What to do against perimenopause brain fog (and why it happens)

Have you ever walked into a room and forgotten why, or struggled to remember a word that’s normally right on the tip of your tongue? If so, you’ve met brain fog. Many women describe it as a mental cloud that makes concentrating, recalling details, or staying sharp more difficult. It’s frustrating, especially when you’re juggling work, family, and everything else life demands. But brain fog in perimenopause and menopause is common - and there are practical ways to manage it.

What causes brain fog during menopause?

Brain fog is linked to shifting hormone levels, particularly oestrogen and progesterone. These hormones influence neurotransmitters like serotonin and dopamine, which affect memory, focus, and mood. As levels fluctuate, many women notice their mental clarity feels less reliable. Sleep disturbances, hot flushes, and stress - common companions of perimenopause - also add fuel to the fire. When your body is tired or anxious, your brain has less energy for memory and concentration.

How long does menopause brain fog last?

The experience is different for everyone. Some women only notice occasional lapses, while others feel foggy for months or years. Research suggests that cognitive symptoms often improve after the menopause transition, once hormones stabilise again. In the meantime, there are steps you can take to make brain fog less disruptive.

Lifestyle changes to improve brain clarity

Prioritising sleep: Quality sleep is the foundation of cognitive health. Creating a cool, dark, screen-free sleep environment and keeping a consistent bedtime routine can support sharper thinking during the day.

Moving your body: Exercise boosts blood flow to the brain and supports neurotransmitters that improve focus. It doesn’t have to be intense: a brisk walk, yoga, or strength training can all help.

Managing stress: Chronic stress releases cortisol, a hormone that interferes with memory and concentration. Relaxation techniques like meditation, breathwork, or journaling can lower stress and improve mental clarity.

Nutrition and supplements for brain fog relief

What you eat fuels your brain as much as your body. A nutrient-rich diet can help support mental clarity through the menopause transition.

Omega-3 fatty acids: Found in oily fish, flaxseeds, and walnuts, omega-3s support brain cell communication and may improve memory and focus.

B vitamins: Vitamins B6, B12, and folic acid help with energy production and neurotransmitter function. Low levels are linked to memory problems and fatigue.

Vitamin D: Known as the “sunshine vitamin,” vitamin D supports brain health and mood regulation. Deficiency is common, especially in colder climates.

Hydration: Even mild dehydration can cause concentration problems. Keeping a water bottle nearby is a simple way to support mental clarity.

Medical support for severe brain fog

If brain fog is persistent and significantly affecting your quality of life, professional help may be needed.

Hormone replacement therapy (HRT): For some women, HRT not only helps with hot flushes and sleep but also improves memory and focus by stabilising hormone levels.

At Flouria, we offer a personalised care trajectory for perimenopause, including consultations with perimenopause experts and prescription of HRT. For more information, click here.

Other medical options: Doctors may also check for other underlying issues, such as thyroid conditions, anaemia, or vitamin deficiencies, that can worsen brain fog. Addressing these can make a big difference.

Coping strategies when brain fog strikes

Even with good habits, brain fog can still pop up. Having strategies ready can make it less disruptive.

Writing things down: Keeping lists, notes, or phone reminders takes the pressure off your memory and keeps you organised.

Breaking tasks into steps: When concentration feels hard, dividing tasks into smaller, more manageable parts can help you move forward without overwhelm.

Taking short breaks: A quick walk, stretch, or even stepping outside for fresh air can reset your focus when your brain feels sluggish.

Remember: brain fog is not a sign of weakness or failure, and it’s not something to beat yourself up over. It’s a normal response to hormonal changes, and you’re not alone in experiencing it.

Key takeaways

Brain fog in perimenopause and menopause is caused by hormonal changes and made worse by poor sleep, hot flushes, and stress.
Symptoms often improve after menopause but can last for months or years.
Good sleep, regular movement, and stress management support clearer thinking.
Nutrition, especially omega-3s, B vitamins, and vitamin D, plays a role in brain health.
HRT and medical support may help if symptoms are severe.
Practical coping strategies like note-taking, breaks, and task management can reduce frustration.

References:

Aras, S. G., Grant, A. D., & Konhilas, J. P. (2025). Clustering of > 145,000 symptom logs reveals distinct pre, peri, and menopausal phenotypes. Scientific reports, 15(1), 640. https://doi.org/10.1038/s41598-024-84208-3

Brinton, R. D., Yao, J., Yin, F., Mack, W. J., & Cadenas, E. (2015). Perimenopause as a neurological transition state. Nature reviews. Endocrinology, 11(7), 393–405. https://doi.org/10.1038/nrendo.2015.82

Maki, P. M., & Jaff, N. G. (2024). Menopause and brain fog: how to counsel and treat midlife women. Menopause (New York, N.Y.), 31(7), 647–649. https://doi.org/10.1097/GME.0000000000002382

Kverno K. (2021). Brain Fog: A Bit of Clarity Regarding Etiology, Prognosis, and Treatment. Journal of psychosocial nursing and mental health services, 59(11), 9–13. https://doi.org/10.3928/02793695-20211013-01

Zhu, C., Thomas, E. H., Li, Q., Arunogiri, S., Thomas, N., & Gurvich, C. (2023). Evaluation of the Everyday Memory Questionnaire-Revised in a menopausal population: understanding the brain fog during menopause. Menopause (New York, N.Y.), 30(11), 1147–1156. https://doi.org/10.1097/GME.0000000000002256