Did you know when estrogen levels go down, it can also affect how our brains work (aka, cognitive functioning)? If you’ve been concerned about your memory and ability to remember things, it could be because your estrogen levels are changing. Nearly two-thirds of people going through menopause may encounter memory problems during the menopausal transition.

While everyone’s brains will age, the memory issues and brain fog associated with menopause can feel like they appear out of nowhere and will often occur when we’re noticing other menopausal symptoms. “Brain fog” is not a medical term but includes a variety of symptoms including difficulty with: 

• Concentrating.
• Processing information.
• Solving problems.
• Finding the right words.

Why does menopause cause brain fog and memory issues?

During perimenopause and menopause, estrogen and progesterone levels are changing. There’s a direct link between the change in estrogen levels and how our brains work. Estrogen affects certain parts of the brain that deal with cognitive function. Those parts of the brain have a high number of estrogen receptors. When hormone levels drop, the receptors in the brain don’t get as much estrogen. As a result, they don’t work like they used to. This can lead to symptoms like forgetfulness or having a hard time concentrating.

For example, a study done with males and females ages 45 to 55 found that females outperformed males of their same age in detailed memory tasks. But for females with lower estrogen levels, and those in their postmenopausal years, the difference between males and females was reduced.

There have been studies that suggest that declining levels of estrogen also affect levels of serotonin (a “feel good” hormone). Serotonin affects mood, but it may also affect cognition. More studies need to be done, but scientists are noticing a connection.

In addition to the chemical processes happening in your brain, lack of sleep and mood changes, like depression (also related to menopause), can also temporarily affect memory, attention, word retrieval, and other cognitive functions. You probably know from personal experience that a bad night’s sleep can leave you feeling foggy the next day. And you’re not alone. Around one-third of U.S. adults get less than 7 hours of sleep each night, and up to half of those experiencing menopause have sleep quality issues.

When you’re stressed and focused on your worries, you may become more forgetful or feel like you’re in a daze. And being an adult in your 40s and 50s can present its own unique set of challenges. You could be dealing with career demands, money, raising a family, caring for aging parents, etc.

What may help with brain fog and memory issues during menopause?

There are mixed study results on whether menopause hormone therapy (MHT) can be helpful with cognitive issues during perimenopause and menopause. Some studies have shown mild benefit while others report no benefit or even possible harm. The effects may depend on the age you start taking MHT and how long it's taken. MHT may be an option during perimenopause, especially if you have other symptoms that MHT can treat. However, it’s best to talk to your doctor about the risks and benefits of taking MHT to see what's right for you.

There's been more research done on people who’ve experienced surgical menopause (ovaries removed at an age before they reach menopause). Estrogen therapy until the natural age of menopause (around age 51) may prevent cognitive decline in those with surgical menopause.

What else can I do for my brain health?

There are many things you can do to help keep your brain (and body) healthy and help reduce the risk of developing cognitive decline in later life. Start caring for your brain today:

• Move your body. Aim for at least 150 minutes (2 hours, 30 minutes) of moderate-intensity exercise each week. A physically active lifestyle has been linked to brain health and has beneficial effects on brain structures.
• Quit smoking. If you’re struggling to quit, ask your doctor for help or you can call 1-800-QUIT-NOW to find out more about free and local resources.
• Reduce alcohol intake. This is especially important for those with an alcohol use disorder, and those who binge drink or are heavy drinkers.
• Eat healthy, well-balanced meals and snacks. Fill your plate with fruits, vegetables, legumes, whole grains, fatty fish (like salmon), eggs, leafy greens, and walnuts. Work to reduce saturated fat, trans fat, fried foods, and foods with added sugar.
• Aim for a healthy weight. Talk to your doctor about what that looks like for you.
• Manage hypertension, high cholesterol, and diabetes. A healthier heart means a healthier brain. Work with your doctor to get your blood glucose, blood cholesterol, and blood pressure in a healthy range.
• Exercise your brain. Challenge your brain by reading, volunteering, learning a new skill, or practicing a new language. These activities can increase cognitive reserve, which is how flexible and efficient your brain is at processing information.
• Socialize. There’s some evidence that shows an association between increased social interaction and a decrease in dementia. Call or get together with friends and family when you can.

When do menopause brain fog and memory issues end?

If you're a female between the ages of 40 and 65 and experience brain fog or memory issues, you're not alone. 26%* of your peers have had some brain fog and 23%* have had temporary memory issues. The good news is that most people find these symptoms temporary. As hormones stabilize after menopause, brain fog and some memory issues often disappear, and our brains feel more normal. In addition, hormonal changes don't affect intelligence, knowledge, or functions like strategic thinking and planning.

Memory and brain fog can negatively impact day-to-day function, the ability to concentrate, or remember simple things, like someone’s name, for example. These cognitive issues can resemble some early symptoms of conditions like dementia or Alzheimer’s. If you start noticing these symptoms in yourself or a loved one, it can feel scary.

But just because you can’t remember where you put your keys, don’t assume the worst. Talk to your doctor or a telehealth provider if you’re concerned about your memory or cognitive function.

*Data from Attitudes & Usage study conducted in August 2021 with 4,578 female participants ages 40-65. Funded by Kenvue.