Ugh! The Dreaded Perimenopause Brain Fog

Brain fog can be the symptom that scares you the most, because it doesn’t just make you tired, it makes you doubt yourself. If you’ve ever forgotten a simple word mid-sentence, walked into a room and blanked, or reread the same thing three times and still not absorbed it, you’re not alone. I’m Susie Garden, naturopath and clinical nutritionist, and I’m unpacking why brain fog is so common in perimenopause and menopause, and why it’s usually a functional shift you can improve, not the start of cognitive decline.

I dig into the oestrogen brain connection and how hormone fluctuations can disrupt memory, attention, processing speed and mood through neurotransmitters like dopamine and serotonin. Then I zoom out to the full-body drivers that often get missed: blood sugar swings that trigger the afternoon crash, rising inflammation during the menopausal transition, and the gut brain axis that links digestive health with mental clarity. I also explain why sleep fragmentation, especially those 2–3am wake-ups, can tank focus by reducing deep restorative sleep and the brain’s overnight clean-up systems.

You’ll leave with a grounded, practical roadmap: why stabilising blood glucose is often step one, how protein and fibre support steadier energy, why strength training helps insulin sensitivity and chronic inflammation, when omega-3s and magnesium may be useful, and the lifestyle basics that matter more than most supplements. If brain fog is sudden, severe, worsening, or comes with neurological symptoms, I also cover when to seek medical support to rule out issues like thyroid dysfunction or nutrient deficiencies. If this resonates, subscribe or follow, share it with a friend who needs reassurance, and please leave a five-star review so more women can find the show.

