By Tye Johnson, DNP, PMHNP-BC
Are you having trouble recalling words in the middle of a sentence, walking into a room and not knowing the purpose of the visit, or reading the same line of an email multiple times without making sense of it? Don’t worry; you’re not losing your mind. Your brain is just going through a massive hormonal shift, and it feels like it’s running as slow as honey.
I know from experience. It just happened to me during one of my sessions. I was talking away, feeling good, and suddenly, the word I wanted to say was gone. Not the word on the tip of my tongue, the word was just gone. I talked on, and later, I was like, “This is the moment where so many women are silently wondering, ‘What is wrong with me?’”
The answer is absolutely nothing.
What brain fog looks like
Brain fog looks different for different women, but the common complaints are:
- Difficulty concentrating on the important things
- Forgetting the word in the middle of the sentence, especially the nouns
- Thinking slowly, or having blank moments
- Difficulty finishing tasks that used to come easily
- Feeling like making decisions is too hard
Why it happens
Estrogen levels affect brain areas responsible for memory and attention. It goes up and down during perimenopause, and the brain responds. Brain fog is not one thing; it is usually the accumulation of:
- Sleep problems due to night sweats, increased cortisol, and decreased progesterone
- High levels of stress, or increased cortisol
- Fluctuations in blood sugar levels
- Increased brain inflammation
- Changes in nutrient requirements, including B vitamins, omega-3 fatty acids, magnesium, and vitamin D
The good news is that, for the vast majority of women, this is temporary and improves as hormones stabilize.
5 small steps to start this week
It’s simple. Just keep a record of brain fog for 2 weeks in a notes app or a notebook. Just record your sleep, food, stress, and where you are in your cycle. Sometimes just seeing a pattern is helpful.
- Maintain a regular sleep and wake schedule
Wake up within 30 minutes of the same time each day, even on weekends.
Get morning light within 30 minutes of waking. - Just get outside or in front of a bright window for a couple of minutes in the morning. It really helps regulate your body clock.
- Have a protein breakfast.
A protein breakfast will help regulate blood sugar and keep focus stable. - Stop caffeine earlier in the day than you think.
Caffeine stays in your system for 5-7 hours. Why don’t you try stopping caffeine in late morning and see if that improves your sleep? - Do something relaxing each day.
Two minutes of slow breathing, a walk, prayer, meditation, or some gentle stretches. Just some small signal to your nervous system that you are safe.
When to seek help
If you are experiencing:
- Rapidly worsening memory or confusion
- Disorientation or safety issues
- New problems with speech, vision, balance, or coordination
- Severe depression or thoughts of harming yourself
- Increasing anxiety or panic that interferes with daily life
If you are looking for a menopause-savvy practitioner, The Menopause Society has a list of practitioners on its website (menopause.org).
Perimenopause is NOT a personal failure. It is a neurohormonal adaptation. Your brain is doing its best, and you can help it without turning your life upside down.
Disclaimer: This is for educational purposes only. It is always best to consult a healthcare provider for your individual needs.
About the Author
Dr. Tye Johnson is a board-certified Psychiatric Mental Health Nurse Practitioner with JMS Behavioral Health. She provides psychiatric care services for patients in S. Jersey. She is currently completing an Integrative Women’s Health Fellowship specializing in menopause, mental health, and neuroinflammation.
