#60 - Beating the brain fog of menopause

While you may have expected many of the physical symptoms of menopause, the one that might really take you by surprise is brain fog. If you find daily tasks a real slog, you’re struggling to focus, or just forgetful in ways you would have never dreamed possible-know that this is a very common midlife experience. But what is really going on and is there anything we can do to better support our brains in this season? 

In this episode, I’ll share how hormones are the culprits (yet again) and the good news that brain fog won’t last forever! While what you eat won’t make the brain fog totally disappear, there are several things that you can do to support your brain, which I’ll share too. I’ll also let you in on one of the sneaky reasons that brain fog intensifies-and it’s one I bet you haven’t considered!

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Transcript

Jenn Huber  00:02

Hi, everyone, welcome to this week's episode of the midlife feast. So I'm taking on brain fog today, whenever I put a call out for podcast suggestions or topics that people want me to talk about, brain fog is always at the top of the list. And it's an interesting one, because most of us, I think, go through this as we journey through perimenopause into menopause and beyond. Researchers, you know, somewhere about two thirds of people will experience some change in the experience of using our brain. So whether that is remembering why we walked into a room or remembering what's on our list, or remembering that we even made a list. And it can also be just a change in focus. So finding it difficult to focus, short term long term on a task. 

Some of us just feel like fuzzy all the time. And so I'm excited to tackle this one today. And I'm going to do a couple of things. In this episode one, we're going to break down exactly what is brain fog, because it's not a medical term, but it's very accurate. So we're gonna talk a little bit about what it is, we're going to talk about why it's happening. So kind of bring it back to those changes, especially in estrogen and progesterone. I'm going to share some information about nutrition and diet and brain fog that might come as a surprise to you. And then I think everybody can learn from and then I'm going to give some general suggestions around how can we support brain health, in midlife and beyond? So let's get started.

 So I remember hearing the term brain fog when I was early, you know, early in my practice, from women who are were my age now. So in their 40s, and 50s. And kind of thinking, what did they mean by that? What do they mean by brain fog? And isn't that just like what happens when you get older that you know, you just slow down and you don't think as quickly your reaction times are reduced, like isn't that just normal, but of course, over time and experience, and then going through it myself realizing that, it's, it's kind of an uncomfortable thing, because if you're used to being sharp and quick, and or at least just have a reliable brain, to all of a sudden feel like, something is inaccessible to you, which is how to how it felt like, to me, is really scary. 

And so, I've described myself before, as you know, I'm type A, I definitely have ADHD, I have always had a hard time sitting still, but for the most part for most of my adulthood, anyway, I am pretty organized, I am really good at keeping lists, I'm really good at using technology like reminders and schedulers. And for the most part, I think people see me as an organized person. And certainly in my family. I'm the household manager. And so I'm always the one to remember things or to make sure that you know, something gets done. And I remember that it was in my late 30s, which I now know I was well into perimenopause, I'd forgotten something. And I can't remember what it was, which is actually funny. But I just remember that it was something big and important. And my husband, Brent had looked at me and he was like, are you okay? Because it was the second or third, like big thing that I had just completely forgotten, forgotten to do forgotten to try and remember forgotten that it was there. And it was like a big enough thing that it would never have been possible for me to forget this before. So I remember at that time feeling like, 

Okay, I'm actually feeling a little scared about this. And that's often when I talk to other people who kind of go through the same thing. They'll say, Yes, that's it. I was scared, I felt like is this, the beginning of the end is this one I like lose my proverbial mind. So I want to reassure you first. So let's start with the what is brain fog, so it's not actually a medical condition. So brain fog isn't a recognized symptom in a diagnostic list. Interestingly, having lived and worked in Canada and now living in Europe, brain fog is used more casually in medical discussions and is accepted as a more medical casual term. Here in Europe, it seems like in Canada where there seems to be a bit of resistance to using it, but it is a really great descriptor. So I think it's still a good word to use when you're trying to describe how you're feeling to someone. But what it is, is it's a change. It's a cognitive change, that you Isn't this is important that is not linked to an increased risk of dementia or Alzheimer's. So if you feel like oh my goodness, is this the beginning of something bigger? It probably isn't. As always, this is not medical advice. So please talk to your healthcare team about any concerns that you have including memory. 

