New Thinking on Brain Fog for Midlife Women

It happens to all of us. We’re in the middle of a conversation and a word – an easy word, one that we’ve called on thousands of times – vanishes from the storehouse of verbal memory. 

Or you’re at your desk trying with all your might to wade through the thick cloud between you and your work. You’re determined to squeeze your mind into it, to focus. But you can’t. 

You reach for another cup of coffee. You feel that little kick of energy you’ve come to rely on. But the buzz does nothing for the haze between your brain cells and your work, cells you never thought to think about – before now. 

Or you find your cell phone in the fridge, your car keys in the freezer. Maybe you can’t find your way home from work. That’s when you start to worry. Something so obvious, so mundane to your daily existence, is shot. 

You’re struggling to stay afloat in a sea of menopause brain fog. 


Brain Fog Is a Common but Often Dismissed Experience 

Brain fog is one of the most troubling experiences in midlife and later. Even so, it doesn’t get as much attention as many menopausal symptoms. Most women seek medical advice during and after menopause because of hot flashes, weight gain, mood swings, vaginal dryness, or dwindling interest in sex. We tend to think of these as the most common menopausal symptoms. But women struggle just as much, if not more, with having a foggy brain and forgetfulness during midlife and later. 

A 2004 study of 575 menopausal women showed brain fog as the most frequent middle age symptom. More than 84% of women in the study complained of forgetfulness. Forty percent had hot flashes.

Still, you’re bound to wonder if you’re losing it. Any time we experience cognitive change, we naturally worry about cognitive impairment. Many women who wade through brain fog fear that this is the first sign of cognitive decline, dementia, or Alzheimers disease. Try not to jump on that train so quickly. Brain fog is a common experience of midlife. But do pay attention – your body is sending you cues.

Brain fog is a cue about brain function. For a long time, conventional medicine has said hormone levels – namely estrogen – play a role. This thinking has to do with evidence that dementia is more prevalent in older women than in older men.

But there’s a catch. Researchers have started considering something about prevalence that they had not before: Women live longer than men. The increased lifespan for women seems to account for the higher numbers of cognitive decline – in later age. Statistics need context.

What’s more, numerous studies now show that estrogen decline in midlife does not contribute to a decline in cognitive performance during or after the menopause transition. Even so, it’s not uncommon for women to go on hormone therapy (hormone replacement therapy or HRT) to deal with cognitive changes. The evidence is inconclusive about its use. Some studies show benefits. Others don’t.  Hormone therapy also comes with risks, including breast cancer. An increasing number of women prefer not to roll that dice. 

But brain fog and cognitive decline are not necessarily the same thing. It’s always a good idea to read between the lines and look to see if someone’s trying to sell you something when you’re searching Dr. Google. Otherwise, you may wander down a path that won’t take you where you want to go – in this case, clear-headed understanding about brain fog and menopause or postmenopause. 

Brain function is incredibly complex. The brain is a physically functioning organ that steers cognition, it’s the control center for stress, and it’s a fountain of feeling. These are just a few of countless brain functions. 

As to hormone imbalances, estrogen may have brain-protective benefits related to supporting healthy neurotransmitter levels and quieting inflammation. When estrogen declines due to either natural or surgical menopause, that natural protection wanes. That’s a clue to follow because there are other ways to support healthy neurotransmitter levels and quiet systemic inflammation. But before going further, I want to emphasize that there’s nothing wrong or shameful about going on hormone replacement therapy if this choice feels right for you.

Neurotransmitters and Systemic Inflammation Affect Brain Activity

Neurotransmitters are chemical messengers that, in the brain, regulate brain activity. Brain fog is a symptom of depression at any age and often links to decreased levels of the neurotransmitter, serotonin. Studies show that probiotics can increase serotonin levels because 98% of the body’s serotonin is produced in the gut with the help of friendly microbes.

Per our comment above about searching Dr. Google and what people sell: NATURELI formulates and sells a type of supplement called a synbiotic. Synbiotics are a combination of probiotics and prebiotics that support your gut microbiome. Studies show women’s microbiomes become less abundant and diverse in midlife. These changes affect neurotransmitter levels and systemic inflammation (see below). Restoring the microbiome with a quality multi-species synbiotic has been shown to alleviate some symptoms of menopause and support healthy aging and brain health. 

Brain fog can also signal inflammation. Low-grade systemic inflammation affects the brain in many ways. Quieting systemic inflammation in your body may clear your head.

gut inflammation

An unhealthy gut is the primary source of systemic inflammation in the body. Culprits that lead to gut inflammation are:

  • Processed food 
  • Grains that contain gluten 
  • Proteins found in dairy (casein and whey)
  • Fresh foods grown using chemical pesticides (including herbicides and fungicides) 
  • Antibiotics
  • Municipal water
  • Chronic stress

All these can lead to changes in the composition of gut microbes. When the abundance and diversity of microbes diminish, the inner lining of the gut gets inflamed, setting the stage for a leaky gut. Simply put, when stuff that belongs in the gut leaks out, inflammation begins in the tissues surrounding the gut and cascades out across the body, including the brain. 

