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lifting the brain fog

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Muddling through midlife forgetfulness? Niki Bezzant shares five things you need to know to clear your head.

You may know the feeling. You’re searching your brain for a word or a name you know, but just can’t seem to get it out. Or you walk purposefully into a room… and completely forget what you’re there for.

If you’re nodding along in recognition, you’re not alone. Brain fog can happen at any time, but for women in midlife and perimenopause – that time before menopause kicks in, which can start as early as our mid-thirties – it can be particularly sudden and distressing.

Memory, multi-tasking and concentration levels can all start to fluctuate, and we can feel like we’re not in control of our own brains any more.

Here’s what you need to know about brain fog and what you can do about it.

1. It’s a real thing

While brain fog is not a clinical term, the feeling it describes is real. Brain researcher Dr Lisa Mosconi, whose work is focused on women’s brains, says females often report similar symptoms in midlife as they do at another turbulent time: post pregnancy.

“We say, ‘I have baby brain,’ right? That is pretty much what women experience as they go through perimenopause and menopause: being confused, feeling like you’re not sharp, you’re having a hard time getting through mental processing where you otherwise wouldn’t have.”

Many women also report problems with multi-tasking. “Women have to write things down, they have to make lists, they have to cross things off, they have to start doing one thing at a time, which I think is really disconcerting as a woman, says Dr Mosconi.

We are great at multitasking, so losing that, or a decline in that capacity, can be really shocking.

2. It might be your hormones

Midlife is a time when women are juggling a phenomenal volume of things, including kids, parents, relationships, friends, career and general lifeload. All of which can overload us.

But there’s also a strong potential hormonal component to brain fog. That’s because women’s brains are loaded with hormone receptors – particularly oestrogen receptors – that drive many of the functions of our brains and bodies. As perimenopause kicks in, the levels of hormones start to fluctuate, typically going up and down and up again like a roller coaster, and creating all kinds of havoc, including in our brains.

brian fog

Christchurch-based endocrinologist and menopause specialist Dr Anna Fenton says even though brain fog is totally normal, it’s something women find quite distressing.

“The term is nominal dysphasia – not being able to find words and names,” she says. “And it’s really quite inhibiting. We’ve localised that to a very small part of the hippocampus, which is the memory department in the brain.”

Unfortunately, says Dr Fenton, scientists are still in the very early stages of understanding what’s going on here. “Is this an oestrogen-related thing? Or is it related to some of the other hormones that may be changing, like testosterone? We don’t really know.”

Dr Mosconi says the oestrogen link makes sense, since the hippocampus is very rich in oestrogen receptors. “So if the oestrogen doesn’t attach itself to the receptors, there’s no activation of that region. That’s why there could be memory lapses.”

3. It makes you more like a man

Get this, ladies: what some may have suspected about men’s brains versus women’s brains could be true. Ours are simply superior in many ways.

The areas of the brain associated with word finding and memory, according to Dr Fenton, “are areas of a woman’s brain that actually function at a higher level than the male brain. The joke is that what happens at menopause is we drop to their level,” she explains.

However, this doesn’t mean our brain performance is slipping. “We do know from a number of studies that women actually outperform men on cognitive testing in any stage of life,” says Dr Mosconi. “Even women with a diagnosis of early Alzheimer’s disease perform better than men with the same diagnosis.

The point is: your brain is going through a transition, and you get back. Many women plateau and somehow adjust after menopause.

4. You don’t have to put up with it

Fixing brain fog is not simple, given the range of potential causes. But there are some things that can help and can also protect our brains as we age.

Sleep is super important and addressing this can solve lots of other issues as well, including mood problems. If you’re struggling with sleep, it’s well worth talking to your doctor – getting enough quality sleep can be the key to a well-functioning brain.

Exercise is also a huge brain booster. It’s great for heart health – and what’s good for the heart is good for the brain. Aerobic exercise boosts blood flow and gets more nutrients and oxygen to the brain, making us feel more clear-headed. For women, fitness in midlife is associated with lower risk of dementia as we age, too. Exercise lowers stress and helps us sleep better.

Taking time to move every day, even if it’s just a quick walk, allows us time to decompress and clear the head. All of which can go a long way towards lifting the fog.

Of course, food has a role to play, as well. Dr Mosconi favours a Mediterranean pattern of eating: tons of vegetables, wholegrains, fish, olive oil. Throw in some natural plant oestrogens from whole soy beans and fermented soy foods such as miso and tempeh and we’re on the right track. Knocking the alcohol on the head will also make a big difference.

5. Hormone therapy can help

For some women, hormone replacement therapy (HRT) can help, especially if brain fog is just one symptom we’re suffering in relation to perimenopause. While HRT has been widely misrepresented in the past, it can be a godsend.

Dr Fenton says HRT doesn’t work for every woman experiencing brain fog, but it can be worth trying. “I don’t have brain fog on my list of symptoms that I can guarantee will totally go away with hormone therapy, but for a lot of women it certainly does get better.”


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