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Forgetting words, losing things, no clue what you’re doing in this room, missing events… how’s that brain fog feeling?

Brain fog is one of the most common and least appreciated signs of menopause. That ‘cotton wool brain’ where focus, memory, and concentration have drifted off elsewhere. The impact of this can range from mildly annoying for some, to sadly quite debilitating for others.

Swathes of perimenopausal mid-lifers have reported refusing promotions, for example, or giving up jobs and businesses they’ve loved and succeeded in, all because they can’t cognitively cope any more.

My mind has always been pretty sharp, but I’ve had brief spells of brain fog for decades when I’m tired, stressed or run down. Mostly I start losing words. Names of famous people and friends, and just random words I want to put in a sentence.

I love words, so forgetting them is a considerable frustration. One that, since perimenopause, has become more and more frequent, along with dwindling concentration levels and limited patience to deal with it all.

Is it brain fog, or dementia?

My first concern, like many my age (53), was whether this was the first throes of Alzheimer’s disease. It seems, however, that menopausal brain fog is a temporary state, and I’m likely to get my mojo back at some point. In the meantime, as a nutritional therapist, I’ve been researching everything I can do to support my perimenopausal brain.

My first concern, like many my age, was whether this was the first throes of Alzheimer’s

So why does it happen in the first place? Like most activity in our fantastically complex bodies, we don’t fully understand. But we do know that the reproductive hormones progesterone, oestrogen, and testosterone are important to the health of our brain cells, and protective against both cognitive and mental decline.

So when progesterone and testosterone start dropping, and oestrogen starts fluctuating in perimenopause – which can last for sometimes a decade – this is bound to have an impact. The first year after menopause, when periods stop for good, has been found to be the worst for brain fog, and that’s when oestrogen levels are likely to plummet.

Stress, menopause, and brain fog

Midlife is also a time when we tend to have an awful lot on the many plates we might be spinning. With women increasingly choosing to have families later in life, perimenopause can often coincide with one’s children going through puberty, and the loss or additional support needs of elderly parents. By now we may also be struggling under the weight of accumulated responsibilities, traumas and general world-weariness. All of which can takes its toll on our short-term memory and general cognitive state.

Midlife is also a time when we tend to have an awful lot on the many plates we might be spinning

Our stress hormones and reproductive hormones are so closely linked that we need to support both at the same time. Stress hormones are made in the adrenals, and we make them all the time in a rhythm that usually contributes to health and wellbeing.

Elevated stress hormones, however, can disrupt menstrual cycles and fertility, and may impact hormonal transitions such as puberty and perimenopause. Depleted levels can also be problematic.

After menopause, we convert some of our adrenal hormones into oestrogen, progesterone and testosterone to help keep us ticking along, so we need them to stay buoyant. It makes sense to try and maintain regular patterns of adrenal hormones throughout our lives.

Balancing hormones

We can do this with regular mindfulness practices, like meditation, yoga, and qi gong. Moderate levels of exercise can also be helpful, such as brisk walking, running, and dancing.

Plus there are specific nutrients and ways of eating that can keep the adrenals balanced, such as B vitamins, vitamin C, zinc, and magnesium, as well as avoiding blood sugar spikes and crashes. Having regular protein and fibre, including early in the day with breakfast, and reducing sugar and refined carbohydrates, can really help blood sugar.

The same nutrients are also helpful for regulating reproductive hormones. Testosterone, for example, needs a lot of zinc and certain amino acids from protein. Oestrogen is a little more complicated: it’s metabolised in the liver and put through processes that require B vitamins, vitamin C, magnesium and a number of other nutrients.

These processes convert the oestrogen to different sub-types that may be stronger- or weaker-acting, according to what you need right now, or broken down completely to be got rid of. Before your body poos them out, however, some of the microbes in your gut microbiome check in to see if you actually need some recycling back into your system.

Read: How to boost the feel-good chemicals in your brain

So take care of your gut health

Look after your gut and microbiome health, with plenty of plant-based fibre and regular fermented foods. Interestingly, a well-populated gut microbiome can also help keep stress levels in check, and may even help with cognitive health.

Plus, of course, your brain needs good levels of hydration, which for most people means about two litres of water a day. Additionally, your brain cells need specific types of omega 3 fatty acids called EPA and DHA, which you can get in fish oil and vegan algae-derived supplements. There’s also a nutrient called phosphatidyl serine that can improve brain function.

Movement, and rest

I’d like to come back to exercise, because one of the most mind-blowing pieces of research I have found in recent years is this: “…resistance exercises and resistance training evoked substantial functional brain changes, especially in the frontal lobe, which were accompanied by improvements in executive functions. Furthermore, resistance training led to lower white matter atrophy and smaller white matter lesion volumes.” (Herold et al).

…one of the most mind-blowing pieces of research I have found showed “…resistance exercises and resistance training evoked substantial functional brain changes…”

This conclusion is based on just a small amount of studies, but it’s still motivated me to get some home weights and lunge on an almost daily basis.

Equally, it’s important to rest. Of course, lack of sleep is going to be feeding into any brain fog issues – who can focus on anything when sleep-deprived? There are lots of different layers of nutritional herbal support that can be so helpful here, from Montmorency cherries to valerian and Passiflora.

But for many there’s no magic sleep switch, and focussing too much on it may just be anxiety-inducing. But please make sure you get enough downtime. Carve out five minutes here, half an hour there, maybe even a whole day or weekend where you can, to just do nothing. Stare out of the window, read a novel or a magazine, relax in a warm bath. Or maybe a gentle stroll, or something artistic like sketching, painting or singing. You don’t want to stagnate, but you do want to feel rested.

Worried about brain fog?

If you’re concerned about brain fog, there are lots of tips here you can play with and see how they work for you. Of course, not everything is appropriate for everyone, so if in doubt, seek advice from a registered nutritional therapist and/or herbalist. And remember that, like puberty, this too shall pass.

FOODS TO HELP BEAT MENOPAUSAL BRAIN FOG

Foods rich in –
B Vitamins: whole grains, beans, seeds, nuts, mushrooms, avocado, fish, meat, eggs, liver, green leafy vegetables
Vitamin C: green leafy vegetables (raw), fruit (raw), onions (raw)
Magnesium: green leafy vegetables, nuts
Zinc: nuts, seeds, chickpeas, chicken, lamb, beef
EPA and DHA: oily fish (salmon, trout, sardines, mackerel, herring, anchovies)
Phosphatidylserine: soy beans, egg yolks, liver

Protein-rich foods: beans, lentils, nuts, seeds, cheese, eggs, fish, meat

Fibre-rich foods: vegetables, nuts, seeds, whole grains, beans, peas, lentils, herbs, spices, fruit

Fermented foods: yoghurt, kefir, well-ripened cheese, sauerkraut, kimchi, kombucha, miso, unfiltered apple cider vinegar (“with mother”)