107. Brain Fog & Memory Loss in Perimenopause: How to Get Clear & Calm Again
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Brain fog, forgetfulness, irrational thoughts, and focus issues are common in perimenopause – but rarely explained.
In this episode, we explore what’s really happening to the female brain during the perimenopausal transition, why symptoms often start in the late 30s and intensify in the 40s, and what women can do to protect long-term brain health.
In this episode, you’ll learn:
- How estrogen, progesterone, and testosterone play key roles in brain function
- The real reason brain fog, memory loss, and poor focus show up in perimenopause
- How rumination and anxiety are connected to nervous system and progesterone
- Why perimenopausal brain symptoms are not the same as Alzheimer’s or dementia
- How nutrition, lifestyle, and hormone support can protect cognitive health after 40
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RESOURCES:
- The XX Brain: The Groundbreaking Science Empowering Women to Maximize Cognitive Health and Prevent Alzheimer’s Disease
- Effects of the Menopause Transition and Hormone Use on Cognitive Performance in Midlife Women
- Type 3 Diabetes and Its Role Implications in Alzheimer’s Disease
- The Impact of the Digital Revolution on Human Brain and Behavior
- Zenbiome Cope (must use code: claudia123)
MENTIONED IN THIS EPISODE:
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Why You Feel Like You’re Losing Your Memory After 40
If you’re in your 40s or even 50s and you find yourself forgetting words mid-sentence…
Walking into a room and having no idea why…
Reading the same paragraph over and over again…
What you are experiencing is the very real brain changes that begin in perimenopause.
And it might be one of the most frustrating parts of this hormonal transition.
I see this constantly with clients.
And I experienced it myself—especially in my late 30s.
There were moments where I genuinely thought, How can I keep running a business, speaking, teaching… when I can’t even finish a sentence?
I’d lose words. I’d forget names. I’d struggle to focus.
And for someone who’s always been sharp and articulate, that was scary.
And full transparency, even with all the strategies and support I’ve put into place over the last 5-6 years, my brain at 43 is definitely not the same as it used to be.
What’s Actually Happening in Your Brain
So what’s the deal…
Estrogen is a brain hormone. It plays a big role in:
- Memory
- Focus
- Verbal fluency
- Mood regulation
- How the brain uses glucose for fuel
As estrogen starts to fluctuate—and eventually decline—your brain has to adapt.
And that’s when symptoms show up like
Brain fog.
Forgetfulness.
Difficulty concentrating.
Feeling mentally slower.
The Role of Progesterone and Anxiety
Progesterone – our calming hormone, which supports GABA, our primary calming neurotransmitter.
So with estrogen fluctuating, progesterone dropping—it can feel like you’re losing it at times.
Many women in perimenopause become:
- More anxious
- More fearful
- More introverted (that’s been so true for me – wanting so much alone time)
- Less social
- More prone to rumination and mental spirals – worry about things beyond your control
Some women even tell me they feel afraid to leave the house, afraid to travel, scared to drive and have even become really indecisive – they get easily overwhelmed.
And what I’ve noticed clinically—over and over —is that all those symptoms are also a sign that the nervous system is struggling and there are nutritional imbalances.
So when I see intense fear or anxiety – I see low progesterone, fluctuating estrogen and a nervous system and body in need of physiological support.
Adequate progesterone (not tiny doses) can be profoundly stabilizing for the brain, as well as estrogen – yes, in perimenopause, yes, while you’re still cycling.
I see a lot of providers hesitate to give women in perimenopause estrogen. And I really believe it is such a disservice to these women.
Testosterone and Mental Clarity
And we can’t ignore testosterone. While we often think of it as a ‘male hormone,’ women need it for focus, motivation, and mental clarity.
When testosterone drops, many women notice they feel less driven and more scattered. So when many women start testosterone, they say brain fog improves.
While I love that there’s more awareness around testosterone hormone therapy, my only gripe is that it can take a long time to feel the benefits for a lot of women, myself included.