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Transcript

Welcome To Ageless And Awesome

SPEAKER_00 0:00

Hi, I'm Susie Garden and this is the Ageless and Awesome Podcast. I'm an age-defying naturopath and clinical nutritionist, and I'm here to bust myths around women's health and ageing so that you can be ageless and awesome in your 40s, 50s, and beyond. The Ageless and Awesome Podcast is dedicated to helping women through perimetopause and menopause with great health, a positive mindset, and outrageous confidence. Hit subscribe or follow now and let's get started. Hello, gorgeous one, and welcome to this week's episode of the Ageless and Awesome Podcast. This week's topic is one that's very close to my heart. It's one that I've experienced a lot during my perimenopause and sometimes postmenopause journey. Um, and it's also something that is so, so common in the women that come to me for help. And often it's a really key driving symptom of perimenopause, sometimes post, um, that can be even more distressing than the hot flashes, the night sweats, some of the other more well-known symptoms of peri and post-menopause, and that is brain fog. So today I really want to talk about brain fog, how it impacts you, what we can do to support you in this time, because it can be deeply unsettling, brain fog, and it's possibly something that you have not even considered is going on with you. It's possibly something that's been dismissed. It's only relatively recently that the medical profession has recognized brain fog as an actual real symptom. Um, and it actually has a medical definition now. So what is it? How does it manifest? So, firstly, some of the symptoms that you may have experienced and not really thought much of are forgetting words mid-sentence. This used to happen to me a lot, and it still does happen to me occasionally now. But um, yeah, you can literally be in the middle of a sentence and think, where the hell was I going with this? And cannot just think of the next word, even though you know you know what that word is. Um, walking into a room and not knowing why you're there, losing your train of thought, going onto the internet and then going, What did I come here for? Going, or you know, knowing you need to respond to an email, but you can't remember what it is. It's very frustrating. Sometimes you can be just reading, reading something three, four times, it's still not going in. And, you know, you can sometimes have this most confronting of all thoughts, you know, that quiet fear of is this permanent? Am I losing my mind? And particularly if you have parents with cognitive symptoms or grandparents, and you're thinking, My gosh, am I starting to show signs of this? Am I going down that path? And if you've ever had that thought, even fleetingly, please stay with me today because brain fog in your 40s and 50s and beyond is incredibly common, really common. And not really, I think it now it's probably being talked about more, but certainly when I was going through it, it was not talked about at all. Um, it is often very hormonal, and and you may have experienced this throughout your life in relationship with your menstrual cycle. Uh, and most importantly, I think it's not the beginning of cognitive decline. And that is really important to note is that this is actually an opportunity. So let's unpack what's actually happening at this time. Um, and brain fog can feel really so scary because for many of us, cognitive clarity has always been a part of our identities. Um, you know, you're capable, you're organized, you're sharp, you're efficient. So when your brain starts misfiring in small ways, it feels personal. And you can really feel like you're losing yourself. But here's what I want you to understand brain fog during perimenopause is usually a functional shift. It's not structural damage, it's about signaling, not loss. And that's a really important distinction, okay? And that's where we have opportunity. And I wanted to talk about next the estrogen brain connection. Estrogen does far more than regulate your menstrual cycle. And I think it's really exciting that now we are becoming more and more aware of that as even as lay people, but also as healthcare professionals. We've always, I was always taught when I was a nurse, when I was in the pharmaceutical industry, when I was, you know, doing my uh nutrition and naturopathy qualifications, we only ever were taught about estrogen in the context of fertility and the menstrual cycle and the fact that it dropped away in menopause, and that was pretty much it. But it does far more than that. Um, we have estrogen receptors all over our body. So estrogen, in effect, works in a many, many different body systems, and it has powerful effects on the brain. Estrogen supports how neurons communicate, so that's called synaptic plasticity. Um, so how the nerve cells communicate with each other. It also supports verbal memory, working memory, attention, processing speed. This is starting to build a little picture for you. Maybe, certainly for me when I uh, you know, I was researching this. Um, it also influences neurotransmitters, which are brain chemicals, like dopamine, which is responsible for motivation and focus. Estrogen also influences serotonin, which has a mood impact, and acetylcholine, which is memory formation. And during perimenopause, estrogen doesn't just decline slowly, it fluctuates, it goes up, then it can drop down, it spikes, it can change every 90 minutes. You know, if you get a blood test done to test your hormones, 90 minutes later, those hormones can look quite different. And those fluctuations can temporarily disrupt cognitive efficiency. And that's why brain fog in perimenopause is often intermittent. It's worse around certain cycle phases, it's worse if you're not getting good sleep. And let's face it, sleep in our 40s can be quite elusive and our 50s. Um, and it also can be worse during stress. But here's the reassuring part of this: research shows that for many women, cognitive function stabilizes after the menopausal transition. This is a transitional phase, it is not necessarily a deterioration. So let's talk about something a bit less obvious because estrogen plays a major role, but there are other things at play here. Your brain runs almost entirely, not all, not completely, but almost on glucose. Not sugar highs, but stable glucose levels. So when blood sugar swings, you your focus can drop, your recall can slow, your irritability can rise. Hangry anyone, um, and fatigue increases. And in perimenopause, insulin sensitivity we know does uh have the tendency to get a little worse. So what used to feel fine, like skipping breakfast, grabbing a coffee, having carbs at lunch, like a carb-heavy lunch, I should clarify, now can cause crashes. So if you're getting brain fogged, particularly sort of a couple one to two hours after lunch, that afternoon slump, often that can be a glucose issue. And that's why stabilizing blood sugar is one of the first interventions that I make inside the GLOW