“Dear Mariella, is it possible to identify brain fog, as opposed to that vague feeling of simply not being sufficiently across things, which many women suffer from?”
Brain fog is less talked about, but it is as common a [menopause symptom] as the ubiquitous hot flush. As someone who comes from two generations of dementia from my maternal line, I feel like a permanent damp sponge has been in my head since the age of 48.
When I did live radio every day, I scribbled down every passing thought or it would evaporate into thin air. Worse still is forgetting names, such as that of my best friend’s 20-year-old. That happened to me last weekend as I was telling an anecdote. Their name floated back into my head at 2 am the following morning when I’d much rather have been asleep.
The reality of brain fog
During my work as a menopause campaigner, I have heard thousands of anecdotes about brain fog, many of which have been utterly devastating. Women have forgotten vital appointments or even struggled to do their jobs. In our 2024 Menopause Mandate Survey of almost 20,000 women, an extraordinary 82% reported suffering from brain fog. Did the other 18% forget to answer the question, I wonder?
Now we’re helping provide data for Aimee Spector, professor of clinical psychology of ageing at University College London. She’s doing much-needed research into the difference between menopausal brain fog and the general fuzziness that comes when we’re overwhelmed.
We have so few answers at the moment. It’s almost as if scientists forgot to look into the specific challenges of ageing in women. Aimee tells me the key thing about brain fog is that although many women in their 40s and 50s report it, there is no clear definition. She explains that a lot of women feel as though they’re becoming forgetful, losing their train of thought and missing things.
Midlife is already a pressurised time for women. We are often at the peak of our careers, children – if we have them – are growing up (bigger kids, bigger problems…) and our parents are getting older. We are still expected to do the majority of the domestic work, along with being the main carers.
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What causes brain fog?
One reason for midlife brain fog can be the drop in oestrogen we experience. Low oestrogen can be linked to brain performance, as well as causing insomnia and anxiety. If you’re tired, you might have brain fog. It’s hardly surprising that you might drop some of your frantically juggled balls – and it’s all very confusing.
I went to the very top of the expert tree, but brain fog is only just starting to be investigated. Thank goodness for the professor and her colleagues. They are leading research into this most elusive of symptoms. But for the moment, it’s hard to know if you’re struggling with general exhaustion and life stress, or if it’s a transient part of hormonal disruption. Or all three.
Aimee says that the definition of brain fog is less important than how it makes you feel, a sentiment echoed by most good menopause experts. Thankfully, I can reassure you that greater minds than mine have concluded that there are solutions.
Brain fog solutions
If your cotton-wool brain is related to menopause, then HRT – if you can take it – can help. Post-menopause, the brain resets, so it should improve. If you want to read further, The Menopause Brain by the US expert Dr Lisa Mosconi is a good delve into the subject. Whether or not there’s oestrogen involved, a healthy diet and lifestyle, good sleep and low stress should all make a difference. Easier said than done, I know.”