Brain Fog or Something More?

Cognitive Decline During Perimenopause and Menopause

Have you ever walked into a room and forgotten why? Struggled to find the right word mid-sentence? Or felt like your once-sharp brain is now wrapped in cotton wool?

If you’re in your 30s, 40s or 50s, you might assume it’s just stress or aging. But for many women, these changes are linked to perimenopause and menopause and they’re more common than you think.

Let’s unpack what’s happening to your brain during this hormonal shift, what’s normal, what’s not, and what science says about supporting cognitive health through it.

The Hormone-Brain Connection

Estrogen isn’t just a reproductive hormone it’s a neuroprotective hormone, with receptors in key cognitive regions like the hippocampus, prefrontal cortex, and amygdala.

🧠 A 2013 study published in Frontiers in Neuroendocrinology confirms that estrogen plays a vital role in synaptic plasticity, neurotransmitter regulation, and cerebral blood flow, all critical for memory and cognition.
  (Source: Brinton RD, 2013)

As estrogen levels fluctuate and decline during perimenopause and menopause, many women experience:

• Word-finding difficulties
  
• Memory lapses
  
• Difficulty concentrating
  
• Slower mental processing
  
• Mood changes or anxiety
  
  

When Do Cognitive Changes Happen?

A major longitudinal study the Study of Women’s Health Across the Nation (SWAN) found that cognitive performance, especially verbal memory and processing speed, declines during the menopause transition, particularly in the 2 years surrounding the final menstrual period.
  (Source: Greendale GA et al., 2009)

Key phases:

• Perimenopause: Hormone fluctuations start; many women first notice brain fog.
  
• Menopause: Estrogen drops sharply; symptoms may peak.
  
• Post-menopause: Some symptoms ease, but not always.
  
  

Is It Dementia or Menopause Brain Fog?

One of the biggest fears women have is that cognitive changes mean early dementia. But there are key differences:

 

That said, it’s important to know that two-thirds of Alzheimer’s patients are women, and menopause may be a neurological tipping point.
  (Source: Mosconi L et al., 2021, The Lancet Neurology)

What Can You Do To Support Cognitive Function?

🔬 1. Balance Blood Sugar
  Insulin resistance worsens both menopause symptoms and cognitive decline. Studies link type 2 diabetes and insulin resistance with increased dementia risk.
  (Source: Biessels GJ et al., 2006)

🥬 2. Boost Mitochondrial Health
  Nutrients like CoQ10, alpha-lipoic acid, and NAD+ boosters may support brain energy and reduce oxidative stress.

🛌 3. Prioritise Sleep
  Chronic sleep issues affect 40–60% of menopausal women and significantly impair memory.
  (Source: Kravitz HM et al., 2003)

🏋️♀️ 4. Move Your Body
  Exercise boosts brain-derived neurotrophic factor (BDNF), a key protein for learning and memory.
  (Source: Erickson KI et al., 2011)

💡 5. Consider Hormone Testing and HRT
  Tracking levels of estradiol, progesterone, testosterone, cortisol, and thyroid hormones gives insights into what’s driving your symptoms.
  Some studies support the timely use of HRT (within 5 years of menopause) to preserve cognitive function, particularly when estrogen is used alone or with natural progesterone.
  (Source: Maki PM, Henderson VW, 2016)

Final Thoughts

Cognitive changes in perimenopause and menopause are real, common, and under-acknowledged. But they’re not something you just have to "put up with."

Whether it’s misplacing your keys or feeling like your brain isn’t firing like it used to, understanding what’s happening is the first step in regaining clarity.

At Nudae, our advanced hormone and cognitive health testing gives you a roadmap not just reassurance. Because your brain deserves just as much attention as your body.

Disclaimer: Nudae Life provides educational testing, not diagnosis or treatment. Always consult a licensed medical professional before making health decisions.