protocol because when glucose stabilizes, clarity improves, mood steadies, afternoon crashes reduce. And I see this all the time with my clients within the first two weeks, they will report big improvements. And it's so shocking when you see these improvements, when you feel these improvements in your body, because you think, gosh, this happened, this reversal happens so freaking quickly. So quickly. We can manage blood glucose very, very quickly with food choices. Um, so this is something that I think women don't really realize how important the food you're putting in your mouth is when it comes to your mood, your energy, and your brain. We always think of food, we tend to think of food as weight and weight management, but it is so important for so many other aspects of health, including our brains and our moods. So that's blood glucose, is one part of things. So we've talked about hormones and particularly estrogen, we've talked about glucose, but one of the other things is inflammation and the gut brain axis. Estrogen decline also affects inflammation. This is why you can get joint pain, uh, you get dry skin, things like that, because you're getting increased inflammation when estrogen declines. Estrogen has quite a good anti-inflammatory effect, which again a lot of us didn't know about this. Um, it's not something that was widely talked about. And it is getting more talked about now, but I feel like there's still quite an education deficit in women. It is getting better, but but this we know from surveys and things that a lot of women still aren't seeing the these messages of everything that goes on and is influenced by the changes in hormones in perimenopause. So estrogen decline impacts inflammation or increases inflammation. And low grade inflammation impacts cognitive function because we know um, oh, actually, I'm just gonna wait a minute to talk about this. So low-grade inflammation impacts cognitive function. So when you add in things like alcohol, for example, ultra-processed foods, poor sleep, gut issues, the brain becomes more sluggish. And what we also know is your gut microbiome shifts in perimenopause and your gut produces neurotransmitters, including serotonin. So there's that mood um angle there. So when gut health suffers, we get increased low-grade inflammation. That's going to impact the brain. We know if the gut is inflamed, that the brain is inflamed. When I use language like that, I don't mean in as in an infected brain, I just mean that we know that when we have gut irritation and inflammation because of the gut brain connection, that that does impact our brain. Um, so when gut health suffers, brain clarity also suffers. It's why brain fog is not just a brain issue, it's a systemic issue, and our gut brain access has a lot to do with this. So, improving gut health actually will help your cognitive function and decrease brain fog. So, we come on to the next level of this is sleep and the impact of sleep on cognitive performance. I think most of us kind of have an idea that if we don't sleep well, we're probably not thinking that well the next day. But sleep fragmentation is one of the biggest contributors to brain fog. And even if you're technically sleeping seven hours a night, which is pretty good for a woman in perimetopause, um, if you're waking sort of, you know, that 2 to 3 a.m. and having trouble getting back to sleep, if you're hot, if you're restless, if your sleep is light and not getting that deep sleep, your brain isn't getting deep restorative cycles. And deep sleep supports your memory consolidation, it supports emotional regulation, and it's necessary for detoxification of the brain via the gymphatic system. The gymphatic system is like a lymphatic system for your brain, and it only activates when you're in this kind of deep sleep. So when deep sleep drops, your clarity drops or your brain fog increases. So there's a number of factors. I'm just gonna quickly summarize all of them again. So we've got the estrogen component, the estrogen brain connection, we've got blood sugar in the brain, we've got inflammation and the gut brain axis, and we've got sleep and cognitive performance. So there's a lot going on here. When we talk about brain fog, we I think a lot of us kind of dismiss it a little bit. Maybe because the name sounds a bit funny, maybe we should rename it. Um, but it is a quite a complex set of circumstances that's going on that contributes to this brain fog. And strangely, even though it is a complex set of circumstances, it's actually pretty simple to correct it, to reverse it, to make it easier to live with. So let's talk about that next. Let's talk about what actually helps. And it's not necessarily a supplement. Um, I don't know if you've worked that out about me, but I'm not big on prescribing supplements for things that we can fix with food. Our body is designed to operate with food, and the way I like to work with clients is to try and get them off as many supplements as possible and just get really targeted with supplements if they're needed, if the food as medicine approach isn't working. So, anyway, I'll get off my soapbox now. Let's talk about what actually helps brain fog. So, firstly, stabilizing blood sugar. Okay, so that's having protein at every meal. Ideally, having three meals a day, breakfast, super important, three meals a day, no snacks, just having fixed um time fasting periods, about five to six hours between breakfast and lunch, lunch and dinner, is really good for stabilizing blood sugar. So protein at every meal. Ideally, having two bites of protein first, because this helps trick your body into thinking you're having a high protein meal and it really slows your insulin production, which helps to keep your blood sugar more steady. Having fiber, good quality fiber at every meal is good for many, many things. Um, and reducing, I would say reduce snacks altogether. If you're someone that's doing a lot of training, like physical training, then sure, snacks may be required for you, but make sure they're not high sugar snacks. Make sure they're not ultra-processed foods. I know a lot of um more athletic people rely on gels and things like that. You'd be much better having like a date or something like that that's actually still going to give you some good energy, but it is not ultra-processed. Honestly, don't even get me started on that. Let's let's uh uh yeah, let's not go down that trial. Um, so stabilizing blood sugar number one, okay. Strength training. Strength training actually improves insulin sensitivity and it reduces um inflammation in the body. And you might find that um surprising that strength training actually reduces inflammation, it reduces chronic inflammation. You can get like a short-term inflammation from strength training because we are with strength training to get hypertrophy or grow muscle, you're actually injuring the muscle. So we do see some inflammation markers rise in the short term after strength training. But strength training reduces chronic inflammation because it in it