What does brain fog feel like?

“Brain fog” is not a medical diagnosis; it is a phrase for the mental cloudiness many people experience during this period. Typical examples are a word you know not coming to you mid-sentence, not being able to remember the name of someone familiar, walking into a room and forgetting why, losing focus while reading, or struggling to juggle several tasks at once.

According to The Menopause Society, 40–60 percent of midlife women report cognitive symptoms (to do with thinking and memory) such as forgetfulness, difficulty concentrating, and trouble remembering words and names (The Menopause Society, Perimenopause). The NHS lists this among menopause symptoms under the heading “problems with memory and concentration, brain fog,” and forgetfulness is also on the list from the Turkish Society of Obstetrics and Gynecology (TJOD) (NHS, Symptoms; TJOD).

These changes are often noticed most by the person themselves. The authors of the SWAN study also note that the measured test results were consistent with the memory difficulties women perceive during this period (Greendale et al., 2009). In other words, what you are experiencing is not in your head.

Why does brain fog happen in menopause?

A 2022 expert paper from the International Menopause Society notes that midlife women often experience changes in cognitive function during the menopause transition, and examines the role of estrogen and menopause symptoms in these changes (Maki and Jaff, 2022). According to The Menopause Society, cognitive function in midlife is affected by the stage of menopause, by sleep and by changes in mood (The Menopause Society, Mental Health).

So brain fog has no single cause. Hormone fluctuations, sleep broken up by night sweats and low mood can feed into one another. The NHS also notes that memory and concentration problems may feel worse when you have sleep problems and feel very tired (NHS, Symptoms).

Is menopause forgetfulness normal, and does it go away?

According to The Menopause Society, complaints about concentrating and remembering are common during the transition and the years after it. The typical changes of midlife are subtle and mild (The Menopause Society, Mental Health).

There is also an encouraging finding that these changes may be temporary. In the SWAN study, 2,362 women took cognitive tests at regular intervals over 4 years. Normally, scores rise a little as the same tests are repeated, because people “learn” the test. In women in perimenopause, this learning effect was not seen; in other words, during this period they did not learn new information as well as before. After menopause, however, performance returned to its pre-menopause level. The researchers note that this finding suggests the cognitive difficulties linked to the transition may be limited in time (Greendale et al., 2009).

Even so, how long it lasts varies from person to person. The International Menopause Society paper stresses that the duration and severity of these changes are things to assess together with a clinician, and highlights how important it is for clinicians to tell women that this experience is common (Maki and Jaff, 2022).

Is forgetfulness a sign of dementia?

This is the first question that comes to many people’s minds when forgetfulness starts. The International Menopause Society paper also notes that women worry whether these changes are the start of a more serious cognitive disease (Maki and Jaff, 2022).

The sources are clear on this: dementia is very rare in midlife (The Menopause Society, Perimenopause). Alzheimer’s disease is very rare before age 60 and appears in only a small proportion of people under 75 (The Menopause Society, Mental Health). Even so, marked changes should always be assessed, because some of the factors that contribute to forgetfulness can be addressed.

What else can cause forgetfulness?

Menopause is not the only cause of forgetfulness. The NHS lists stress, anxiety, depression and insomnia among the common causes of memory loss; it notes that some changes in memory can be a natural part of aging and, rarely, a sign of a more serious condition such as dementia (NHS, Memory loss).

That is why these need to be considered together:

  • Sleep: Sleep broken up by night sweats or other causes directly affects attention and memory the next day. For more detail, see the pages on menopause insomnia and night sweats.
  • Mood: Low mood and anxiety make it harder to concentrate. If your forgetfulness comes with hopelessness, loss of interest and sleep problems lasting more than two weeks, this may be a sign of depression (The Menopause Society, Mental Health). More detail: mood swings and irritability.
  • Stress and load: Carrying too many responsibilities at once can scatter your attention on its own (NHS, Memory loss).

What can you observe yourself?

The feeling that “I’ve become so forgetful” is one of the hardest complaints to make concrete at an appointment. Noting the following for a few weeks helps:

  • What kind of forgetfulness you have: struggling to find words, forgetting names, unfinished tasks, missed appointments.
  • How you slept that night, and whether you had night sweats.
  • Your overall mood and stress level for the day.
  • Where you are in your menstrual cycle.
  • Which tasks the forgetfulness affects at work, at home or in your social life.

After a few weeks, you can answer the question “does it happen on days after I sleep badly?” The record shows something else too: does your forgetfulness go up and down with good and bad days, or is it steadily getting worse over the months? A mild picture that rises and falls with sleep and stress looks more like the mild changes the sources describe for this period. Changes that keep getting worse, disrupt daily tasks or are noticed by people close to you should be assessed without waiting (The Menopause Society, Mental Health).

The Menopause Society mentions general recommendations that support brain health against age-related cognitive decline: a wide social circle, staying physically and mentally active, a Mediterranean-style diet rich in whole foods, not smoking, keeping alcohol limited, and reducing heart and blood vessel risks such as high blood pressure, diabetes and high cholesterol (The Menopause Society, Mental Health). These are general health tips; they are not expected to clear brain fog on their own.

When should you see a doctor about forgetfulness, and what should you ask?

The NHS advises seeing your family doctor (GP) if memory problems are affecting your daily life (NHS, Memory loss). The Menopause Society also asks that marked changes in memory or thinking be taken to a health professional (The Menopause Society, Mental Health).

Your clinician may look for other factors that could be contributing to your forgetfulness and that can be addressed; that is why it is important not to put off getting marked changes checked (The Menopause Society, Mental Health).

At the appointment, you could ask:

  • Is what I’m experiencing consistent with perimenopause, or should we look for another cause?
  • How much are my sleep and mood contributing to this?
  • What changes should make me come back?

Having notes with you that show when the forgetfulness started, on which days it gets worse and how it relates to your sleep makes the assessment easier. This page does not recommend any medicine or supplement; talk through the options with your clinician.