I had it all figured out. Anytime I walked into a room and forgot why I was there, I’d play it off with a casual, “Gosh, has anyone seen my car keys?” Or, if I lost my train of thought in the middle of a meeting at work, I’d say something like, “Hey, guys, don’t forget to play Mega Millions tonight!” And if I really embarrassed myself, like the time I pulled the house phone out of my pocketbook—I’d blame my damn kids!

Look, I knew I was losing it, but I wasn’t ready to let the world in on my little secret—not me, the laser-sharp Wonder Woman who somehow managed my own hectic schedule, along with every playdate, soccer match, birthday party, music lesson, doctor’s appointment, school event, family trip, and all the other details of our lives—and here I was, suddenly hard-pressed to remember the day of the week!

At first, I chalked my absent-mindedness up to working long hours, chronic lack of sleep, and wearing so many hats that I couldn’t possibly keep track of everything. But when I went from your run-of-the-mill forgetfulness to a full-blown bumbling idiot, I knew something more sinister was happening with my brain. If I wasn’t wandering through my days looking like a lost puppy, I was begging everyone’s forgiveness and asking the same damn question: “Can you repeat that…again?”

And let’s not forget the increasing difficulty I had with word recall or processing things that were once a matter of routine. Like when I stood in front of the kitchen sink, asking myself: “Do I put the pasta in a pot of cold water and bring it to a boil, or do I boil the water first?” Or how about the time the exit ramp to my house was detoured, and I spent the better part of an hour driving in circles, desperately trying to find my way home?

Why Midlife Memory Problems Mimic Early Dementia and Alzheimer’s

After becoming completely unnerved by this whole thing, I decided to speak with my doctor. To my surprise, she assured me that my brain fog lined up with the other symptoms I was experiencing and that my shifting hormones were likely to blame. What a relief to know I wasn’t losing it after all! And thank goodness she recognized it for what it was and didn’t brush off my concerns.

Of all the symptoms of perimenopause, brain fog tends to be one of the most overlooked, even though research tells us that up to 62% of women report cognitive impairment during the transition into menopause. According to Dr. Gayatri Devi, a leading neurologist, menopause-related memory problems are often misdiagnosed because the cognitive changes some women experience can “mimic those seen early in the course of other dementias, including Alzheimer’s disease.”

Although I had no risk factors for Alzheimer’s or dementia, you still couldn’t have told me something wasn’t seriously wrong with me. Making matters worse was having no idea that perimenopause came with a boatload of baffling symptoms I knew nothing about. Like most women, I’d heard all about the hot flashes and night sweats, and I understood that menopause essentially wiped out my fertility. But who knew it could also impair my cognitive functioning?

Inside The Menopause Brain by Dr. Lisa Mosconi

In her widely acclaimed book, The Menopause Brain, New York Times bestselling author and leading neuroscientist Dr. Lisa Mosconi unravels the mysterious connection between the menopausal transition and its impact on the brain. Contrary to popular belief, the symptoms of menopause don’t originate in the ovaries but—get this—in the brain, validating “what scores of women have been saying all along: menopause changes your brain.”

After examining scores of brain scans before, during, and after menopause, Dr. Mosconi found that during perimenopause, the brain undergoes profound changes in energy, structure, connectivity, and overall chemistry, resulting in what she calls the “menopause brain.” During this period of adjustment, the brain is essentially being rewired and challenged to find workarounds.

And precisely what is the brain forced to contend with as it experiences a drastic drop in hormones and works to readjust itself? You guessed it: brain fog—along with hot flashes, night sweats, mood swings, anxiety, and a host of other neurological symptoms that are scientifically proven to exist and are not, as some outdated beliefs suggest, merely figments of our imagination.

How Midlife Hardships Compound Cognitive Function

In Demystifying the Female Brain, Dr. Sarah McKay also points out that brain fog can be further compounded by “the life circumstances women often find themselves experiencing in their late forties and fifties.”

While most women typically plow through life without taking the time to connect the dots, Dr. McKay argues that we may not realize how much our cognitive function is affected by midlife hardships, such as coping with a rebellious teen or aging parents, while simultaneously managing our own health concerns, demanding jobs, and relationship problems.

Now, ain’t that the truth! There’s no question my memory got exponentially worse during the two and a half years I spent caring for my ailing mother. Along with working full-time, raising my kids, and attending to my household, I also helped manage my mother’s affairs. Even after she passed away, the pressures never let up. Not only was I grieving her loss, but issues involving her estate utterly consumed me.

In hindsight, I can see how these typical midlife challenges made what was already a very dark and confusing time in my life even more unsettling—particularly for someone who, like most fiercely independent women I know, prided herself on always being on top of her game.

