Perimenopause symptom #1: Foggy foggy head

Wait. What was I going to write about? Oh, right. Perimenopause, symptoms of

There seems to be some confusion over what perimenopause is, when it starts, and when it’s no longer “peri,” it’s just full-on menopause. So let’s talk about some of the key symptoms that let you know when you’re in the countdown to the End of Periods.

Perimenopause usually starts in a woman’s 40s, though it can happen as early as the mid-30s. Reproduction is winding down, estrogen levels are declining, periods become irregular. Perimenopause typically starts 4-5 years before menopause, though it can be much earlier. Menopause is defined as the stage of life beginning when a woman has had no periods for 12 consecutive months.

So how do you know when perimenopause starts? There are some key signals that you’re experiencing the onset (or are in the thick of it), and we thought an in-depth discussion of some of the symptoms might be useful.

So…hang on, which one was I going to start with….?

Cognitive problems in perimenopause

What’s the problem?

Memory loss, lack of concentration, fuzzy thinking: Many women report difficulties in staying focused on the task at hand. They may find themselves groping for words, unable to retrieve a name when making introductions, or wondering what they were planning to do in the room they find themselves in. Sometimes retaining information like lists or doing mental math seems impaired.

What’s happening?

Estrogen helps with brain function, and as the body’s estrogen levels start to decline in perimenopause, things may feel fuzzier for a while. This doesn’t mean your brain function is in permanent decline, simply that your body is dealing with hormonal changes. It doesn’t help that many women feel foggier during this time because their sleep is disrupted, thanks to night sweats and insomnia.

What can you do to alleviate the symptom?

Take care of yourself. Smoking can increase the intensity, duration, and frequency of hot flashes, so stop smoking if you can. Exercise daily to help relieve stress and promote better sleep (consider exercising in the morning, though; some women say exercising in the evening may worsen night sweats). There may be some benefit to hormone replacement therapy or even continuing to take oral contraceptives during perimenopause (and remember, it’s still possible to get pregnant during perimenopause).

Exercise your brain like any muscle. Your brain gets stronger the more you use it, so do something new like take a photography class or download an app to learn a new language. There are also brain games that may help you stay sharp. Ellen Dogen of the Huffington Post suggests putting your brain on a regimen of "cranium crunches" with puzzles intended to rewire your brain and processing skills. The daily crossword isn't a waste of time--it's a great way to buff up your vocab and reclaim your confidence. 

When is it time to talk to a doctor?

If you feel your symptoms merit a trip to your ob/gyn or a consult with your physician, by all means, do it. In her article “How to talk to your doctor about menopause” on, Shirley Weir lists guidelines for when a doctor visit might be necessary. If your cognitive symptoms rise to the level of constant worrying, lack of pleasure in the things you used to enjoy, chronic anxiety, or suicidal thoughts, you should talk to a medical professional. Even if your symptoms aren’t this serious, your doctor may be able to provide treatment options that can improve your quality of life.

It’s real, and it’s temporary

Thankfully, according to Lindsey Konkel’s article in Live Science, brain fog is temporary and will likely improve after the first post-menopausal year. That may not provide much relief to those who are going through it and who may be finding it difficult to convince others that their brain fog is real. It is real, and it can be a barrier to living your life as you've always lived it. But reducing or alleviating this symptom may be as simple (and fun) as spending time with the daily crossword!



The information on this site is not meant to take the place of advice from a medical professional. If you’re concerned about the symptoms you’re experiencing, consult with your doctor.

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