Menopause Brain Fog Explained: A Naturopathic Doctor’s Guide to Cognitive Changes In Mid-Life
- Dr. Tamarah Chaddah, ND
- 5 days ago
- 4 min read
By: Dr. Tamarah Chaddah, ND, MSCP (f. NAMS) | Menopause Practitioner
Follow me on socials @drchaddahnd
Menopause Brain Fog Explained: A Naturopathic Doctor’s Guide to Cognitive Changes In Mid-Life
Most of us are familiar with the term “brain fog”, one of the most common and frustrating symptoms that can happen during the transition into menopause.
Brain fog can feel like being mentally “cloudy,” less sharp, or slower than usual. Many women describe the sensation of having a word on the tip of their tongue but being unable to recall it, or walking into a room and forgetting why they’re there.
While unsettling, these experiences are extremely common during perimenopause and menopause.
So, let's talk about it.
Disclaimer:
This content is for informational and educational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, naturopathic doctor, or other qualified healthcare provider with any questions you may have regarding a medical condition or health concern. Never disregard professional medical advice or delay seeking it because of something you have read here.
Cognitive Symptoms in Perimenopause and Menopause
During the menopause transition, women frequently experience a range of cognitive changes, including:
Memory lapses
Difficulty with focus and attention
Reduced concentration
Changes in executive function
Slower processing speed
Women may notice challenges with recalling new information, completing tasks, multitasking, or maintaining attention for extended periods.
The Role of Estrogen in Brain Function
Research shows that estrogen plays a significant role in cognitive performance. Estrogen influences activity in brain regions rich in estrogen receptors, including:
The prefrontal cortex (attention, planning, decision-making)
The hippocampus (memory and learning)
As estrogen fluctuates during perimenopause, these brain regions can be temporarily affected, leading to the cognitive symptoms many women experience.
What the Research Says About Cognitive Performance in Perimenopause
Studies indicate that women in perimenopause may demonstrate poorer cognitive performance compared to premenopausal women, particularly in areas such as:
Reaction time
Visual memory
Attention
Working memory
These findings help validate what many women are already feeling that this is not “all in your head.”
Why Does Menopause Brain Fog Feels So Distressing?
These cognitive changes often occur during midlife, a time when many women are:
At pivotal points in their careers
Carrying a significant mental and emotional load
Managing work, family, aging parents, and personal health
When cognitive symptoms arise during this phase, they can feel frightening and destabilizing.
Is Menopause Brain Fog a Sign of Dementia?
This is one of the most common fears I hear in practice.
The good news is that current research shows these cognitive changes are generally temporary and most often related to:
Hormonal fluctuations
Sleep disturbances
Increased stress
They are not typically indicative of dementia or long-term cognitive decline, which is uncommon in women in this midlife age group. In most cases, cognition improves as the body adapts to a new hormonal environment after menopause.
When Is Further Cognitive Evaluation Needed?
If cognitive changes feel atypical, severe, or do not improve after the menopause transition, a thorough evaluation is warranted. This is especially important if symptoms are:
Progressively worsening
Affecting daily functioning
Not explained by hormonal changes, sleep, or stress
Preventing Cognitive Decline: Why Midlife Matters
If cognitive symptoms were related to neurodegeneration, treatment options are unfortunately very limited once dementia has progressed. This is why prevention is key, and midlife is a powerful window for intervention.
The encouraging news is that many modifiable lifestyle factors have a profound impact on brain health and cognitive decline prevention.
Modifiable Risk Factors for Cognitive Decline and Dementia
1. Weight and Metabolic Health
Maintaining a healthy weight, particularly in midlife, is important for long-term brain health.
2. Cardiovascular Risk Factors
Managing high cholesterol and high blood pressure can significantly reduce the risk of cognitive decline.
3. Blood Sugar and Diabetes
Preventing or properly managing diabetes is crucial for protecting cognitive function.
4. Smoking
Avoiding or quitting smoking is strongly recommended for both brain and overall health.
5. Alcohol Consumption
Limiting alcohol intake is important, as excess consumption is associated with increased dementia risk.
6. Psychological Stress
Chronic stress negatively affects cognition. Learning to reduce and manage stress is essential.
The MIND Diet and Cognitive Health in Menopause
Diet plays a major role in brain health. The MIND diet (Mediterranean–DASH Intervention for Neurodegenerative Delay) has shown promise in reducing cognitive decline and dementia risk.
Research has found that higher adherence to the MIND diet is associated with:
Slower cognitive decline
Reduced risk of developing dementia
In my practice in Aurora, Ontario Canada, I provide patients with a screening tool to evaluate where they can incorporate more MIND diet foods. Starting these changes in midlife and perimenopause can only benefit long-term brain health.
Physical Activity and Brain Health
Regular physical activity is consistently associated with better cognitive function and reduced risk of cognitive decline. Exercise supports blood flow to the brain, reduces inflammation, and improves metabolic health.
Why It’s Worth Starting Now
Addressing these modifiable risk factors during midlife and perimenopause can have a significant impact on reducing the risk of cognitive decline and dementia later in life — so why not start early?
Technology, Multitasking, and Modern Brain Fog
On a personal note, one area I’m thinking about more is how technology use is affecting brain function.
While we believe we are multitasking, we are often just splitting our attention, leading to:
Increased distraction
Reduced focus
Lower productivity
My mission is to develop practical, realistic strategies to refine how we use technology so it supports, rather than undermines our cognitive health and day-to-day productivity.
Personalized Menopause And Perimenopause Support in Ontario
Dr. Tamarah Chaddah, Naturopathic Doctor, currently sees patients inside Women 360 Care in Aurora, Ontario, Canada. She offers in-person menopause and perimenopause care in Aurora, Toronto and York Region, with virtual naturopathic appointments available across Ontario.
You can book a visit with Dr. Chaddah, ND using the button below.
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