Brain Fog
Forgetting why you walked into a room, losing your train of thought or quite frequently searching for that word that is just on the tip of your tongue. Sound familiar? This confusing feeling is often referred to as “brain fog.” It's a very common symptom of Menopause and over 60% of women between the ages of 40 – 60 report difficulty in concentration and general cognitive decline. Although cognitive decline is generally considered to be a result of aging, in reality there is actually a very strong connection to hormonal aging as well. For many women Brain Fog has a significant impact on both their personal and professional life, and can have a comprehensive effect on their overall wellbeing.
60% of women report experiencing Brain Fog during the menopausal transition years
The good news is that treatment is available, and normally the symptoms fade as a woman enters post-menopause.
Why is this happening?
Women have reported several cognitive problems during menopause: a change in the ability to think daily activities through clearly, difficulty making decisions, a feeling of mental dysfunction, or difficulty incorporating new information into daily interactions. Medical researchers feel the large proportion of women self-questioning their cognition on anecdotal assessment criteria may also be suffering from negative mood disorders resulting from menopause at the same time.
As estrogen levels drop, changes in the body occur, and there is a drop in the metabolism of glucose in the brain. Brain function may be affected by the change in metabolism, as it requires estrogen, progesterone, follicle stimulating, and luteinizing hormones to work together. During menopause, hormone levels are fluctuating and, post-menopause, their production is reduced. However, the body adjusts to stable post-menopausal levels and symptoms of brain fog are considered temporary, not progressive.
Brain fog is considered to be a temporary symptom
If you are noticing an increase in forgetfulness or your brain function has deteriorated in ways that you feel are negatively impacting your daily life, it is important to speak to a medical professional to determine the cause and appropriate treatments.
Other impacted areas
Research has indicated that premature peri-menopause onset may be correlated to later risk for dementia, including Alzheimers. If a woman enters menopause before 40 years of age, she is thought to be 35% more likely to receive a subsequent diagnosis of dementia than a woman who enters menopause later. It is unclear why this correlation occurs, however it is presumed that prolonged lowered levels of estrogen plays a factor in the onset of dementia. If this is something that concerns you, please speak to our doctors or another medical professional specialized in Menopause that can answer your questions or refer you to someone who can.
Diagnosis
Diagnosis of Brain Fog is performed through patient self-reporting. As it is a common symptom for many women during menopause, it is easily diagnosed through a tele-medicine consult without the need for an in-person doctor’s visit.
Possible triggers or risk factors
Brain fog may be positively correlated to other peri-menopausal symptoms such as sleep disturbances, higher perceptions of stress, depression, and excessive fatigue. To eliminate causes of brain fog unrelated to hormonal levels, it is wise to stay well rested and to keep work/life balance and associated stresses in check. The strong inter-relationship between brain fog and a wide variety of physiological conditions means that decreased mental performance may be related to more than one cause, including dipping levels of estrogen and progesterone.
Want to speak with a Menopause doctor?
Treatments & remedies
There are few direct interventions available to dissipate or relieve brain fog, however there are many interconnected factors that lead some women to find relief through pharmacological and non-prescriptive alternatives. Let’s look at some of the most common treatments available today and whether they are reliable for brain fog reduction.
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Nutrition
Nutrition (and even a daily dose of caffeine stimulation) can affect brain activity positively. Think about the following recommendations:
- Excellent hydration
- 1 – 2 cups of coffee (200 mg of caffeine) daily was proven to improve memory consolidation for 24 hours after consumption
- The Mediterranean Diet (MIND diet) has been found to slow cognitive decline
- Brain boosting foods found to be effective for overall cognitive function include: caviar, dark leafy greens, berries, olive oil, cacao (over 80% dark chocolate works!)
Exercise
Exercise is essential for effective brain operation and blood flow.
- Maintain a healthy weight
- 45 – 60 minutes of moderate exercise is ideal
- Aerobic and resistance training are associated with increased brain function
- Tai chi exercise, specifically, has been proven to help stave off the effects of aging and to improve cognitive functions in adults over 50 experiencing brain dysfunction.
Mindset
Positive mental health lifestyle choices may include:
- Reducing multi-tasking to promote working memory attention requirements
- Participation in brain strengthening games such as puzzles
- Using written lists for complicated activities or busy times
Supplements
Even though there are many OTC products such as supplements out there claiming to improve brain function, there is actually no definitive scientific proof supporting these claims.
Fish oil and curcumin (turmeric) are two of the most frequently named (and used) supplements to improve brain function. It can’t hurt to take either of these in the recommended doses, and if you think it can be beneficial it is safe to take. However, having a healthy diet (incl dark chocolate!) may actually work just as well, if not better. So it might be a good idea to give that a try first.
OTC Products
Over-the-counter treatments for memory lapses and feelings of foggy brain are not available.