Because there are some other risk factors that may be true for you that you should definitely be aware of and talk about. But when we're talking strictly about brain fog that happens and perimenopause and menopause, it isn't linked to any increased risk of long term cognitive changes. And so most people experience this as changes in short term memory. Not usually long term memory, which is a different kettle of fish. But, you know, where did I put my keys? Why did I walk in this room? What was I going to get at the store again? What did I want to ask my partner, like, all of those things seem to involve like a lot of work, it feels like it takes a lot of brain energy to remember those things. So this fuzziness this lack of mental clarity, you know, difficulty focusing, which an interesting kind of side discussion for another podcast is going to be on the rise of ADHD diagnoses and women in midlife. So stay tuned for that. But all of these things fall under the umbrella of brain fog. Now, it can be easy to make the connection between sleep changes, for example, and brain fog, so Oh, well, I'm feeling fuzzy and forgetful because I'm not sleeping. Okay. Yeah, that makes sense. And maybe you're also having really heavy periods. And so maybe you're also anemic. Yeah. Okay, that also makes sense. 

And maybe you're also experiencing changes in mood, so you're feeling more anxious, or maybe you're depressed. Yeah, that also makes sense as to why we might feel fuzzy. But all of those things can be true. And all of those things can be happening. And also, we do know that there are some distinct relationships between estrogen and progesterone, and memory and cognition. And we know that the brain has estrogen and progesterone receptors. So just like the rest of our body, these fluctuations in perimenopause of estrogen and progesterone that are on this roller coaster, can affect how our brain functions. So one of my naturopathic colleagues, Dr. Jordan Robertson, best described it as the evidence seems to indicate that this brain fog that happens in midlife is a learning problem. It's not a brain memory problem. And I think that that's actually a really good description, because it seems like perimenopause, and which you know, can include, you know, that year up to the year before your last period. And for some, even the year after, in terms of the fluctuations, not the terminology. 

But in terms of the fluctuations, this seems to be the period of time when women are most likely to experience the symptoms and changes. And we also know that there's an association between verbal memory skills, so kind of that being lost for words and the severity of hot flashes, for example. So one study found that people who had more hot flashes in a day also had the worst scores on a verbal memory test. So again, that may not, you know, be a big surprise, because maybe you're also having those hot flashes at night, meaning that you're having night sweats, and maybe you're not sleeping well. But it is also very likely that it's because of these big fluctuations in estrogen or progesterone. So, all of this to say there is a lot happening that can contribute to why we feel fuzzy. It is the lack of sleep, it is the mood changes, it is also the changes in estrogen and progesterone. And I'm going to come back and comment on hormone therapy at the end. But so just to recap, you know, you are noticing a change in how you experience using your brain. That is not all in your head. I guess that's kind of a pun, but it is in your head, but it's not all in your head. There are reasons why this is happening. And everyone always wants to know, what can I eat that is going to support my brain health help reduce my brain fog?

Jenn Huber  09:27

And you know, and that's a great question because of course, as I always say Food Matters just not in the way that we've been led to believe. But when it comes to our long term health, cognitive health or otherwise, what we eat can have an impact. 

But one of the things that I see and I always take advantage of being able to call out on this diet, culture wellness, cultural narrative around health is that we will often see things like eat these foods to reduce brain fog, or you know, eat more fat or eat more protein or don't eat carbs. carbs read this kind of carb or don't have sugar. And we don't have any evidence that there is any one particular food diet that can or can't influence brain fog. We do have evidence for cognitive health and the, and reducing the risks associated with dementia, and also Alzheimer's, with patterns of eating over a long period of time, which from that we can, you know, also tease out that, yeah, what I eat will influence my brain health and therefore may influence my experience of using my brain. But you're probably not going to be able to eat your way out of midlife brain fog. So just want to kind of be clear about that. 

So first, I want to talk a little bit about the Mediterranean diet. And you may have heard this also referred to as the mind diet, which is kind of the variation on the Mediterranean diet, which has, you know, found in several studies to support or that there was an association between people who have less cognitive decline, or risks of cognitive decline in later in life, if they eat a diet that adheres to what is outlined in the Mediterranean diet, which tends to be less red meat, more chicken and poultry, more fish, more beans, lentils, nuts, seeds. So getting lots of those mufas and PUFAs, the types of fats that we seem to think are associated with better health, including better brain health. And less alcohol, for example, including some some dairy but not over relying on it as a primary source of anything, but certainly including it. But really just kind of looking at a diverse amount of different kinds of foods, those partake in, especially those that are high in what we would consider kind of essential fats. 

