Many women find that that their thinking feels foggy and that their memory doesn’t seem to be as good during the menopause transition. Some have trouble concentrating or finding the right words. Organizing and staying on task may feel more difficult. Cognitive tests of women during the menopause transition back up their observation that their memory is worse.

This is another area (like aches and pains, bladder control, and bone loss) where it is hard to separate how much of a complaint is due to “normal aging” and how much is from the menopause transition. Even in middle age, there is a small decrease in memory, how quickly we processing information, and paying attention.

Searching for words does NOT mean you have dementia. Nor is there any research linking brain fog during the menopause transition and later dementia. If you have memory problems that are getting in the way of everyday life, talk to your health care provider.

We need more research to understand cognitive problems during menopause, let alone prevent it.  Read on to learn what we do know.


Although the fogginess is real, the reasons for it are still poorly understood . It may be that the large hormone changes during the perimenopause affect cognition. Studies have tested cognitive performance at difference reproductive stages and followed women through the menopause transition and postmenopausal period. They find small decreases in memory. However, it is hard to separate the effects of aging from the effects of the menopause transition. A decline in cognitive function is part of normal aging that begins around age 50.

Studies of women after a surgical menopause also find some brain fog.


A very large study found that 31% of premenopausal women said they were forgetful, compared to 44% of women beginning perimenopause and 41% of women post-menopause. In this study, cognitive issues were the #2 complaint of women. (#1 was increased aches, pains, and joint stiffness.) The good news: cognition eventually got better again.

Research suggests that other factors that may make brain fog worse:

  • stress (e.g. unemployment, financial problems, difficult teenagers at home, aging parents, career demands, and relationship problems)
  • untreated hypertension, diabetes, or high cholesterol
  • some medications
  • less than a high school education
  • smoking
  • nonwhite race/ethnicity
  • low physical activity.




  Treatments that are inappropriate or have not been studied for this symptom are not listed.


Cui C, Birru RL, Snitz BE, Ihara M, Kakuta C, Lopresti BJ, Aizenstein HJ, Lopez OL, Mathis CA, Miyamoto Y, Kuller LH, Sekikawa A. Effects of soy isoflavones on cognitive function: a systematic review and meta-analysis of randomized controlled trials. Nutr Rev. 2020 Feb 1;78(2):134-144. doi: 10.1093/nutrit/nuz050. PMID: 31504836; PMCID: PMC7808187.

Espeland MA, Rapp SR, Shumaker SA, Brunner R, Manson JE, Sherwin BB, Hsia J, Margolis KL, Hogan PE, Wallace R, Dailey M, Freeman R, Hays J, Women’s Health Initiative Memory Study. Conjugated equine estrogens and global cognitive function in postmenopausal women: Women’s Health Initiative Memory Study. JAMA. 2004; 291:2959–2968. doi:10.1001/jama.291.24.2959. PMID: 15213207.

Gold EB, Sternfeld B, Kelsey JL, et al. Relation of demographic and lifestyle factors to symptoms in a multi-racial/ethnic population of women 40-55 years of age. Am J Epidemiol 2000; 152:463–473.

Greendale GA, Huang MH, Wight RG, Seeman T, Luetters C, Avis NE, Johnston J, Karlamangla AS. Effects of the menopause transition and hormone use on cognitive performance in midlife women. Neurology. 2009; 72:1850–1857. doi:10.1212/WNL.0b013e3181a71193. PMID: 19470968.

Henderson VW, Guthrie JR, Dudley EC, Burger HG, Dennerstein L. Estrogen exposures and memory at midlife: a population-based study of women. Neurology. 2003; 60:1369–1371. doi:10.1212/01.wnl.0000059413.75888.be.PMID: 12707448.

Luetters C, Huang MH, Seeman T, Buckwalter G, Meyer PM, Avis NE, Sternfeld B, Johnston JM, Greendale GA. Menopause transition stage and endogenous estradiol and follicle-stimulating hormone levels are not related to cognitive performance: cross-sectional results from the study of women’s health across the nation (SWAN)J Womens Health (Larchmt). 2007;16(3):331‐344. doi:10.1089/jwh.2006.0057. PMID: 17439378.

Maki, Pauline M. PhD1; Henderson, Victor W. MD, MS2 Cognition and the menopause transition, Menopause: July 2016 – Volume 23 – Issue 7 – p 803-805
doi: 10.1097/GME.0000000000000681

Phillips SM, Sherwin BB. Effects of estrogen on memory function in surgically menopausal women.Psychoneuroendocrinology. 1992; 17:485–495. doi:10.1016/0306-4530(92)90007-t. PMID: 1484915.

Phillips SM, Sherwin BB. Variations in memory function and sex steroid hormones across the menstrual cycle. Psychoneurodocrinology. 1992; 17:497–506. doi:10.1016/0306-4530(92)90008-u. PMID: 1484916.

Santoro N, Epperson CN, Mathews SB. Menopausal Symptoms and Their Management.   Endocrinol Metab Clin North Am. 2015 September ; 44(3): 497–515. doi:10.1016/j.ecl.2015.05.001. PMID: 26316239.

Taylor CM, Pritschet L, S Yu S,Jacobs EG. Applying a women’s health lens to the study of the aging brain. Frontiers in human neuroscience, 2019, 13, 244, doi: 10.3389/fnhum.2019.00224.

Woods NF, Mitchell ES, Adams C. Memory functioning among midlife women: observations from the Seattle Midlife Women’s Health Study. Menopause. 2000; 7:257–265. PMID: 10914619.

Authors: Dr. Leslie Snyder, Dr. Katherine Newton, & Dr. Susan Reed.  Last reviewed April 23, 2021.


Start typing and press Enter to search