Brain Fog: Could It Be Menopause?

Health Writer
Medically Reviewed

When you think about menopause, it typically brings to mind the symptoms most closely associated with “the change”— hot flashes, night sweats, vaginal dryness, and mood shifts.

What many women might not expect as they enter this transition is the “brain fog” that sometimes descends, shrouding their memory and clouding their concentration.

Women earlier in life have the edge over men in memory and cognitive performance, but their lead thins and then disappears after menopause, according to findings published online in November 2016 by the journal Menopause. The study, led by Harvard Medical School researchers in Boston, looked at 211 men went tests evaluating four components of memory:

• Episodic memory—the ability to remember events

• Executive function—memory and other skills needed to plan and complete tasks

• Semantic processing—the ability to process words and their meanings

• Verbal intelligence—the ability to use language to solve problems

Premenopausal women outpaced men on all four memory measures. Yet, after menopause, women no longer retained the same advantage. In particular, postmenopausal women had more trouble recalling information they’d recently learned.

A link to estrogen

This study’s researchers say reduced levels of estradiol—a form of estrogen—were associated with the women’s difficulty in recalling new information.

Estrogen, which declines during and after menopause, plays an important role in learning and memory.

“The importance of estrogen to memory and other mental functions has been well studied,” says Peter Rabins, M.D., M.P.H., a professor at the Erickson School of Aging, University of Maryland, Baltimore County, and founding director of geriatric psychiatry at Johns Hopkins University School of Medicine in Baltimore.

“A number of estrogen receptors have been found in the part of the brain that regulates memory and learning. Estrogen might also protect nerve cells in the brain and help them communicate with one another.”

Not all women experience memory problems when they reach menopause. And some women suffer more severe brain fog than others. Researchers hypothesize that these differences in mental acuity might be a result of other factors, such as pressures from work and relationships, and health conditions that affect memory.

Is it serious?

No matter your age, if you’ve been especially forgetful lately, you might worry that misplacing your keys and being unable to recall friends’ names could be a sign of impending Alzheimer’s disease. But dementia that starts in midlife is rare.

It may be difficult to tell the difference between menopausal brain fog and actual early dementia. If you’re at all concerned, the best thing to do is to check with your doctor.

You might also wonder whether your current brain fog might be the first sign that you’re headed for dementia in the future. The Menopause study couldn’t confirm this; women with a family history of Alzheimer’s disease didn’t score any better or worse on memory tests than those who weren’t at increased risk for dementia.

The authors say future research could help clarify the connection between menopausal brain fog and later dementia.

Hormone therapy’s risks

Because estrogen has been linked to a sharper memory before menopause, some researchers have wondered whether menopausal hormone therapy during and after menopause might protect a woman’s memory.

Studies of hormone therapy to preserve cognitive function have been mixed, and some research has found that taking estrogen might accelerate mental decline.

“There is no convincing evidence that estrogen therapy has any long-term benefit in terms of cognition, or that it’s helpful when women take it for a brief period during and just after menopause,” Rabins says. “And, because estrogen therapy has been linked to a higher risk for cancer, heart attack, and stroke, prescribing it is controversial.”

The North American Menopause Society does not recommend taking hormone therapy to improve memory symptoms.

8 factors that can affect memory

Memory troubles in midlife don’t always stem from menopause. Several factors that arise around the time of menopause—from empty-nest syndrome to worries over aging parents—can also contribute.

The North American Menopause Society highlights eight other factors that can disrupt your memory during this time of life:

1. Cognitive aging

2. Stress

3. Fatigue

4. Depression

5. Sleep disorders

6. Hot flashes

7. Medication effects

8. Medical illnesses, such as thyroid disease

Read more about causes of memory loss and how dementia is diagnosed.