How to help lift mid-life menopausal brain fog

Are you wondering why your brain isn’t working quite as well during the midpoint of your life? Do you forget where you’ve put your phone, if you returned that school permission form or just the name of a friend’s husband who you know rather well? This can really knock your confidence and self-esteem. We expect to have “mummy brain” when our kids are little, but beyond that, why do our brains still feel like cotton wool?  Here are some natural ways to combat perimenopausal and menopausal brain fog and help you think more clearly.

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What is menopausal brain fog?

Brain fog, often referred to as ‘mental fuzziness’ is a common menopausal symptom, which up to two thirds of women experience. It can mean issues with cognition – not being able to think straight, memory issues, poor word recall, distraction and an inability to finish tasks. Many women simply feel scattered and forgetful.

This menopausal brain fog can have a significant effect on working life, with many feeling they’re not performing as effectively at work. According to a survey of 1,000 women in the UK carried out by the British Menopause Society, 45 per cent felt menopausal symptoms had a negative influence on their work and 47 per cent who needed to take time off work due to menopausal symptoms felt they couldn’t tell their employer the real reason.

Why do women get menopausal brain fog?

The first hormone level to drop when going through perimenopause is usually progesterone, and this can lead to irritability, mood swings as well as brain fog. The drop in progesterone can also cause disturbed sleep, and poor sleep can affect the brain’s ability to function well.

A fall in oestrogen can reduce dopamine levels, which affects pleasure, motivation and learning. This decline in oestrogen levels after menopause may also mean difficulty with both the processing and reuptake of dopamine and can worsen executive function. It maybe why many women feel they have developed ADHD-type symptoms (such as procrastination, poor focus and impulsiveness) during the mid-point of their life when oestrogen levels are dropping.

GABA concentrations in the cortex of the brain decline during perimenopause and even further after the menopause due to lower oestrogen levels. GABA is a key neurotransmitter which helps us stay calm and zen-like and if your levels drop you can experience insomnia, irritability and a high anxiety state.

When oestrogen and progesterone levels decline, serotonin levels can also fall, which can contribute to increased anxiety and sadness, as well as memory, attention and cognition issues. Falling serotonin levels can also trigger mood swings that make you feel less able to cope with things you would usually breeze through.

Testosterone (not just a male hormone) is produced by the ovaries and is also important for women’s brain health. Testosterone strengthens the nerves in the brain and helps with mental clarity and overall brain energy. It also strengthens the arteries that supply blood flow to the brain, which is crucial to help protect against memory loss.

Some women’s brains are more sensitive to these hormonal fluctuations than others, which can affect their neurotransmitter production and reuptake. Making and synthesizing these neurotransmitters involve complex processes fuelled by the food we eat and the intestinal bacteria in our gut microbiome.

Genetics may also play a role, as some women are more predisposed to fluctuations in one of several neurotransmitters. You can find out your genetic makeup through specialist testing via a nutritional therapist, and then targeted nutrition can support these pathways over the longer term. These genetic differences are why a woman’s experience of menopause can seem spookily like their mothers!

When HRT is not enough

Some women find that turning to Hormone Replacement Therapy (HRT) and getting the support of the right levels of oestrogen, progesterone and testosterone can help quite a few of these symptoms of brain fog. However just replacing these hormones is often not enough to feel fully brain sharp and switched on.

Diet and active lifestyle can make a huge difference to brain fog and here are three key steps you can take:

  • Less sugar – avoid consuming a diet high in refined carbohydrates and white sugar as this can lead to fluctuations in blood sugar levels. These fluctuations of the sugary stuff can result in feeling muddled and forgetful, as the brain relies on a steady supply of glucose for optimal function. Eat plenty of protein and healthy fats, especially at breakfast to help regulate blood glucose better instead.
  • Better hydration – even mild dehydration can affect cognitive function and lead to feelings of fatigue and brain fog. Adequate hydration is essential for overall health, including proper brain function. If water passes straight through you then consider coconut water or electrolytes.
  • Feed your gut microbiome – the beneficial bacteria in our intestines are building blocks for a whole host of neurotransmitters including GABA, dopamine and serotonin. These can be supported by eating a wide range of fruits and vegetables, pulses, nuts, seeds and wholegrains as well as consuming cultured foods such as live yoghurt and kefir.  

Specific nutrients to help with menopausal brain fog

There are several specific nutrients and plants which might help lift the fog and support a healthy brain. These can be given alongside HRT or as standalone support. Ideally get the iron, B vitamins and omega 3 through diet, but some people find supplements can be helpful as a top up.

  • Iron – iron helps to move oxygen around the body and brain. Many women are low in iron due to heavy periods or fibroids during the perimenopausal years. Some do not eat many iron-rich foods so they can end up with low iron stores or even become anaemic. Iron is the most abundant mineral in the central nervous system and getting enough each day can help with mental stamina and acuity. Iron rich foods include liver, red meat, green veg, eggs, pulses, apricots and prunes.
  • B vitamins – vitamin B6 (in the pyridoxal-5-phosphate form), Folate (vitamin B9 in the methyl tetrahydrofolate form) and vitamin B12 (in the methyl form) are key for neurological health. A recent study found that a multi-vitamin containing a mixture of B vitamins could help prevent memory loss and slow cognitive aging among older adults. B vitamins can be found in offal, red meat, green veg, pulses and wholegrains.
  • Omega 3 – helps the brain cell membranes to stay flexible so that they can communicate easily, remain neuroplastic so it is adaptable to learning new things, and helps dial down inflammation in both the body and brain. Omega 3 is found in oily fish such as salmon, sardines, anchovies and mackerel as well as seafood such as prawns and crab.
  • Lion’s mane mushroom (Hericium Erinaceus) – many studies have found that this species of fungi has neuroprotective properties. It may help when there is mild cognitive impairment and has also been found to help mood and stress. You can mix lion’s mane mushrooms into hot chocolate or coffee, or take it as a supplement.
  • Brahmi (Bacopa Monnieri) – an Indian herb often taken in a blend with lion’s mane mushrooms, this again has neuroprotective properties and has been found to help with word recall, improve memory and reduce anxiety. This herb is usually taken in capsule form.


Although menopausal brain fog can be very frustrating in our mid-years, and sometimes a little alarming, it is very common and a mid-life turning point for many of us. The good news is that we can make simple changes to our diet and take some natural supplements to help support our brain health against these menopausal side effects.

If you would like further advice and recommendations on thriving and blossoming through the peri and menopausal years, please join our online Nutrition for Menopause course. We will take you through step by step on how to make positive changes. On this course we also share which nutritional and lifestyle tweaks you can make which can help make a difference to you and your body during these big hormonal changes.

If you feel you would really value some one-to-one support from a menopause expert, please book in with one of our NatureDoc Nutritional Therapist specialists who can run full hormone, nutritional and genetic tests to get an understanding of why you are experiencing so many troublesome symptoms.

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