Brain Fog in Perimenopause: How to Move Through and Gain Clarity
Have you ever walked into a room and forgotten why you went in? Or stared at your to-do list wondering how the simplest task became overwhelming?
If so, you’re not alone—and you’re definitely not losing your mind.
Welcome to one of the most frustrating and under-talked-about symptoms of perimenopause: brain fog.
What Is Perimenopausal Brain Fog?
Brain fog isn’t a medical diagnosis—it’s a term used to describe that sluggish, scattered, mentally cloudy feeling that makes it hard to think clearly or stay focused. Many women experience it in their 40s and early 50s as hormones begin to fluctuate in the lead-up to menopause.
What Causes Brain Fog During Perimenopause?
Brain fog isn’t just “getting older” or “being tired.” It’s often the result of several interconnected factors, including:
🔄 Hormonal Shifts
Estrogen and progesterone play key roles in brain function, memory, and mood. As these hormones decline during perimenopause, you may notice more forgetfulness, mental fatigue, and difficulty concentrating.
😴 Poor Sleep
Hot flashes, night sweats, and hormonal changes (declining progesterone and estrogen) can all disrupt your sleep. And without deep, restorative rest, your brain can’t detox, recharge, or process information effectively.
⚡ Increased Stress & Cortisol
Midlife stress—think careers, caregiving, aging parents—can raise cortisol levels. Chronic stress impairs memory, decision-making, and focus.
🧬 Nutrient Deficiencies
Low levels of B vitamins, magnesium, omega-3s, and vitamin D can all contribute to mental fatigue and cognitive slowdown.
🔁 Insulin Resistance
Hormonal changes during perimenopause can lead to blood sugar fluctuations, which may cause energy crashes, cravings, and brain fog.
You’re Not Broken—Your Brain Needs Support
It’s easy to feel discouraged when your mind doesn’t feel like “you.” But brain fog is not a sign of decline—it’s a signal that your body is asking for a shift in how you nourish and care for yourself.
Here are a few ways to start:
Balance Your Blood Sugar
Eat protein, healthy fats, and fiber at every meal to keep energy and focus steady. As we age, the support we get from nutrition gets very important.
2. Move Your Body—But Don’t Overdo It
Strength training and walking improve brain health and insulin sensitivity. But too much high-intensity cardio can elevate cortisol and worsen fatigue.
3. Support Your Hormones
Consider adaptogenic herbs, HRT or supplements - but talk to your healthcare provider first. Certain herbs and supplements could make conditions worse if you take them without supervision.
4. Prioritize Deep Sleep
Create a nighttime wind-down ritual: magnesium glycinate, a cool dark room, and calming scents like lavender or cedarwood can make a difference.
5. Calm the Nervous System
Stress and anxiety can play a big part in falling asleep…..because we can’t turn our brain off. Breathwork, meditation, and even just unplugging for 10 minutes a day can lower stress hormones and improve focus.
A Quote to Keep in Mind
"You’re not forgetful—you’re hormonal. Brain fog in midlife isn’t a failure, it’s a signal to slow down, nourish, and reset."
Final Thoughts
Perimenopausal brain fog is common, frustrating, but manageable. The more we talk about it, the more we normalize it—and the better equipped we are to support ourselves and each other. As a pharmacist and woman in her forties, I am using a combination of the above recommendations to feel my very best in this stage of life.
Your brain is still brilliant. It just needs a little more care, grace, and support right now.