Perimenopause and your brain

Menopause is a time when you transition from one phase of your life to the next. This change will happen physically as well as mentally. In fact, your brain will undergo significant changes throughout the process of menopause.

Perimenopause is the time that it takes your body to transition from childbearing years to menopause. Women typically experience this change at some point in their thirties or forties. The estrogen levels in the body fluctuate as estrogen production gradually declines. As a result, you might experience irregular menstruation as well as hot flashes, insomnia, and vaginal dryness.

You may also start to experience brain fog. For example, you might find that you are forgetful and less focused. This brain fog can also be related to lack of sleep.

Many women report that this brain fog often causes difficulties with memory. This is even true for women who previously had no trouble with their memories. Keeping track of daily tasks and even basic conversation can become challenging during this time.

This often affects short-term memory, making tasks like math or scheduling more difficult. Women who experience memory problems like this may also experience issues with focusing or completing tasks, depression, and anxiety.

Some ways to help yourself get back to the present moment when you experience perimenopausal brain fog are:

Take a moment. Start to identify when you are feeling distracted or have brain fog. Stop what you are doing at the moment and take a few breaths. Center yourself and give yourself the time to process before returning to your activity.

Exercise regularly. Staying active not only gives you physical benefits but can also improve your mental state. For example, it has been found to increase the size of the memory processing center in your brain.

Get proper sleep. Maintaining a healthy sleep schedule can help you minimize brain fog. Be sure to minimize exposure to phone and computer screens as you prepare for bed.

Use memory techniques. If you’re getting distracted and confused frequently, it can be a good idea to utilize memory techniques such as mnemonics or acronyms of things you often forget. This can help you feel grounded and give you a way to remember important things you may need in your day-to-day life.

Brain changes during menopause

Most of the known brain changes that occur during perimenopause are caused by hormonal changes. The majority of changes that happen in your brain during menopause can also occur during perimenopause.

Some of the changes that occur in your brain during perimenopause include:

  • Reduction of gray matter (made mostly of neurons), impacting social awareness, memory, and cognition
  • Reduction of white matter (nerve fibers that link neurons)
  • Changes in the way blood flows through your brain
  • Interference with the brain’s consumption of glucose, which can cause memory and cognition issues
  • Changes in the amyloid-beta deposits, which are the part of the brain most associated with Alzheimer’s disease

While these changes are evident, it has also been proven that the female brain has ways of compensating for the effects of menopause on the brain. The brain produces extra ATP (the source of energy for cells) and blood flow in the areas most affected.

Additionally, all the changes that occur during this period often reverse in the next couple of years after you get accustomed to menopause. In fact, many post-menopausal brain scans have revealed increased brain functioning in the areas most impacted by menopause.


If menopause occurs in a woman younger than ___ years, it is considered to be premature. See Answer

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Medically Reviewed on 10/5/2021

Harvard Health publishing: "Sleep, stress, or hormones? Brain fog during perimenopause." Mayo Clinic: "Perimenopause."

University of Rochester Medical Center: "‘Brain Fog’ of Menopause Confirmed."

Weill Cornell Medicine: "Imaging Study Reveals Bain Changes During the Transition to Menopause."