You walk into a room and forget why you came in. A word you use often escapes you in the middle of a conversation. Or you find yourself reading the same paragraph three times because you can’t seem to concentrate.

Sound familiar?

Changes in memory, recall and mental clarity are concerns I hear from many women I work with in midlife and beyond. Understandably, they can be unsettling. You might find yourself wondering whether this is related to changing hormones, aging, or something that deserves a closer look.

While cognitive changes are common during hormonal transitions like perimenopause and menopause, we shouldn’t automatically dismiss them as “just hormones.” Understanding the potential contributors, and knowing what steps can be taken, can help support your current and long-term cognitive health.

How Can Perimenopause Affect Memory and Concentration?

Estrogen plays an important role in brain function, including memory, concentration and word recall. During perimenopause, estrogen levels fluctuate significantly, which may contribute to changes in how clearly we think.

Research suggests that many women experience subtle changes in memory and concentration during this transition. These changes often improve over time, although experiences vary. But hormones are rarely the only consideration.

What Else Could Be Contributing?

Several factors can affect memory, concentration and mental clarity, including:

  • Poor sleep: Night sweats, frequent waking and sleep apnea can affect memory and concentration.

  • Stress and mental overload: Juggling work, family and other responsibilities can make it harder to focus and recall information.

  • Blood sugar regulation: Low or persistently high blood sugar can affect energy and concentration.

  • Nutrient deficiencies: Low iron or vitamin B12 can affect energy and cognitive function.

  • Thyroid function: Thyroid imbalances can cause symptoms that overlap with perimenopause.

  • Mood and mental health: Anxiety and depression can affect memory and attention.

  • Medications and alcohol: Some medications can affect memory or alertness, while alcohol can affect sleep, concentration and memory.

This is why it’s important to look at the bigger picture rather than assuming every symptom is related to changing hormones.

What Can You Do?

Supporting your brain health starts with many of the same foundations that support your overall health.

  • Prioritize sleep. Consistent, restorative sleep is essential for memory and concentration. If your sleep is regularly disrupted, it’s worth investigating why.

  • Nourish your body. Focus on adequate protein, fibre-rich carbohydrates and healthy fats. Eating enough and having regular, balanced meals can help support energy throughout the day.

  • Stay physically active. Regular strength training and cardiovascular exercise support circulation, metabolic health, mood and long-term brain health.

  • Manage stress and mental overload. Multiple demands in midlife can increase stress. It’s often not possible to remove those demands, but building in time for something that helps you unwind, such as a walk, deep breathing or a short meditation, can help.

  • Investigate potential contributors. Depending on your symptoms and health history, assessing thyroid function, iron status, vitamin B12 and blood sugar regulation may be helpful. Reviewing medications, supplements and alcohol use is also an important part of understanding the full picture.

When Does Brain Fog Deserve a Closer Look?

If changes in memory or concentration persist, worsen or interfere with everyday activities, they deserve further assessment.

In my practice, this starts with understanding what has changed, how it’s affecting your daily life and what else may be contributing. When appropriate, I also use established cognitive screening tools, such as the Montreal Cognitive Assessment (MoCA) and the General Practitioner Assessment of Cognition (GPCOG).

These tools don’t diagnose dementia, but they can help identify concerns that warrant further evaluation and guide decisions about referral.

Thinking Beyond Brain Fog

While addressing your current symptoms is important, midlife is also an opportunity to think about your long-term cognitive health.

Research has identified several potentially modifiable risk factors for dementia, including high blood pressure, elevated LDL cholesterol, diabetes, physical inactivity and hearing loss.

The steps we take to support cardiovascular and metabolic health can also play an important role in supporting brain health and reducing dementia risk.

Finding a Way Forward

Brain fog during perimenopause is common, but understanding what’s contributing to it is an important step in knowing what to do next.

In my naturopathic practice, I help women look beyond individual symptoms to understand the bigger picture of their health. By reviewing your health history, symptoms and relevant blood work, we can identify areas that deserve attention and develop a plan that supports both how you’re feeling today and your long-term health.

If you’ve been experiencing changes in your memory or mental clarity and aren’t sure what to make of them, I’d be happy to help.

I offer virtual naturopathic care across Ontario and in-person appointments in Southampton.

Book a Naturopathic Assessment to get started.

This article is for educational purposes and isn’t a substitute for individualized medical advice.