If your words, focus or short-term recall have started to feel less reliable in your 40s, you probably have three questions: is this perimenopause, will it last, and what can you do about it?
Quick Answers
- Is perimenopause brain fog real? Yes. Menopause experts describe these complaints as common,¹ and a large U.S. study of women going through the transition measured changes in processing speed and verbal memory during perimenopause that tended to be temporary.²
- What helps? The basics add up: protect your sleep,³ move most days,⁴ lower your stress load, lean on lists and calendars, and ask your clinician to rule out other causes.⁵
- When is it most likely? Most often in perimenopause, when periods become irregular. For many women it eases after menopause, though some changes can linger for some women.¹
- When should I worry? See a clinician if you notice changes in your memory that worry you, especially if you get lost in places you know well, have trouble following directions or recipes, or the changes make everyday tasks like driving harder.⁵
What Perimenopause Brain Fog Feels Like
Menopause experts describe cognitive complaints at this stage as common, and the ones women report include difficulty recalling words and numbers, misplacing things like keys, trouble concentrating or losing a train of thought, and forgetting appointments and events.¹ Difficulty concentrating also appears on clinician-style menopause symptom checklists.⁶
Some women describe walking into a room and forgetting why they came in.
For the wider picture, see our guides to perimenopause symptoms and the 100 symptoms of perimenopause.
Why It Happens: Estrogen, the Brain and a Busy Season of Life
Estrogen acts on parts of the brain involved in memory and focus, such as the hippocampus and prefrontal cortex. As estrogen levels fall during perimenopause, researchers think this likely contributes to the shifts in verbal memory and working memory that studies have measured.¹
The Study of Women's Health Across the Nation (SWAN), a large, multi-ethnic U.S. study, measured a dip in processing speed and verbal memory during perimenopause that was transient and wasn't explained by sleep problems or hot flashes. Real, but not necessarily permanent.²
If this season of life also feels crowded, count stress load too. Stress researchers describe the brain as central to how the body responds and adapts to stress, and they call the cumulative toll of ongoing stress "allostatic load."⁷
When It's Most Likely, and Does It Go Away?
Brain fog most often shows up in perimenopause, when periods become irregular, and for many women it eases after menopause, though some changes, especially in learning new verbal information, can linger for some women.¹
Not sure where you are? Our perimenopause age guide walks through the stages.
What Else Can Feel Like Brain Fog
Other things can cause similar memory and focus problems, including thyroid problems, medication side effects, depression or anxiety, sleep problems and low vitamin B12. That's why it's worth asking your clinician to check.⁵
Low iron can also cause tiredness and trouble concentrating, and heavy or frequent periods are one cause, so it's worth asking your clinician about a simple blood test.⁸
Everyday Steps That May Help
Protect your sleep. Short or broken sleep on its own can make it harder to focus, remember things and make decisions the next day,³ so protecting sleep is one of the most useful everyday steps. NIA's everyday memory tips include getting enough sleep, generally seven to eight hours each night.⁵
Move most days. Moving most days helps more than you might expect: U.S. guidelines say activity can ease anxiety and improve sleep quality, even in the short term, and recommend at least 150 minutes a week of moderate activity like brisk walking, plus strength work twice a week.⁴ Menopause experts include regular aerobic activity in their brain-health advice.¹
Use memory tools, and go easy on alcohol. NIA's everyday memory tips also include planning tasks, making to-do lists and using calendars and notes, and avoiding or limiting alcohol.⁵
Do one thing at a time. When your head feels crowded, try doing one thing at a time and finishing it before you start the next.
Build in a stress reset. A few slow breaths are an easy place to start. Our guide to deep breathing exercises walks through simple techniques.
Choline: Why Women Need More After Estrogen Falls
Choline is a nutrient the body needs to build cell membranes, and it's a source of methyl groups needed for many steps in metabolism.⁹
The enzyme that makes choline internally, PEMT, is induced by estrogen — so as estrogen falls, the body makes less of its own. In a controlled feeding trial, postmenopausal women had a measurably higher dietary requirement for choline than premenopausal women.¹⁰
The Adequate Intake for women 19 and older is 425 mg a day, and most people in the U.S. get less choline than the Adequate Intake; in national survey data from 2013–2014, adult women averaged 278 mg a day from foods and beverages. Eggs, meat, poultry, fish, soybeans and cruciferous vegetables like broccoli and Brussels sprouts are good sources. The upper limit for adults is 3,500 mg a day.⁹
More on why women need more choline and choline bitartrate.
Magnesium: An Everyday Mineral Many Diets Run Short On
Magnesium plays a role in normal nerve and muscle function. Many people's diets provide less than the recommended amount, though total intake is generally above it once supplements are counted; the RDA for women over 30 is 320 mg a day.¹¹,¹²
Even "natural" supplements can interact with medicines or matter before surgery, so tell your health care providers about everything you take.¹³ Your pharmacist is a good person to ask, too.
If you're weighing supplements, our guide to supplement categories for menopause brain fog walks through the options.
When to See a Clinician
Mention brain fog at your next checkup, and book sooner if you notice any of these signs. NIA lists signs that it might be time to talk with a doctor: asking the same questions over and over, getting lost in places you used to know well, having trouble following recipes or directions, and becoming more confused about time, people and places. Serious memory problems can make everyday things like driving harder.⁵ If memory problems persist after a few weeks, talk with your doctor.⁵
Also contact your provider if you have symptoms of low iron, such as feeling weak or tired more often than usual.⁸
FAQ
Is perimenopause brain fog real?
