Brain fog in perimenopause
What do you think is the main symptom women experience during perimenopause? I bet that a lot of people would say ‘hot flashes/flushes’ but that couldn’t be further from the truth. Whilst hot flashes are of course commonly experienced during perimenopause, there is an array of other symptoms that actually bothers women a lot more than those hot flashes. In a recent survey, the British doctor Dr Louise Newson (a GP and renown menopause specialist) found out that the number one issue for women in perimenopause is brain fog, followed by low mood and memory problems (here is a link to her Instagram post). In fact, most of the top 10 symptoms were either linked to cognitive function or mental health. So why is that?
It's due to multiple factors - a combination of hormonal shifts, neurotransmitter changes and metabolic stressors. During perimenopause estrogen fluctuates and ultimately declines, and progesterone steadily declines (have a look at this blog for more information), and these changes have an impact on the brain. Fluctuating estrogen can lead to reduced glucose uptake in the brain which means brain cells have less energy. Neuronal communication slows down, and memory and concentration decline. Estrogen also has antioxidant effects, so when there is less estrogen, neuroinflammation can result which then impacts cognitive clarity. In addition, the declining progesterone leads to increased anxiety, mental restlessness and poor sleep because the calming effect of progesterone is reduced. These factors contribute to brain fog and also explain why there are mood changes during perimenopause.
Most women in perimenopause these days also have significant stress in their lives as they raise children/teenagers whilst working at the same time and often also looking after elderly parents. Chronic stress leads to elevated cortisol, which impacts memory formation and sleep quality. Poor sleep reduces the brain’s ability to clear metabolic waste, which makes brain fog worse.
This all sounds pretty depressing you are probably saying! Good news is that we are not powerless and there are strategies that help lessen the impact of those changes.
Strategies to help with perimenopausal brain fog
Eating a nutrient-rich diet should be a priority. This will not just help with brain fog but will improve all aspects of life. So what foods should we focus on?
Healthy fats like avocado, olive oil and nuts/seeds – these help with brain membrane support
Complex carbs (vegetables, whole grains) for steady glucose supply – yes, don’t go low carb, it won’t help your brain fog or mood
Protein at each meal (aim for 1.8-2g protein per kg of body weight every day) to support neurotransmitter production
Antioxidant-rich foods like berries, leafy greens, turmeric, green tea to reduce inflammation and lower oxidative stress
Isoflavones found in soy foods as these can bind to estrogen receptor beta in the brain, where they mimic some of estrogen’s neuroprotective effects such as supporting neuronal growth, enhancing glucose uptake by the brain and reducing inflammation.
Lifestyle changes
Sleep – try to have between 7-9 hours of sleep every night (make sure to practice proper sleep hygiene to ensure you get those hours)
Stress management – this is a big one and many find it hard to do. Breathing exercises can be very effective and the good thing is they cost nothing and can be done anywhere. Yoga, meditation journaling are also very effective although maybe slightly more time intensive.
Exercise – aim for a mix of cardio (brisk walking counts!) to improve brain blood flow, strength training to support metabolic health (and bone health!) and mind-body exercises like yoga and pilates as these are great for managing stress.
Cognitive training – keep your brain active! This will also help with preventing dementia – in fact all of the above helps with dementia prevention. Learn a new skill, do a puzzle and/or brain games, read books and engage in social interactions (social isolation is a big risk factor for dementia!).
Supplements/herbs
There are a variety of nutrients and herbs that can help substantially here. Talk to a qualified practitioner to ensure that you are getting the supplements that address your particular situation. Everyone is different and one size does not fit all! There are many products out there that will promise a lot but probably do very little. If you want to find out how naturopathy and nutrition can help improve your symptoms, book a 1:1 consultation here.
