Understanding brain fog in menopause needs more data, experts say
More research is needed to better understand the link and prevalence of cognitive difficulties such as brain fog for women in menopause, experts say.
In a new review, published in The Lancet Obstetrics and Gynaecology, researchers from the University of Melbourne, Monash University and University College London argue that the prevalence and long-term impacts of brain fog and other cognitive symptoms remain unclear.
Cognitive problems are one of the top priorities identified in a recent global survey of women called the Menopause Priority Setting Partnership.
The researchers say many women report varying degrees of forgetfulness, attention or concentration difficulties, as well as fogginess.
Professor Martha Hickey, from the University of Melbourne and Royal Women’s Hospital, said there are no clear, evidence-based interventions to prevent or treat brain fog and other similar cognitive issues.
“Our analysis of the best available research shows that many women experience cognitive symptoms, such as brain fog, during the menopause transition,” Professor Hickey said.
“But there’s a lack of long-term data, which means that there’s a gap in our knowledge about how the brain fog symptom develops and changes from peri-menopause to after menopause ends.
“It’s a real gap in our understanding.”
Professor Hickey said there may be a number of competing factors that also influence brain fog, such as ageing and general stress, as well as the hormonal changes already at play.
“It’s also true that sleep disturbance is common in menopause, and of course that may also impact brain fog as well,” Professor Hickey said.
“This may mean that things like cognitive behavioural therapy (CBT), exercise, mindfulness or relaxation therapy could improve sleep in women who are perimenopausal and post-menopausal, which may then help some of their cognitive symptoms too.”
Study author Professor Caroline Gurvich, from HER Centre Australia, Department of Psychiatry, School of Translational Medicine at Monash University, said the research also sets out some questions for GPs.
“Given that there may be a number of contributing factors to cognitive symptoms during perimenopause, we suggest clinicians should ask patients questions around how substantially their concentration or memory is impacted, how long it has been going on, how has daily life been impacted, as well as ruling out other medical concerns,” Professor Gurvich said.
“GPs and clinicians have a really important role to play here in validating women’s experiences of these cognitive symptoms during menopause, talking about potential causes as well as offering treatment options. We are still gathering evidence about whether hormone therapy can help cognitive symptoms. There are also evidence-based lifestyle changes that may be helpful in the short term as well as reducing the risk of later life cognitive decline.”
Professor Aimee Spector from the University College London spoke to the impact of brain fog in the workplace.
“We increasingly see women, typically at the peak of their careers; losing confidence in the workplace, often translating to leaving work or reducing work hours. Having simple strategies to support and retain them at work is also a broader economic issue.”