So when people are asking what can I eat to support my brain fog, I'll say, well, there's no one food in particular. But if you're looking for some kind of outline, structure, recipe inspiration, or general guidelines, anything that would support including foods in the Mediterranean style of eating would be a great place to start. And they're also delicious. So I always like that too. And there is also some interesting research looking at getting a serving of leafy greens, most days slowing cognitive decline, leafy greens, being a vegetable, also included in these Mediterranean studies. But also just you know, I think in general, most people know that getting more leafy greens has potential health benefits beyond the brain. But there have been a number of studies which have looked at, you know, in particular, people who eat a serving of leafy greens most days, also potentially slowing cognitive decline. 

So all that being said, we're still just talking about eating, building balanced plates on a regular basis with a variety of foods that are nutrient dense. So that's kind of the takeaway from that. But the connection that I make between diet that you may not have thought of before or may not have realized is that if you were dieting, and always thinking about what you should eat, when, how, why that may be taking up valuable real estate in your brain. So I want to talk a little bit about what I mean by that. So you may have heard me or other people say that when you stop dieting, it opens up so much space in your life for other things. And that is also true with our brain. Because when we're trying to control every bite of food, because we're following a set of food rules, we're following a plan we're tracking, we're counting we're measuring, you're always thinking about food. So you're always thinking, how many calories have I had today? Have I tracked my snack? How many grams of carbs? What's my net gram of carbs? Have I had enough carbs? Have I had too many carbs? Can I have a snack while I'm watching Netflix tonight? Or do I need to skip supper or something at supper so that I can still maintain that caloric deficit? All of this is valuable brain real estate. And we've already established that we actually are in a bit of, you know, it's a bit it's a bit of a weird market in our brain at this stage of life, because we are having these fluctuations in estrogen and progesterone. And we're also experiencing some pretty real changes in our sleep and our mood and our energy levels. And we might also have anemia and all of these things. That why why would I add to my brain's burden by constantly thinking about food. 

So an interestingly This is what I often hear people say, so people will come back. And they'll say, I realized that by learning to eat intuitively and not always thinking about what I'm going to eat and why and how that I actually have more capacity to use my brain for other things. So if you haven't made that connection before, and maybe if by listening to this, you think, Oh, I think that's me, then, let's talk about that. Let's explore why pursuing intentional weight loss through counting, measuring, tracking, that constant feeling of I have to be on a diet, am I on the right diet? Am I eating the right way? 

Should I be doing something else, that's all taking up valuable real estate in your brain. And that might feel like a challenge at this age and stage of life. So, but I also want people to know, and I've been saying this for a while now that for most people, it gets better. And we also have research to support that. I knew six months before I was able to actually ring that menopause Belle at one year, that I had reached a new normal in terms of how I was feeling. And I was quite confident in certain that I was not going to get another period. And one of the big reasons is that I felt like I got my mental mojo back. So I had spent, you know, three or four years feeling like I was I was doing okay, and I think other people would look at me and be surprised that I would describe it this way. But I felt like my brain was just walking through sludge most days. You know, it was it felt like a slog, just to get the usual things done. 

And I did not have any capacity for anything creative, or extra or more. And I really felt like it was so hard just to manage that day to day. And then literally all of a sudden, I woke up one day, and I was like, Okay, here's 18,000 ideas that I want to start tackling. Now. That's my ADHD brain, for sure, talking. But also, I was actually able to kind of think in the way that I used to think about things. So it will come back for most people. That is the experience that I've also heard from others that like, yeah, I wake up one day, and I realized that okay, I'm feeling more like myself, again, I'm feeling like things are kind of back to normal. Do I think that I have the reaction time and memory capacity of my 22 year old self? No, but I'm okay with that, too. But I feel much more confident in that the learning problem of midlife is mostly on its way out for me. So what else can we do? So we've talked about the Mediterranean style of eating, and we've talked about some of the things that might be important there. And I've hopefully introduced this idea. And it may be kind of just inserted this little idea that planted the seed, I guess that maybe thinking about food all the time is actually hurting your ability to you know, use your brain in this age and stage. 

But there are some other things that I think are worth mentioning. And one question that always comes up is, well, what about hormone therapy? If the problem is these fluctuations, then can hormone therapy help? It might. And there certainly is some early evidence, more recent evidence that you know, for some people, this could be an important strategy for managing brain fog. Of course, we know that menopause hormone therapy or hormone replacement therapy is very valuable at managing symptoms, especially hot flashes, and night sweats can be can make a huge difference for some people with sleep and mood as well. And, as we talked about, these are all things that play into brain fog. And so it makes sense that maybe the hormone therapy can be helpful. But if you're like some, if you're someone like me, and hormone therapy isn't something that you've been able to or want to choose, then what else can we do?

