Brain Fog and Menopause
Menopausal brain fog is temporary and typically disappears after the transition is over…….
What is Brain Fog?
The scientific definition of brain fog is the constellation of cognitive symptoms …which most frequently manifest in memory and attention difficulties and involve such symptoms as encoding and recalling words, names, stories or numbers, difficulties maintaining a train of thought, distractibility, forgetting intetions, and difficulty switching between tasks.
More simply speaking, brain fog is that awful feeling where your brain feels like it’s full of cotton wool, you find it difficult to think clearly and make decisions. You may also find that there are other changes you are experiencing within your brain as you go through peri-menopause. For example:
•Difficulty concentrating
•Memory loss
•Forgetfulness
•Difficulty recalling the right words
It is very likely that in this time of your life, you will be feeling more stressed, this will mean that your cortisol levels will be high and this is going to interfere with how well your brain in functioning.
WHY DOES THIS HAPPEN?
As we go through menopause, some people may also experience changes to their sleep pattern resulting in a lack of sleep. There is a well-established link between sleep and brain fog, with robust evidence from sleep deprivation studies of a causal role of sleep disturbance in verbal learning and memory difficulties - this has been shown to be particularly prevalent for those women who also experience night sweats.
Additionally, it is well known that throughout peri-menopause we have fluctuating hormones, especially oestrogen. Oestrogen is important for keeping our brain healthy as it promotes the survival and growth of both neurons and synpases as well as how they are able to use glucose for energy.
DOUBLE CHECK…..
There are so many symptoms that women can experience throughout the menopausal transition and this in itself can mean that other possible causes go unchecked. Changes in memory, brain fog or poor recall could also happen if your thyroid hormones are not at optimal levels, so it’s worth checking your thyroid as well, just to make sure.
In addition to the thyroid, if you are deficient in vitamin B12 or folate, it will be harder for oxygen to be delivered around the cells (including brain cells) which may cause a slowling of brain function, resulting in brain fog as well as poor memory.
Interestingly there is also a link between brain fog and a nutrient called choline. Acetylcholine is a chemical that we make within our bodies and is used for learning, cognition and memory. In order to make acetylcholine the body needs good levels of choline. If you have insufficient levels or you have a variant on a particular gene which slows down the production of acetylcholine you may well suffer from memory loss and brain fog. Good levels of oestrogen are also required for this same gene to work efficiently. So if you are in perimenopause / menopause and you have this gene variant, getting additional levels of choline into the diet will be important.
To help keep levels of acetylcholine high you need to include choline in your diet – eggs are a great source of choline. Try including 12 eggs on a weekly basis to help to keep your levels at an appropriate level.
Symptoms of menopause and long COVID are very similar and may lead to misdiagnosis, if you’ve had COVID which resulted in changes to your brain health, seek help and advice on recovering fully.
WHAT CAN WE DO TO HELP BRAIN FOG?
There are some modifiable risk factors that have been shown to be linked to better cognitive health, including obesity, hypertension, diabetes, physical activity, smoking, cognitive activity, social interaction, hearing impairment and depression. Tackling these will be a great benefit to your brain health as well as to your health generally.
Heart health is brain health. Assess and treat hypertension, dyslipidemia and diabetes, aiming for a blood pressure level of ≥120/80 mmHg to optimize brain health.
The following will also help with brain fog:
Exercise regularly - Moving your body is the best exercise you can provide for your brain.
Regular sleep routine – good sleep hygiene
Stress management – daily incorporation - Cognitive Behavioural Therapy (CBT) can challenge negative thinking and help you break out of the vicious cycle
Find time to relax - Make time to ‘switch off’. Whatever you like to do to relax, build some time into your day to do it, and don’t feel guilty about it.
Blood sugar balancing - check your diet is balanced, incorporating good levels of fibre and protein.
Make sure your gut health is spot on - get your gut health checked if you are experiencing changes.
Hydrate - drink 2 litres of water everyday
Develop your own coping strategies - Embrace reminders, notes, and lists sections on your phone or other electronic devices. Make lists and tick things off
Check for nutrient deficiencies - B6 and B12, folate and acetylcholine
Check your genetic profile for blocks in specific pathways.
Avoid excessive alcohol intake and quit smoking to optimise brain health.
NEUROPLASTICITY
As we have already looked at, there are things we can do to alleviate brain fog. The main key focus is to use your brain as much as possible and in new ways! This will increase neuroplasticity. This refers to the ability of your brain to recover from damage.
We can help our brain become more plastic and reduce the effects of brain fog during menopause. Here are some examples:
Exercise your mind with brain games - Sudoku, crosswords, chess and jigsaws - brain games should be challenging, fun, exercise memory and have increasing difficulty.
Take physical exercise - whenever we exercise, our brain releases adrenaline, a hormone that enhances physical performance and brain activity.
Enjoy a balanced healthy diet - the Mediterranean diet is ideal as it is based on fresh vegetables and fruits, nuts and seeds, and healthy fats and contains lots of omega rich fish.
Try natural supplements - maca promotes brain function and eases brain fog, magnesium deficiency impacts your brain activity negatively, making it harder to concentrate and Ashwagandha can help you relieve stress and ease mental fatigue.
References
Inspiriko , T. (2022) "Menopause brain" it's real: Here is what can help, Inspiriko. Available at: https://inspiriko.co.uk/blogs/article/menopause-brain-it-s-real-here-is-what-can-help (Accessed: April 25, 2023).
Jaff, N.G. and Maki, P.M. (2021) “Scientific insights into brain fog during the menopausal transition,” Climacteric, 24(4), pp. 317–318. Available at: https://doi.org/10.1080/13697137.2021.1942700.
Maki, P.M. and Jaff, N.G. (2022) “Brain fog in menopause: A Health-Care Professional’s guide for decision-making and counseling on cognition,” Climacteric, 25(6), pp. 570–578. Available at: https://doi.org/10.1080/13697137.2022.2122792.