In Good Company: Perimenopause Brain Fog Happens to the Best of Us 

And then one night, while Googling through the fog, I came across the article “What Menopause Does to Women’s Brains.” I secretly rejoiced, knowing that an award-winning New York Times bestselling author and journalist had experienced the same difficulty with word recall that I did. I laughed out loud as she found herself using descriptors like “the piece of glass between me and the world” when the word “windshield” escaped her.

I soon found another piece in which an experienced surgeon shared how she could hardly recall the name of a medical instrument—while in the middle of surgery! “Yes!” I shouted at the top of my lungs. Trust me, this wasn’t a case of misery loves company so much as a relief to know I was in good company.

Transparent, personal accounts like these, from highly accomplished women whom we tend to think are either immune to or unfazed by life’s challenges, normalized my experience with brain fog and drove home the point that, no matter who you are, we’re all in this together.

The Fog Lifts 

You’ll be glad to know that the brain fog experienced during perimenopause eventually lifts, and when it does, you’ll be back to your normal lousy memory. My personal experience, along with findings from a study of more than 2,300 women, revealed that memory eventually rebounds to premenopausal levels after menopause.

Until then, nutritionist Staci Gulbin says a number of lifestyle changes can help improve memory during this transition, and may continue to benefit cognitive health even after the fog dissipates:

Tips To Ease Brain Fog During Perimenopause

Consume Antioxidant-Rich Foods: Brightly colored fruits and vegetables, and Omega-3 fatty acids found in fish like salmon and trout, and other healthy fats like those from nuts, seeds, and avocado can help to reduce inflammation. By reducing inflammation in the body, you can help lower your risk of cognitive dysfunction like brain fog and memory loss. Avoid foods with trans fats, and be sure to eat a well-balanced diet with a variety of antioxidant-rich foods that’ll fend off the fog and keep your mind sharp. 

Get Enough Sleep Each Night: With our jam-packed schedules, sleep is often pushed to the wayside when it comes to maintaining a healthy lifestyle. However, a prolonged lack of sleep can lead to and exacerbate brain fog. Most adults should sleep between seven and nine hours each night to avoid the damaging effects of sleep deprivation. Making it a point to wind down before bedtime is also a good idea. Try cutting down on digital screentime, take a warm bath, or fix a cup of chamomile tea to help set the stage for a good night’s sleep. 

Exercise A Little Each Day: Staying active is not just good for managing weight and heart health. Research shows that being active can also help improve your brain health in several ways, such as improving blood flow to the brain, reducing inflammation, and lowering cortisol levels, the stress hormone. And you don’t have to be a tri-athlete to reap the benefits. Being active most days of the week, even if it’s just 30 minutes of moderate-intensity exercise like brisk walking, can clear the way for a clearer brain.

Stress Less: It may be difficult to avoid stress since it’s all around us, from traffic jams to financial struggles to issues at home and work. Fortunately, there are ways to help reduce the effects of stress on your health by learning how to manage it better. This may include breathing techniques to decompress during a stressful event, talking to a therapist to learn tools to manage stress, or engaging in yoga or meditation to relax your mind. Whatever you do to help manage your stress will go a long way towards improving your brain health, too! 

Take Your Daily Vitamins: A deficiency of vitamins like vitamin D and B12 can increase a person’s risk of cognitive decline, slowed thinking, and poor memory. Vitamin D is found in sunlight but can also be consumed as a supplement or in fortified milk and yogurt, beef liver, cod liver oil, egg yolk, salmon, sardines, and tuna. B12 can also be taken as a vitamin or found in beef, poultry, seafood, fish, dairy products, fortified cereals, and juices. So be sure to include vitamins D and B12 in your daily diet to boost that brain power. 

Helpful Rule of Thumb

Brain fog during perimenopause may make you feel like you’re losing your mind, but it’s likely not dementia, and luckily, it won’t last forever. Lifestyle changes may also help support brain health and reduce dementia risk down the road. Another thing to keep in mind is Dr. McKay’s rule of thumb: “Normal memory loss involves forgetting where you put your keys, whereas dementia involves forgetting what your keys are for.”

But if you still think your brain fog could be something more serious, get to know the early signs and symptoms of Alzheimer’s disease, the most common form of dementia, and be sure to speak with your doctor about whether cognitive testing is appropriate. Going through perimenopause can be confusing enough, so you owe it to yourself to get some peace of mind and all the support you need.

“Peri Winkler” is the creator of Peri-Winkle Wellness, a women’s lifestyle blog that chronicles the mishaps, misadventures, and unexpected joys of perimenopause and midlife.