Prescription
There are no effective non-hormonal treatments available for cognition problems that are caused by menopause. However it is important to receive an accurate diagnosis, because if cognition changes are related to non-menopausal medical issues, such as thyroid malfunction or cerebrovascular disease, other treatment options may actually be available.
Hormone Treatment
Systemic Estrogen Therapy (progestin and/or estrogen) is a prescription treatment available under a doctor’s supervision. Although some peri-menopausal symptoms have been found to respond well to Hormone Replacement Therapy (HRT), there is unfortunetly no scientific evidence that it clears Brain Fog or reduces the risk of dementia in later life. Having said that, there is also no evidence that it will make it worse - so if you are taking HRT for other symptom management you have nothing to worry about.
Holistic Treatment
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FAQ
What are the symptoms of Menopause?
There are roughly 34 symptoms of Menopause with the most commonly experienced being:
- Irregular periods
- Vaginal dryness
- Hot flashes
- Night sweats
- Fatigue
- Sleep problems
- Mood changes and irritability
- Weight gain
- Thinning hair and dry skin
Medically reviewed and detailed symptom fact sheets can be found here, and a general overview of what (peri) menopause is and entails can be found here.
What is the average age of Menopause?
The average age for menopause in Asian women (including women in Singapore) is 50 - 52. The onset of peri-menopause is usually in a women's mid 40s, with 3.7% of women experiencing it before the age of 30.
What are the symptoms of Menopause?
There are 34 different symptoms associated with the Menopause transition impacting women on a mental, emotional and physical level. Symptoms range from the well known Hot Flashes & Night sweats, to depression, anxiety and a dry itchy skin. For and overview of all symptoms and detailed symptoms fact sheets please click here.
Do men get Menopause?
The short answer is No. “Male Menopause” or “andropause” are terms that are being used by the media, but have no medical basis. Testosterone levels in men do decline as they age, but this is a very gradual process at less than 2% per year starting from their 30s/40s. There is no sudden drop in Testosterone around midlife causing severe symptoms as is the case with Menopause. In many cases the symptoms that are claimed to be part of “male menopause” have nothing to do with (a change in) hormones.
References
Harvard Health Publishing. (2018, November 16). A sharper mind: tai chi can improve cognitive function. Harvard Health.
Thurston, R. C. (2013). Cognition and the menopausal transition. Menopause, 20(12), 1231–1232.
Weber, M. T., Rubin, L. H., & Maki, P. M. (2013). Cognition in perimenopause. Menopause: The Journal of The North American Menopause Society, 1
Weber M, Mapstone M. Memory complaints and memory performance in the menopausal transition. Menopause. 2009 Jul-Aug;16(4):694-700. doi: 10.1097/gme.0b013e318196a0c9. PMID: 19276998.
Greendale, G. A., Derby, C. A., & Maki, P. M. (2011). Perimenopause and Cognition. Obstetrics and Gynecology Clinics of North America, 38(3), 519–535
Cording, J. (2018, March 12). The Top 5 Brain-Boosting Foods You Should Be Eating. Forbes.
Copaken, D. (2019, November 8). How Menopause Could Lead to Alzheimer’s. The Atlantic.
Maki PM. Verbal memory and menopause. Maturitas. 2015 Nov;82(3):288-90. doi: 10.1016/j.maturitas.2015.07.023. Epub 2015 Aug 11. PMID: 26433715.
Gava G, Orsili I, Alvisi S, Mancini I, Seracchioli R, Meriggiola MC. Cognition, Mood and Sleep in Menopausal Transition: The Role of Menopause Hormone Therapy. Medicina (Kaunas). 2019 Oct 1;55(10):668. doi: 10.3390/medicina55100668. PMID: 31581598; PMCID: PMC6843314.
American Heart Association. "Early menopause may raise risk of dementia later in life." ScienceDaily. ScienceDaily, 2 March 2022. <www.sciencedaily.com/releases/2022/03/220302131326.htm>.
https://www.bodylogicmd.com/blog/why-cant-i-remember-the-impact-of-hormones-on-memory/
Brain Fog
Forgetting why you walked into a room, losing your train of thought or quite frequently searching for that word that is just on the tip of your tongue. Sound familiar? This confusing feeling is often referred to as “brain fog.” It's a very common symptom of Menopause and over 60% of women between the ages of 40 – 60 report difficulty in concentration and general cognitive decline. Although cognitive decline is generally considered to be a result of aging, in reality there is actually a very strong connection to hormonal aging as well. For many women Brain Fog has a significant impact on both their personal and professional life, and can have a comprehensive effect on their overall wellbeing.
60% of women report experiencing Brain Fog during the menopausal transition years
The good news is that treatment is available, and normally the symptoms fade as a woman enters post-menopause.
