Written by Dr. Valentina Quintana MD on
November 18, 2022
Reading Time: 7 minutes

Medically Reviewed by our Medical Affairs Team

Written by Dr. Valentina Quintana MD on:

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If you’re like most women, you’re probably in the midst of perimenopause. You may be noticing some changes in your body—like brain fog.

Don’t worry; you’re not alone. This is a common symptom for women going through the menopause transition.

In this article, we’ll discuss what causes brain fog during perimenopause and how you can get rid of it. We’ll also provide some helpful tips on how to manage your symptoms.

Let’s get started.

What is perimenopause?

Perimenopause is the transition period that often occurs in a woman’s life before menopause. It can start as early as your late thirties or forties and last for up to 10 years.

During this time, your body starts to produce less estrogen and progesterone–two hormones essential for reproductive health.

As a result, you may experience a range of symptoms, such as mood swings, hot flashes, irregular periods, and brain fog.


There are several pre-menopausal symptoms, and they vary from person to person. Here are some of the most common ones:

  • Irregular periods
  • Hot flashes (also known as vasomotor symptoms or VMS)
  • Mood swings
  • Brain fog
  • Difficulty sleeping
  • Vaginal dryness
  • Breast tenderness
  • Low libido
  • Weight gain
  • Fatigue

Risk Factors

Although perimenopause can affect any woman, there are certain factors that may increase your risk of experiencing symptoms. These include:

  • Age: The menopausal transition typically begins in a woman’s late 30s or early 40s.
  • Family history: If other female relatives went through menopause at an earlier age, you might be more likely to experience symptoms at a younger age.
  • Health conditions: Certain health conditions, including diabetes and heart disease, can increase your risk of perimenopause-related symptoms.
  • Lifestyle factors: Smoking, drinking alcohol, and being overweight are all lifestyle factors that can contribute to perimenopause-related symptoms.
  • Cancer treatments: Radiation and chemotherapy can cause early menopause and lead to perimenopause-related symptoms.
  • Hysterectomy: Women who have had a hysterectomy may experience an earlier onset of perimenopause-related symptoms.


The most common complication caused by perimenopause, aside from its varied pre-menopause symptoms, is an irregular cycle, which can include one or more of the following:

  • Extremely heavy flow  
  • Longer-lasting bleeding 
  • Bleeding that occurs between periods 
  • Periods occurring less than 21 days 

What is brain fog, exactly?

Brain fog, or mental fatigue, is a common symptom of perimenopause. It’s often characterized by difficulty concentrating, forgetfulness, and confusion.

The exact cause of brain fog is unclear, but researchers believe it may be due to the hormonal changes that occur during perimenopause.

Many women also report feeling overwhelmed and anxious during this time, which can contribute to the feeling of mental fatigue.

Common Causes of Perimenopause Brain Fog

Brain fog during perimenopause can be caused by several factors, but the most common drivers of mental fatigue during this stage are the following:

Sleep disturbances

Most women in the menopausal transition experience lower sleep quality due to the symptoms brought about by perimenopause, such as insomnia, night sweats, and hot flashes at night.

Poor sleep can cause mental fatigue during the day. Aside from causing brain fog, poor sleep can also lead to the following problems:

  • Weight gain
  • Obesity
  • Depression
  • Heart disease
  • Diabetes
  • Hypertension
  • Heart attack
  • Stroke

Hormonal fluctuations

As previously discussed, the hormonal changes that occur during perimenopause, such as decreasing estrogen levels, can lead to a decrease in brain chemicals like serotonin and dopamine, which are essential for memory and focus.

This decrease in neurotransmitters can lead to difficulty concentrating and problems with cognitive tasks.

Depression and anxiety

Many women experience an increase in depressive symptoms during perimenopause.

One study finds that in the United States alone, about 18% of women in early perimenopause and 38% who are in late perimenopause are experiencing depressive symptoms.

Anxious and depressive symptoms can lead to feelings of mental fatigue, difficulty concentrating, and difficulty making decisions.

Stressful life events

Stressful life events such as divorce, a new job, or moving to a different city can all add up and take a toll on your mental health. Stress and anxiety can cause difficulty concentrating and other cognitive problems.

Harvard Medical School also states that increased stress often accompanies perimenopause and menopause, leaving those who are at these stages feeling frazzled and distracted.

One study also suggests that when people are stressed, the hormone cortisol is released into the brain. This can lead to problems with cognitive performance, such as difficulty concentrating, making decisions, or solving problems more efficiently.

Blood sugar levels

Fluctuating blood sugar levels can lead to fatigue and difficulty concentrating. This is especially true for perimenopausal women with diabetes or pre-diabetes, who may experience more severe symptoms.

The Centers for Disease Control and Prevention (CDC) explains that high blood sugar levels could destroy the blood vessels in your brain over time, resulting in inefficient blood flow of oxygen-rich blood.

As a result, the brain cells get damaged, also known as brain atrophy, which causes issues in thinking and memory, and may lead to dementia.


If you’re going through perimenopause, you are more at risk of dehydration—symptoms, such as hot flushes and night sweats, can accelerate the loss of fluids in your body.

One study published in Cambridge University Press also finds that being dehydrated, even for just a small degree, can impact your cognitive function negatively—causing deficits in mood, memory, and visual perceptual abilities.

