SYMPTOM · PERIMENOPAUSE
Brain fog
Forgetting things, words that won't come, trouble concentrating or following a conversation: brain fog affects many women in perimenopause. It's frustrating, but it's temporary and it has nothing to do with any cognitive illness.
Why it happens
Oestrogen helps the brain use glucose, its main fuel. When levels drop and fluctuate, the energy available to certain areas of the brain temporarily decreases. This can affect working memory, concentration and how quickly you find your words.
What tends to make brain fog worse
- Lack of sleep, which makes it even harder to concentrate.
- Stress and a heavy mental load.
- Long stretches without breaks or time away from screens.
- Irregular eating, with energy dips during the day.
In the moment
- Write down what you need to remember rather than relying on memory alone.
- Give yourself a proper few-minute break before going back to a complex task.
- Repeat out loud what you've just heard to help it stick.
Day to day
- Make regular sleep a priority: it's the most direct lever on mental clarity.
- Limit multitasking, which drains your attention more at this stage.
- Move regularly: physical activity supports blood flow to the brain.
Worried about brain fog, or finding it's here to stay?
A healthcare professional can help you tell the difference between the normal effects of perimenopause and other possible causes.
For information only. This does not replace a personalised medical assessment.
If several of these symptoms ring true, it's no coincidence.
Menopause isn't just about hot flushes. Symptoms can begin years before your last period and affect sleep, mood, energy, memory, weight and intimate health.
Click on a symptom to find out more.
Sleep problems
Asleep in ten minutes yesterday, wide awake at 3 a.m. today, for no reason. Progesterone, which helped you switch off at night, is in shorter supply, and deep sleep takes the hit straight away.
Anxiety
Stress that spikes over an email, a meeting, running ten minutes late. Oestrogen affects serotonin: when it yo-yos, everything feels heavier to carry than before.
Joint pain
Knees that creak as you stand up, hands that feel stiff in the morning. Cartilage loses its best anti-inflammatory ally as oestrogen falls, and you feel as if you are rusting up all over.
Hot flushes
A wave of heat rising from the chest to the face, lasting one to five minutes. Deprived of oestrogen, the thermoregulatory neurons in the hypothalamus narrow the thermal neutral zone: a few tenths of a degree are enough.
Palpitations
Your heart suddenly races, with no effort and no reason. Oestrogen also influences the nervous system that sets your heart rhythm. Alarming in the moment, rarely serious.
Mood swings
You laugh, and thirty seconds later you could cry or tell everyone where to go. Hormones rise and fall faster than before, and your mood follows, without warning.
Weight gain
Your tummy rounds out even though nothing on your plate has changed. Oestrogen redirects fat storage towards the abdomen, and your metabolism runs a little slower than before.
Low libido
Desire takes longer to arrive, or barely arrives at all. Oestrogen and testosterone fall, and sensitivity with them. The desire is still there; it just takes longer to get going.
Vaginal dryness
A feeling of dryness, sometimes a little discomfort day to day. Tissues lose their natural moisture as oestrogen falls. It is a common symptom, and still too rarely talked about.
Irregular periods
One cycle shorter, another dragging on, a month skipped altogether. Ovulation becomes less regular as the ovaries slow down. It is often the very first sign of perimenopause.
Night sweats
Waking up drenched in the middle of the night, sheets to change, sleep cut short. It is the same hot flush as during the day, night-time edition, and it wakes you just as surely.
Pain during sex
Discomfort, sometimes real pain, during or after sex. Tissues thin as oestrogen falls, and what never used to be a problem can become sensitive.
Dry skin
Skin that feels tight, marks more easily and seems to have lost some of its bounce. Collagen declines with oestrogen, by up to 30% in the first few years after menopause.
Chronic fatigue
Tiredness that will not lift, even after a good night. Broken sleep, falling hormones: your body runs less efficiently, and you feel it from morning to night.
Hair loss
More hair in your brush, a parting that seems to be widening. Oestrogen used to extend its growth phase. Without it, the cycle shortens and each strand gets finer.