lowers inflammatory markers and releases anti-inflammatory cytokines. So, and one of these anti-inflammatory cytokines is called myocines, it's a myokines, which counter systemic inflammation and improve insulin sensitivity. And even short, moderate sessions improve anti-inflammatory benefits. So that's actually really important. Another benefit of strength training, which is why all women over 40 really should be doing this. Um, whether or not you're doing it for a weight loss goal, just for basic strength, keeping your quality of life good as you enter into later decades, strength training is number one. Uh, another way to help support clearing brain fog is omega-3 fatty acids. So omega-3s again have an anti-inflammatory effect, but they also support neuron your neuron uh membranes, they support the health of those. So omega-3 fats can be in things like walnuts, can be in hemp oil, flaxseed oil, fish oil, oily fish. Um, pretty easy to get omega-3s. A lot of us don't get enough, and sometimes that is probably one of the few supplements I'll often prescribe people is a good quality omega-3, whether it's a vegan option such as flaxseed oil, uh, hemp oil, or it could be fish oil. All really important omega-3 fatty acids. Um, another thing that can help clear brain fog is magnesium because it supports sleep and it really uh helps support your stress response as well. Always with magnesium, get advice. There are so many different forms of magnesium, and some of them are fantastic, some of them will just give you diarrhea. Uh, so you really need to know what form is the best one for you. And there are, as I said, many, many forms available. And and the great thing is you can get a two for one depending on the magnesium you choose. For example, magnesium glycinate will have an extra ability to um uh support sleep. Uh, but yeah, that that's a bigger conversation. I think I've done podcasts on magnesium before. Maybe I need to do another one. I think it's been a while. Uh, but yeah, any questions about that? You can always message me on the perimenopause path on Instagram. Uh alcohol reduction. Alcohol reduction is a big one on how to clear brain fog. Even small amounts of alcohol can disrupt your REM sleep, and that's going to cause issues with brain fog. Uh, morning light improves circadian rhythm and cognitive alertness. As soon as you get out of bed, rather than reaching for your phone, which I think a lot of people do, see if you can avoid your phone until after breakfast. Get out into some natural light, into some sunlight. If you can go for a walk, that is ideal. Uh, because that will it's not just about your vitamin D, which is also a good thing you can get in the morning light, but it's your circadian rhythm and cognitive alertness will benefit as well. And prioritizing sleep architecture. So that might mean earlier nights, that might mean having some sort of bedtime routine, some sleep hygiene. I think sleep hygiene doesn't seem to be used as much anymore, um, but having some sort of bedtime routine is really important to prioritize your sleep architecture. Making sure the bedroom is cool enough. I mean, I live in Queensland, it's very warm, it's still very warm and humid, and having a cool bedroom makes such a difference, certainly to my sleep. Um, really encourage if you're struggling with sleep to have less cover on your bed, to maybe have a um window open, maybe have the air conditioning going. If you're lucky enough to have it, have a fan on, do anything you can to get the bedroom a little cooler, and that will really help with your sleep. Um, having good quality protein and slow complex carbohydrates at dinner will also help to keep that blood sugar uh stable overnight, and that will improve your sleep architecture as well. Um, and the thing is, I've mentioned quite a lot of things here, but small changes compound quickly in this area. So if you're wanting to clear your brain fog, even if if you go, oh my god, Susie, you've just given me seven things, and within those seven things, there's a whole bunch of other things. That's a lot, and I get it. And particularly if you have brain fog, it's like, oh man, where do I even start? So I will tell you where you start is your blood sugar. Okay, if if this all seems overwhelming, your blood sugar, I would say, is number one. And sleep would be number two. That's where I would start. If you're having any issues with sleep at all, definitely that would be your number two. But stabilizing blood sugar will help with sleep anyway, and it will help with everything else. So that's where I would start stabilizing blood sugar. So when to seek further support for this? Okay, this is really important. If brain fog is sudden and severe, if it's accompanied by neurological symptoms, so that could be headaches, that could be weakness, that could particularly if that weakness is down one side of your body, if you're getting pins and needles, for example, they are kind of nerve symptoms. If it's progressive and getting worse, absolutely you need to get assessed by a medical practitioner. That is really important and get it done pretty quickly. Okay. We don't muck around with brain fog. And it it could be so many different things, you know, it can be things like thyroid dysfunction, it can be iron deficiency, it can be B12 deficiency, it can be a severe sleep disorder, it can be something else. But for the vast majority of women in their 40s and 50s, uh brain fog is hormonal and metabolic and very responsive to support, which is awesome. So if you've been quietly worried about your memory or your focus or brain fog, I hope this episode has given you some reassurance. You're not losing yourself. Your brain is responding to hormonal transition, and with the right strategy, clarity will return and it can return quite quickly. So, I mean, if you would like some personalized support, navigating brain fog, uh helping with sleep issues, low motivation, weight shifts, I'd love to help you inside the Glow Protocol. Uh, you can book a free peri weight loss assessment. We can talk through what is driving your symptoms specifically. You'll find a link in the show notes to do that. Um, but yeah, thank you for being here with me today. Next week I'm diving into those 2 to 3 a.m. wakeups and sleeplessness because sleep is the cornerstone of pretty much everything. Uh until then, take care. Trust that your brain is still very much on your side. You just need to give it some support. Um, and I will see you next Tuesday with some brand new content. Thanks so much for joining me on the Ageless and Awesome Podcast. If you would like this episode, please make sure you click the little plus button if you're on Apple Podcasts, or the follow button if you're on Spotify so that you get each new episode delivered to you every single week. If you feel like writing me a five star review, you would absolutely make my day. If you found this episode resonated with you, head over to my Instagram and DM me at the Perimenopause Park. I would love to connect with you.