Dr. June Tan Sheren
Why this is happening
Women have reported several cognitive problems during menopause: a change in the ability to think daily activities through clearly, difficulty making decisions, a feeling of mental dysfunction, or difficulty incorporating new information into daily interactions. Medical researchers feel the large proportion of women self-questioning their cognition on anecdotal assessment criteria may also be suffering from negative mood disorders resulting from menopause at the same time.
As estrogen levels drop, changes in the body occur, and there is a drop in the metabolism of glucose in the brain. Brain function may be affected by the change in metabolism, as it requires estrogen, progesterone, follicle stimulating, and luteinizing hormones to work together. During menopause, hormone levels are fluctuating and, post-menopause, their production is reduced. However, the body adjusts to stable post-menopausal levels and symptoms of brain fog are considered temporary, not progressive.
Brain fog is considered to be a temporary symptom
If you are noticing an increase in forgetfulness or your brain function has deteriorated in ways that you feel are negatively impacting your daily life, it is important to speak to a medical professional to determine the cause and appropriate treatments.
Other impacted areas
Research has indicated that premature peri-menopause onset may be correlated to later risk for dementia, including Alzheimers. If a woman enters menopause before 40 years of age, she is thought to be 35% more likely to receive a subsequent diagnosis of dementia than a woman who enters menopause later. It is unclear why this correlation occurs, however it is presumed that prolonged lowered levels of estrogen plays a factor in the onset of dementia. If this is something that concerns you, please speak to our doctors or another medical professional specialized in Menopause that can answer your questions or refer you to someone who can.
Diagnosis
Diagnosis of Brain Fog is performed through patient self-reporting. As it is a common symptom for many women during menopause, it is easily diagnosed through a tele-medicine consult without the need for an in-person doctor’s visit.
Possible triggers or risk factors
Brain fog may be positively correlated to other peri-menopausal symptoms such as sleep disturbances, higher perceptions of stress, depression, and excessive fatigue. To eliminate causes of brain fog unrelated to hormonal levels, it is wise to stay well rested and to keep work/life balance and associated stresses in check. The strong inter-relationship between brain fog and a wide variety of physiological conditions means that decreased mental performance may be related to more than one cause, including dipping levels of estrogen and progesterone.
Treatments & Remedies
There are few direct interventions available to dissipate or relieve brain fog, however there are many interconnected factors that lead some women to find relief through pharmacological and non-prescriptive alternatives. Let’s look at some of the most common treatments available today and whether they are reliable for brain fog reduction.
Products
Even though there are many OTC products such as supplements out there claiming to improve brain function, there is actually no definitive scientific proof supporting these claims.
Fish oil and curcumin (turmeric) are two of the most frequently named (and used) supplements to improve brain function. It can’t hurt to take either of these in the recommended doses, and if you think it can be beneficial it is safe to take. However, having a healthy diet (incl dark chocolate!) may actually work just as well, if not better. So it might be a good idea to give that a try first.
Over-the-counter treatments for memory lapses and feelings of foggy brain are not available.
There are no effective non-hormonal treatments available for cognition problems that are caused by menopause. However it is important to receive an accurate diagnosis, because if cognition changes are related to non-menopausal medical issues, such as thyroid malfunction or cerebrovascular disease, other treatment options may actually be available.
Lifestyle
Nutrition (and even a daily dose of caffeine stimulation) can affect brain activity positively. Think about the following recommendations:
- Excellent hydration
- 1 – 2 cups of coffee (200 mg of caffeine) daily was proven to improve memory consolidation for 24 hours after consumption
- The Mediterranean Diet (MIND diet) has been found to slow cognitive decline
- Brain boosting foods found to be effective for overall cognitive function include: caviar, dark leafy greens, berries, olive oil, cacao (over 80% dark chocolate works!)
Exercise is essential for effective brain operation and blood flow.
- Maintain a healthy weight
- 45 – 60 minutes of moderate exercise is ideal
- Aerobic and resistance training are associated with increased brain function
- Tai chi exercise, specifically, has been proven to help stave off the effects of aging and to improve cognitive functions in adults over 50 experiencing brain dysfunction.
Positive mental health lifestyle choices may include:
- Reducing multi-tasking to promote working memory attention requirements
- Participation in brain strengthening games such as puzzles
- Using written lists for complicated activities or busy times
Holistic
TCM
Fu ling (poria), huang qi (astragalus), and ren shen (ginseng) help with brain fog by strengthening the spleen. Avoid cold foods and consume warm ones.
Ayurveda
Brain power is boosted by ashwagandha, brahmi, guduchi, shankhapushpi, affecting immunity, concentration, and body functions.
Acupuncture
DU 20 (Bai Hui) raises qi and yang, clearing and calming to benefit brain operations. Si Shen Cong can also provide relief.
Mindfulness
Over-thinking and worry damage the spleen qi and reduce brain function. Focus on being present, calming your spirit with yoga, or deep-breathing practices.
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