There’s more to explore as you search for what’s going on and to clear your head. Midlife is a time of tremendous change. The menopause transition is but one of many things taking place in your life – and body – if you’re like most women in midlife.

  • You might be caring for (and worrying about) aging parents. 
  • You might be preparing your kids to fly the coop and yourself for an empty nest. 
  • You may be navigating a mid-career change or saddled with worry about your partner’s health. 
  • You might be re-birthing yourself after a divorce or contemplating doing so. 
  • You might be dealing with health issues of your own, uprooting to downsize, and on and on. 

Chances are, you’re in the middle of one or more of these and other major life transitions as well.

We invite you to stop reading for a moment and think about all that’s on your plate right now.

Could it be that you’re exhausted? Seriously. In our push-push modern world, what middle-aged woman isn’t flat-out sapped?

Add the body’s everyday effort to adapt to a sea tide of hormonal flux in the menopause transition or to accommodate the changes with age, and your brain is bound to respond. We invite you to let your brain fog be a cue for self-exploration and care and see if things shift. 

clear sky

Some Questions to Consider to Help Clear Your Head

Here’s a short self-care question and response list to help you clear your head:

1) Are you getting enough sleep? 

Your changing body needs a solid 7–8 hours of sleep every day – sleep that’s at about the same time and relatively uninterrupted. Four hours here and there doesn’t provide the sleep duration necessary to restore. 

2) Are you eating well? 

Processed and junk food cause inflammation, as I shared above. Inflammation affects the brain and contributes to forgetfulness. Nutrient-rich vegetables, nuts, seeds, and fruits are information for the body and brain. When the body is well-fed habitually, you will discover that you have more sustained energy. This is because your cells’ storehouse of energy – mitochondria – is nourished. Don’t forget that eating well includes drinking well – staying hydrated. 

Eating well also includes eating for gut health. Maintaining gut health is critical for maintaining brain health. Synbiotics and fermented foods, such as kraut, kimchi, and miso, add friendly microbes to support healthy neurotransmitter levels and quiet low-grade systemic (and brain) inflammation. 

3) Are you getting enough physical activity? 

There is nothing that will bring on brain fog more than being inactive. Moving the body is what moves energy through all tissues, including brain tissue. Rather than depleting energy, daily moderate physical activity “clears the cobwebs” of stagnant energy. Walking, for many, helps clear the mind. A growing body of neuroscience research provides the scientific basis for why this is so. Suppose you have trouble walking or don’t enjoy it. What form of activity would you enjoy doing and commit to daily?

4) Are you “borrowing energy” from coffee, sugar, nicotine, or other stimulants? 

If you’re not getting enough sleep or if the quality of your sleep is compromised, your body doesn’t restore. If you have energy slumps in your waking hours, your body is telling you there’s not enough in reserve to get through the demands of the day without a leg-up. 

Borrowing energy perpetuates the problem. Borrowing energy also contributes to hot flashes and other menopause symptoms like night sweats and difficulty sleeping to perpetuate the sleep-cycle issues. 

When your energy drops mid-day, and you want to reach for that energy boost, you might try: 

  • Taking a short walk and getting a breath of fresh air.
  • Giving yourself 10 minutes of quiet with yourself.
  • Dropping into a short cat nap – no more than 20 minutes so that your body stays out of deeper modes of sleep. That would leave you feeling more tired and struggling to fall asleep at bedtime.
  • Standing instead of sitting if you work at a desk to mobilize stagnant energy.
  • [FILL IN THE BLANK] as you explore new ways of attending to your body’s energy slump.

5) Are you caring for your inner life? 

Our inner life is that whisper inside that begs to be heard. She wants your care, your friendship, your interest, and tenderness. She wants to be discovered by you. She’s just as eager to be known by you. She wants to create, play, sit still, contemplate life’s big and little questions. She wants to wander. And wonder. She wants to put her bare feet on the green, green Earth and pulse with aliveness. She wants to get lost in time, just for a little while. Caring for your inner life is as essential to your clarity of mind and wellbeing as other practices that we are all constantly reminded to cultivate. 

These self-care practices will clear foggy brain for nine out of ten women. You may notice you feel clearer within a couple of days. It may take a month or more if you’re tapped out emotionally, physically, spiritually, and mentally. 

If your symptoms do not improve, there may be more going on to prompt a visit to your healthcare provider or qualified mental health therapist. Even so, these practices will support your brain health and overall wellbeing during the menopause transition and as you age.

Explore More

gut health for menopause transition

Create Gut Health for an Easier Menopause Transition.


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