brain Fog: https://www.letstalkmenopause.org/our-articles/brain-fog
- The Menopause Society- How Menopause Restructures a Women’s Brain: https://menopause.org/press-releases/how-menopause-restructures-a-womans-brain
- Harvard Medical School-Menopause and brain fog: What’s the link? https://www.health.harvard.edu/womens-health/menopause-and-brain-fog-whats-the-link
- Cleveland Clinic-Brain Fog. https://my.clevelandclinic.org/health/symptoms/brain-fog
- UCLA Health-Understanding the Mediterranean diet. https://www.uclahealth.org/sites/default/files/documents/cf/menopause-understanding-mediterranean-diet.pdf?f=77e36b7d
References
Brighten, J. (2025, September 11). Menopause Brain Fog Is Real: 7 Science-Backed Ways To Clear It. Dr. Brighten. https://drbrighten.com/podcasts/menopause-brain-fog/
Cleveland Clinic. (2024, May 14). Brain Fog. https://my.clevelandclinic.org/health/symptoms/brain-fog
Cleveland Clinic. (2022a). Estrogen. https://my.clevelandclinic.org/health/body/22353-estrogen
Cleveland Clinic. (2022b). Progesterone. https://my.clevelandclinic.org/health/body/24562-progesterone
El Khoudary, S. R., Greendale, G., Crawford, S. L., Avis, N. E., Brooks, M. M., Thurston, R. C., ... & Matthews, K. (2019). The menopause transition and women's health at midlife: a progress report from the Study of Women's Health Across the Nation (SWAN). Menopause, 26(10), 1213-1227. https://doi.org/10.1097/GME.0000000000001424
Guennoun R. (2020). Progesterone in the Brain: Hormone, neurosteroid and neuroprotectant. International Journal of Molecular Sciences, 21(15), 5271. https://doi.org/10.3390/ijms21155271
Johnson, H., & Ogden, J. (2025). Much more than a biological phenomenon: A qualitative study of women’s experiences of brain fog across their reproductive journey. Journal of Health Psychology, 30(8), 1963-1976. https://doi.org/10.1177/13591053241290656
Maki, P. M., & Jaff, N. G. (2022). Brain fog in menopause: a health-care professional’s guide for decision-making and counseling on cognition. Climacteric, 25(6), 570-578. https://doi.org/10.1080/13697137.2022.2122792
Olsson, R. & Malloy, S. (2025, June 6) Menopause and Your Brain: Why You Feel Foggy and How to Stay Sharp. Banner Health. https://www.bannerhealth.com/healthcareblog/teach-me/how-menopause-affects-your-brain-and-what-to-do-about-it
Stewart, M. (2003). How to handle menopause brain fog. National Council on Aging. https://www.ncoa.org/article/how-to-handle-menopause-brain-fog/
Sullivan Mitchell, E., & Fugate Woods, N. (2001). Midlife women's attributions about perceived memory changes: observations from the Seattle Midlife Women's Health Study. Journal of Women's Health & Gender-Based Medicine, 10(4), 351-362.
Authors
Cris Meier, MSW, PhD, Moth Huenemann, Ashley Yaugher, PhD
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