Yes. Menopause experts describe complaints like trouble finding words, trouble concentrating and forgetting appointments as common during the transition,¹ and a large U.S. study measured changes in some thinking skills during perimenopause that tended to be temporary.²
Can choline or magnesium help with perimenopause brain fog?
Both are nutrients your body needs. Magnesium plays a role in normal nerve and muscle function, and many people's diets fall short of the recommended amount, though total intake is generally above it once supplements are counted.¹¹,¹² Many people also get less choline than recommended, and choline needs rise after estrogen falls.⁹,¹⁰ Neither is a treatment for brain fog: food comes first, and talk with your clinician before adding supplements.
When in menopause is brain fog most likely?
It's most often reported during perimenopause, when periods become irregular, and for many women it eases after the transition, though some changes can linger for some women.¹
How do you get rid of brain fog with perimenopause?
There's no instant fix, but the basics add up: protect your sleep, generally seven to eight hours each night,³,⁵ move most days,⁴ lower your stress load, use to-do lists and calendars and avoid or limit alcohol,⁵ and ask your clinician to rule out other causes like thyroid problems, low vitamin B12 or low iron.⁵,⁸
When should I worry about memory changes?
See a clinician if you notice changes in your memory that worry you, especially if you get lost in places you know well, have trouble following directions or recipes, or the changes make everyday tasks like driving harder.⁵
Is brain fog a sign of early dementia?
Typical perimenopause brain fog is common and isn't the same as dementia: for the large majority of women, thinking stays within the normal range during the transition, and for many it eases after menopause.¹ If you notice changes in your memory that worry you, talk with your clinician.⁵
Related reading: Menopause and cortisol · Perimenopause symptoms
Bottom Line
Brain fog in perimenopause is worth getting checked. The plan is unglamorous: rule out other causes with your clinician, protect your sleep, move most days, lean on lists and let food lead on nutrition. For supplement categories, see our guide to best supplements for menopause brain fog.
Where Lumera Fits
Lumera is a non-hormonal daily supplement. Per 2 capsules: choline 300 mg (VitaCholine), magnesium 50 mg, folate 400 mcg DFE, D3, K2 and the clinically studied Tamisense-Q™ botanical complex.
Lumera contains 300 mg of Tamisense-Q™ — the same daily amount used in the published clinical research on the ingredient.
If you take a blood thinner such as warfarin, talk to your clinician before taking vitamin K.¹⁴
Lumera is not a treatment for brain fog, memory problems or any medical condition. If your symptoms are affecting daily life, talk with your clinician.
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
References
- Maki PM, Jaff NG. Brain fog in menopause: a health-care professional's guide for decision-making and counseling on cognition. Climacteric. 2022. PMID 36178170. https://doi.org/10.1080/13697137.2022.2122792 (review)
- El Khoudary SR, Greendale G, Crawford SL, Avis NE, Brooks MM, Thurston RC, Karvonen-Gutierrez C, Waetjen LE, Matthews K. The menopause transition and women's health at midlife: a progress report from the Study of Women's Health Across the Nation (SWAN). Menopause. 2019;26(10):1213-1227. PMID 31568098. https://pubmed.ncbi.nlm.nih.gov/31568098/ (review)
- NHLBI. Sleep Deprivation and Deficiency: How Sleep Affects Your Health. https://www.nhlbi.nih.gov/health/sleep-deprivation/health-effects (agency page)
- ODPHP. Top 10 Things to Know About the Second Edition of the Physical Activity Guidelines for Americans. https://odphp.health.gov/our-work/nutrition-physical-activity/physical-activity-guidelines/current-guidelines/top-10-things-know (agency page / federal guideline)
- National Institute on Aging. Memory Problems, Forgetfulness, and Aging. https://www.nia.nih.gov/health/memory-loss-and-forgetfulness/memory-problems-forgetfulness-and-aging (agency page)
- NSW Government. Perimenopause and menopause symptom checklist. 2023. https://www.nsw.gov.au/sites/default/files/2023-05/CS1219_Menopause_symptom_checklist.pdf (government patient resource, based on the Greene Climacteric Scale)
- McEwen BS. Physiology and neurobiology of stress and adaptation: central role of the brain. Physiol Rev. 2007;87(3):873-904. https://doi.org/10.1152/physrev.00041.2006 (review)
- MedlinePlus. Iron deficiency anemia (A.D.A.M. Medical Encyclopedia, article 000584). https://medlineplus.gov/ency/article/000584.htm (agency page)
- National Institutes of Health, Office of Dietary Supplements. Choline: Fact Sheet for Health Professionals. https://ods.od.nih.gov/factsheets/Choline-HealthProfessional/ (regulatory/agency)
- Fischer LM, et al. Dietary choline requirements of women: effects of estrogen and genetic variation. Am J Clin Nutr. 2010;92(5):1113-1119. https://pubmed.ncbi.nlm.nih.gov/20861172/ (human clinical trial)
- National Institutes of Health, Office of Dietary Supplements. Magnesium: Fact Sheet for Health Professionals. https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/ (regulatory/agency)
- National Institutes of Health, Office of Dietary Supplements. Magnesium: Fact Sheet for Consumers. https://ods.od.nih.gov/factsheets/Magnesium-Consumer/ (regulatory/agency)
- NCCIH. Using Dietary Supplements Wisely. https://www.nccih.nih.gov/health/using-dietary-supplements-wisely (agency page)
- National Institutes of Health, Office of Dietary Supplements. Vitamin K: Fact Sheet for Consumers. https://ods.od.nih.gov/factsheets/VitaminK-Consumer/ (regulatory/agency)