Jenn Huber  19:05

This is not going to be surprised but movement or exercise, whatever you want to call it, but regular movement is probably the most evidence based recommendation for anything and it makes sense with brain fog and cognitive health because when we're you know, when we get our heart rate up, and this doesn't mean that you have to be you know, killing yourself out it but you know, when you get your heart rate up, that increases the circulation to the brain which helps to deliver more nutrients. We also know that you know, movement uses our brain in a way that keeps it you know, kind of active and clears the cobwebs out. So whether that's walking, whether that's some kind of other structured activity, all movement counts. 

So the rule of thumb is, do find what you like, do it as often as you can in ways that you enjoy and you will support not just your brain health, but of course your overall health. There is also some evidence for some types of cognitive behavioral therapy So especially if you're having, if you if you feel like you're in a loop with it have these negative thought patterns especially so, you know, some people can get really, really concerned and really just down on themselves and a boat menopause. And it can feel like a really big hole to dig yourself out of. 

So in combination with other types of therapies, CBT can be really helpful in helping to break some of those patterns. And maybe also kind of just teaching you some of the ways that you can work on improving, not just memory, but mood in general. We've talked about diet, we've talked about nutrition, it's probably not a surprise, if you're a regular listener, that I just don't like to put so much emphasis on eating the right thing all the time and perfectly, otherwise, your brain is going to wither and die. That is the message that we get all the time that food is so important, we have to do it perfectly. And we have to be thinking about it. And we're a bad person. If we're not nutrition, and food is the long game. Let's say that, again. I'll say it every day. What you eat matters, Food Matters. But it doesn't have to be perfect. And it doesn't have to be followed to a tee. So even when you see a list of 10 foods that will help to preserve your cognition, great, have a look at them, look at them and say, Yeah, I like those. That's something that we eat. 

That's something I would like to try and learn to cook with. Or that's something I would like to have more often. And approach it with that add in mentality that we talk about intuitive eating, how can I add these in more often I don't have to cut anything out, I don't have to make a plan to never have other foods or only have the foods on that list. I'm just going to try and see if I can add them in more often. And stress, of course, is the is kind of the last thing on this little list. And I think that, you know, it's another word that's thrown around a lot. But again, when we're thinking about what is the role of stress, stress as a response is a survival response. And so when we're feeling acute stress or chronic stress, chances are there's a perceived threat to our survival, whether it's real or imagined, right, this could be the stress of a deadline, or it could be like an actual threat to your survival because of something, you know, sell your own health or someone else's health or whatever it is. But the point of this is that our brain gets very focused on what do I need to do right now? It's not thinking, What can I do to take care of myself in 20 years? 

Because it's just thinking, Okay, I need to like manage the here and now. Because that's what the stress response is, it's how can I keep myself safe and alive today. So if you're feeling stressed, you may not have the brain capacity, the mental capacity, the emotional capacity to really just kind of think about the all of the other things, right? So it's very hard to think about, including leafy greens every day. If you're feeling stressed all the time, it's very difficult to get a good night's sleep if you're feeling stressed all the time. And so, stress management as an overall health practice has a lot of benefits. 

And especially if you're feeling distracted and feeling pulled in 8000 different directions, adding in things like mindfulness, yoga practices, restorative yoga, deep breathing, meditation, all of these things will help in some way, either short term or long term. So the take home message is that there's no quick fix. Unfortunately, you know, we don't have strong data for any one particular thing being the best for brain fog. But I do want you to know that you're not alone. It's a very common symptom. Not everyone, but at least two thirds and probably more are experiencing this symptom at some point in their menopause transition. We do know that it is temporary for most people and is not a sign of worse things to come. It absolutely impacts our day to day experience in very real ways that make it uncomfortable and distracting. And what we eat can make a difference in supporting our cognition and our brain health long term but also how your eating may be impacting you more today than you may have realized. 

So I hope that this episode has maybe given you some reassurance has given you some things to think about and has, you know, as I always say, giving you some food for thought. And if you're looking to maybe just understand a little bit more about some of the products disses that we can put in if you're looking for ways to, you know, include mindfulness if you're looking for some recipes and support in implementing some of the things I've talked about mental health and cognitive health, I guess is a better way to put it is on the menu in the midlife peace membership in April and I would love to welcome you to our community, which is a cozy place full of lovely people. 

And we're all in this together. We're all in the same age and stage so whether you're Peri menopausal or postmenopausal, you will find a community that is ready to support you and I'm there to support you too. So thanks for tuning in to this episode. If you have any questions, as always, let me know. And I hope you have a great day.