Common Symptoms of Brain Fog During Perimenopause

Brain fog during perimenopause can manifest in various ways. Some of the most common symptoms include:

  • Difficulty concentrating
  • Short-term memory loss
  • Confusion and disorientation
  • Poor decision-making abilities
  • Slow reaction time
  • Struggles with problem-solving
  • Sudden mood swings
  • Irritability and headaches

The severity of these symptoms varies from person to person, so if you’re dealing with perimenopause brain fog, know that there are steps you can take to alleviate your symptoms and improve your overall brain function in the long run.

How to Get Rid of Perimenopause Brain Fog

If you’re struggling with brain fog during perimenopause, know that there are ways to manage your symptoms and improve your mental clarity. Here are our recommendations:

Prioritize and optimize your sleep.

Dealing with perimenopause can also mean dealing with sleep disturbances, particularly insomnia. So, prioritizing and optimizing your sleep is crucial for maintaining your brain function during this stage.

So, here’s how you can do it and follow through:

  • Stick to a regular sleep schedule, even on the weekends. Sleep and wake up at the same time each night and each morning.
  • Avoid caffeine late in the day
  • Exercise regularly but not too close to bedtime
  • Avoid screens before bed
  • Create a comfortable sleeping environment by keeping your bedroom dark and cool.
  • Practice a relaxing bedtime routine, such as breathing exercises and meditation, before you sleep.

Eat nutritious meals for perimenopause.

It’s important to nourish your body with the nutrients it needs, especially during perimenopause.

Eating a balanced and healthy diet filled with proteins, fruits, vegetables, healthy fats, and carbohydrates can help regulate hormones in your body, making you feel more energized throughout the day.

You should also focus on foods that boost brain health—leafy greens, eggs, fish, walnuts, and blueberries—to improve your memory and thinking abilities.

Incorporate omega-3 fatty acids into your diet

Omega-3 fatty acids are essential for brain function and can help reduce symptoms of brain fog during perimenopause.

You can increase the amount of omega-3 fatty acids in your diet by eating foods such as salmon, tuna, walnuts, eggs, and flaxseed. You can also take omega-3 supplements with the approval of a doctor.

Add soy isoflavones to your diet.

Several studies have shown that soy isoflavones can reduce symptoms of perimenopause.

It is found that soy isoflavones improved fatigue and mood swings symptoms as well as reduced systolic blood pressure in perimenopausal women.

You can get your recommended daily amount of soy isoflavones by eating edamame, miso, tofu, and tempeh.

Stay hydrated.

As mentioned earlier, dehydration can cause mental impairment and worsen brain fog symptoms during perimenopause.

Drinking 8-10 glasses of water per day is recommended, depending on your activity level and climate.

Try to carry a refillable water bottle with you so that you can stay hydrated throughout the day.

Take supplements for brain fog.

Supplements such as omega-3 fatty acids, B-complex vitamins, and ginkgo Biloba can help improve symptoms of perimenopause brain fog.

These supplements are available at most health food stores; however, always talk to your doctor before starting a new supplement.

Get regular exercise.

Regular exercise is essential for brain health, as it helps increase blood flow and oxygen to the brain. This can help improve thinking abilities and reduce fatigue and anxiety.

So, aim to get at least 30 minutes of aerobic exercise per day, such as walking or jogging, that will help you stay alert and energized throughout the day.

Practice relaxation techniques.

Stress can exacerbate symptoms of perimenopause, so it’s important to find healthy ways to deal with it.

Deep breathing and mindfulness meditation are great tools for reducing stress levels.

Furthermore, engaging in activities such as yoga, Tai Chi, or even regular walks outside can help you relax and clear your mind.

Other relaxing things we recommend that you do include:

  • Spending time in nature
  • Spending time with people that bring you joy
  • Doing a hobby that you like
  • Getting a relaxing massage
  • Reading a book
  • Listening to music
  • Watching a show you enjoy
  • Deep breathing and meditation.

Train your brain regularly.

Just like you exercise your body to stay in shape, it’s important to make time for brain exercises as well.

Doing puzzles such as crosswords and Sudoku can help improve memory and concentration. You can also find fun online brain games that are designed to stimulate the brain and boost cognitive functioning.

Other brain-training activities you can do to keep your mind sharp include:

  • Learning a new skill
  • Trying out a foreign language
  • Doing complex mathematical equations
  • Studying for an exam or test
  • Playing board games with friends and family.

Quit unhealthy habits.

Unhealthy habits like sleep deprivation, smoking, and excessive drinking can worsen perimenopause brain fog.

So, it’s important to quit these vices and replace them with healthier activities, such as the ones mentioned above.

Finally, make sure to get enough restful sleep each night. Sleep deprivation can cause mental fatigue and impair your thinking abilities, so aim for 7-9 hours of quality sleep per night.

How long does perimenopause last?

The duration of perimenopause varies from woman to woman, but in general, it can last anywhere from two to eight years.

It typically begins several years before menopause and ends when menstrual periods become irregular or stop completely.

Wrapping Up

Brain fog during perimenopause is a common issue that many women experience.

Some people may find the symptoms overwhelming and even debilitating—negatively affecting their career, business, and personal life.

By following the tips and advice mentioned above, you can help reduce your unhealthy cognitive symptoms and get back to being your best self.

Remember that it is important to sleep better, stay hydrated, exercise regularly, practice relaxation techniques, train your brain on a regular basis, eat healthy, supplement with vitamins if needed, and quit unhealthy habits like smoking and excessive drinking.

By doing these things, you can help manage your perimenopause brain fog and enjoy a better quality of life.

If you’re looking to learn more about how to cope with brain fog and improve your overall cognitive function more naturally, check out these helpful resources we compiled on our blog.

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