There are some symptoms that are classically linked to menopause, like hot flashes and mood changes. But menopausal brain fog—a range of symptoms that impair cognitive function—is also common (and debilitating). And now, scientists think they’ve figured out what’s behind it.
The findings could have an impact on how estrogen levels are studied in menopause in the future, as well as eventual treatments. Here’s what we know, based on the research.
Meet the experts: Mary Jane Minkin, MD, a clinical professor of obstetrics and gynecology and reproductive sciences at Yale School of Medicine and founder of Madame Ovary. Jessica Shepherd, MD, an ob-gyn in Texas and author of an upcoming book on menopause, Generation M.
What did the new study find?
In a new study published in the journal Scientific Reports, researchers scanned the brains of 54 health women between the ages of 40 and 65. The scans found that women in different stages of menopause had higher estrogen receptor density in certain brain networks, compared to those who hadn’t been through menopause yet. (Estrogen receptors are groups of proteins found in several areas of the brain. They influence the cognitive and behavioral effects of estradiol, the strongest form of estrogen.)
Researchers said that this increase in estrogen receptor density is likely due to dropping levels of estrogen during menopause. Basically, brain cells create more receptors to try to pull in as much estrogen as possible as levels naturally drop during menopause.
Women with higher estrogen receptor density were more likely to be further into menopause, have more brain fog, and more mood symptoms than others, the study found.
What causes brain fog during menopause?
Aside from estrogen receptors, there are a few other potential causes of brain fog during menopause. Other menopausal symptoms—like sleep disturbances—can also factor in, says Mary Jane Minkin, MD, a clinical professor of obstetrics and gynecology and reproductive sciences at Yale School of Medicine and founder of Madame Ovary.
Brain fog during menopause could also "be related to changes in the hypothalamus at the base of the brain, which we know occurs from the decreasing levels of estrogen," Minkin says. The hypothalamus is an area of the brain that produces hormones, per Medline.
Not only that, women going through menopause also have plenty of other life stressors they're dealing with, Minkin points out.
Are there limitations of the study?
There are a few limitations to keep in mind. One is that the study was relatively small, featuring just 36 women who were either in perimenopause (the stage leading up to menopause) or menopause. Those were compared with 18 pre-menopausal women.
The study also didn’t track the same women over time. Instead, it compared brains between the different women.
What should women experiencing brain fog during menopause do?
The study’s findings are “groundbreaking” because they look into how estrogen impacts the brain, especially after menopause, says Jessica Shepherd, MD, an ob-gyn in Texas and author of the upcoming book on menopause, Generation M. But she also notes that there is no good solution for menopausal brain fog that we know of.
While hormone replacement therapy (HRT) may help with symptoms of menopause, Shepherd says that it hasn’t been directly studied as a treatment for brain fog. “Even though many of us give [hormone therapy] for brain fog, it’s considered off-label,” she says.
However, the study also found that the time frame where women may be able to have benefits from hormone therapy may be larger than previously thought, the researchers said in a press release. In the future, the authors hope to research if the density of estrogen receptors changes with hormone therapy, hopefully leading "to fewer symptoms [of brain fog] and better performance on cognitive tests," according to the release.
Ultimately, Shepherd says that it’s best to talk to a doctor who specializes in menopause if you’re concerned about brain fog.
Hormone therapy “isn’t a direct solution to brain fog,” but it “has many benefits, so consider it when going through menopause,” she says.
Korin Miller
Korin Miller is a freelance writer specializing in general wellness, sexual health and relationships, and lifestyle trends, with work appearing in Men’s Health, Women’s Health, Self, Glamour, and more. She has a master’s degree from American University, lives by the beach, and hopes to own a teacup pig and taco truck one day.
