Eleven best ways to beat brain fog in menopause

Brain fog is one of the most common symptoms of the menopause transition, affecting almost two-thirds of women. It’s not only frustrating, but it can also be embarrassing, and it can begin to interfere with your ability to perform at work. Worse still, many women start to worry that perhaps it’s the beginning of dementia, and that’s a terrifying thought.

What causes brain fog?

Scientists’ understanding of the details is sometimes as woolly as our thoughts can be around menopause. The ups and downs of brain function aren’t related to oestrogen levels, the changes of menopause are mixed up with the changes of ageing, and other challenges of menopause such as stress, anxiety, depression and poor sleep all have an effect. However, brain scans and examination of brain tissue all point to extensive changes in the brain occurring around the time of menopause. These changes are not matched by similar changes in men or in women not going through menopause.

Despite the evident changes women notice in the clarity of their thinking and memory around this time, measuring it in the clinic is challenging. The standard tests doctors use to pick up signs of disrupted thinking and memory detect only subtle decreases in verbal fluency and the ability to learn new skills. Reassuringly, these changes return to normal after menopause.

Could my brain fog be due to something else?

Brain fog may occasionally be due not to menopause but to other conditions. The list of possible causes is lengthy but includes disruptions to other hormones from the thyroid or adrenal glands, infections, blood disorders, strokes, many drugs, vitamin B deficiencies, alcohol, diabetes, mental illness and rarely dementia.

What practical steps can I take to minimise the effects of brain fog?

Brain fog is something most women experience around menopause, so, frustrating as it is, it’s normal. There is no magic pill to stop it, but there are plenty of things you can do to make it better. Here are our top suggestions.

1. Make sure any other health problems are sorted out

As we have seen, other factors may contribute to your brain fog, and you wouldn’t want to leave them untreated. On top of that, leaving conditions like high blood pressure, diabetes or hormone abnormalities untreated is only storing up problems for the future, like heart attacks, strokes and dementia. For example, a woman with high blood pressure in her forties has a 70% increased risk of dementia later. Make an appointment to see your doctor or practice nurse and have a general check-up. It’s also an excellent opportunity to see what resources they have about menopause and to plan for whom to see about troublesome menopausal symptoms in the future.

2. Have a look at any medication you are taking

Quite a few medicines can affect thinking and memory. Read through the patient information leaflet that came with your medication or talk to your doctor.

4. Slow down

Recognise when you are getting distracted. Don’t get frustrated; accept it for what it is, take a breath and refocus.

5. Find ways to relieve stress

Menopause arrives at a time when we already have to deal with multiple major stressors. Children are often leaving home and embarking on their own lives and relationships with spouses and partners may be getting reappraised. We may also be caring for ageing parents, and it’s typically a time of peak responsibility at work. The timing is awful.

Being stressed results in worse memory and impairs our ability to adapt to changing circumstances and switch from one task to another. It can become cyclical. Many things are causing stress, and then menopausal brain fog makes an appearance, leading to even more stress, and the symptoms worsen. Finding ways to break that cycle and not let stress run amok is essential.

What works for you may be different for another woman, but recommended strategies include:

1. Taking control: You are the captain of your ship. Sure, many challenging things may be going on, but actively manage them rather than falling victim to them.
2. Being active: Get out and about. Even just going for a walk gives you a change of scenery, daylight, fresh air, and exercise. It can work well as a reboot.
3. Engaging with your support network: People who feel supported by family, friends and co-workers cope far better with stress than those who do not feel well-supported.
4. Getting a hug: It doesn’t matter if it’s a friend, family member or the dog. Getting a hug releases the bonding hormone oxytocin, which is great at lifting our mood and relieving stress.
5. Helping others: This could be volunteering somewhere or just resolving to do one good deed a day. Helping others makes us feel much more positive about ourselves.
6. Working smarter: You may never be able to do everything you feel you should. Focus on the priorities, work efficiently and accept that that’s good enough.
7. Focusing on the positive: Whatever may be going on in your life, there are still many things to be grateful for. Remind yourself of those. Some people find it helpful to keep a gratitude journal.
8. Setting aside some time for yourself: Don’t spend your whole time working and doing chores. Make some time to do whatever gives you pleasure.
9. Learning some relaxation techniques: Popular techniques include imagining yourself on a tropical beach or in a forest glade, meditation, focused breathing, yoga and progressive relaxation (where you allow a wave of relaxation to move slowly from your toes to your head).
10. Doing something creative: This could be playing music, dancing, cooking, creating a piece of art or colouring, for example.

6. Get plenty of sleep

A lack of sleep is a major issue for many women around menopause and it certainly contributes to brain fog. Around half of all women complain of poor sleep through menopause. Waking during the night is the most common complaint but difficulty falling asleep and waking earlier than planned in the morning can also be troublesome. Night sweats are a frequent cause of nighttime waking but women who don’t suffer from night sweats also complain of disturbed sleep.

Where night sweats are a factor in disturbed sleep, getting these under control can significantly improve sleep quality. Keeping a cool environment, light bed linen and medication (antidepressants, gabapentin and hormone therapy most commonly) can all help to reduce night sweats. Hormone therapy also leads to subjective improvements in sleep quality. This seems to be mostly associated with a reduction in night sweats but women who do not suffer from these also report better sleep.

8. Take steps to reduce your hot flashes

As we have discussed, night sweats disturb sleep, and this itself slows the brain, but daytime hot flashes may also play a role. In a small study, women with more hot flashes had more difficulty remembering things they heard. Hot flashes tend to be one of the most troubling symptoms of menopause and one of the most common reasons women visit their doctors at this time. Getting your hot flashes under control may also lead to an improvement in your brain fog.

9. Drink a little, but not a lot

Evidence suggests that low to moderate alcohol intake (up to 14 units per week) is associated with a reduced risk of dementia in later life. Drink more than this, though, and your risk goes up. Don’t use alcohol as a coping strategy on difficult days.

10. Learn some memory-boosting techniques

There are a few tricks to help you remember the name of someone you’ve just been introduced to, for example. Immediately repeat their name when you’re told it, slip it into the conversation a bit later, and use their name again when you part. Our memory for other things is boosted if we make a mental picture, the more ridiculous, the better.

For some tips on improving you memory, check out the great infographics at: 7 Techniques to Help Improve Your Memory

If you like more detail, have a look at The Science of Memory: Top 10 Proven Techniques to Remember More and Learn Faster

11. Talk to your doctor about hormone replacement therapy

Studies suggest hormone therapy (HT) improves reading and verbal memory in women under sixty. The evidence is not strong enough to recommend HT solely for brain fog. However, if you need it for other menopausal symptoms, such as hot flashes, you may find it also helps clear the brain fog. There is some evidence that HT may actually harm brain health in women over sixty, so it’s not usually started at this late stage.

Brain fog in menopause is one of the most concerning symptoms of the menopause transition for many women. There is no magic bullet to rid yourself of the mental wooliness, but each of the steps we have discussed can ease the symptoms somewhat, and put together, they can bring about significant improvements. Above all, don’t get frustrated and be kind to yourself. Keep your sense of humour and be reassured that this is just temporary.

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