And often times, you need a higher dose, but when you increase, it can be accompanied by androgenic symptoms like acne, oily hair, oily skin, more hair – I feel like I have to constantly shave because I’m at a slightly higher dose currently in attempt to reap the systemic benefits because I was not seeing them at lower doses. And I’ve been on testosterone for several years, different doses, different application sites, but the jury is still out. But it may work wonders for you.
The Impact of Modern Life on Your Brain
We also have to talk about culture.
We’ve normalized constant multitasking and overstimulation.
Many women could get away with this in their 20s and 30s.
In perimenopause? The brain simply doesn’t tolerate it the same way.
Focus becomes harder, your brain is less resilient to chaos.
And don’t get me started on social media.
It is bad news for our brains – I often ask clients ‘how much time they’re spending on there?‘
I do not spend a lot of time on social media anymore, even with a business.
My days are busy and when I have down time, I’m outside, connecting with Mike and family or friends, I read, or I just rest and do nothing.
We don’t allow ourselves to be bored anymore – we have to occupy every minute of our day.
It’s no wonder our nervous systems are fried.
That constant communication with others, group chats – this is not connection – it’s codependency.
So if you want to support your brain health, you cannot overlook some of these daily habits.
Rethinking Work and Stress in Midlife
I also want to zoom out and talk about work culture – especially for women.
We live in a culture that rewards constant productivity and availability. Many of us got really good at that in our 20s and 30s.
But in perimenopause, our brain and nervous system often stop tolerating that pace.
I had to look at this myself. I’ve shared on previous episodes, when I started my business, I was working more than I ever did—trying to prove myself, hit income goals, manage clients, manage a team, create content for social media – that can feel like a job itself.
But at some point, it became clear: this wasn’t sustainable.
I had to get support, had to hire help, and reassess how I was working and spending my days.
Because you can eat perfectly, take hormones, do all the “right” things—
but if you’re running on empty, available 24/7, saying yes to everyone and everything, your nervous system will push back.
It’s not about giving up your ambition, quitting your job and going to live on a remote island – although that sounds freaking appealing some days…it’s really about living differently.
And that may feel counterculture.
Simplifying and slowing down where you can – becomes non-negotiable in midlife.
If you’re feeling stressed and like you can’t really handle everything life is throwing at you right now, I’m going to link to a supplement in the show notes by Microbiome Labs, called Zenbiome Cope. It combines a well-researched psychobiotic, B vitamins, and saffron to provide targeted support for coping with day-to-day stressors and mood changes.
Is It Dementia or Something Else?
Another concern I hear from women is:
“Is this dementia or Alzheimer’s?”
Especially if they have a family history of that.
Alzheimer’s and dementia are multifactorial:
- Genetics play a small role
- Metabolic health matters
- Blood sugar regulation matters
- Inflammation, nutrient status, and of course hormones
Research suggests Alzheimer’s disease is a form of “Type 3 diabetes”, representing a state of insulin resistance in the brain that disrupts glucose metabolism and fuels neuro-degeneration.
Supporting Your Brain in Perimenopause
Which brings us back to basics:
- Consuming adequate protein for your needs
- Healthy fats
- Quality carbs
- Stable blood sugar
- Minerals
- And hormones
Your brain needs fuel—and hormonal signaling—in order to function well.
This is why I’m such a strong advocate for hormone replenishment starting in your 40s.
Not because it’s a magic fix, but because: you do not need to suffer – and prevention matters.
We worry so much about aging—yet many women are terrified of the very tools that could protect their brain long-term.
For me, supporting my hormones, changing how I eat, addressing mineral depletion, calming my nervous system, and simplifying my life changed everything.
My focus improved.
My confidence is way better.
And my brain feels like mine again.
And this is the work we do inside The Perimenopause Method—supporting your brain, your nervous system, your metabolic health, and hormones together, not in isolation.
Your brain is changing—but with the right support, you can feel good, yes even in perimenopause.
If this episode resonated with you, apply to work with us so we can support you and make sure you share this episode with a friend. The more awareness around perimenopause, the better. See you soon.
Claudia Petrilli is a Functional Health Coach, Integrative Nutrition Coach, Women’s Health Educator, and creator of The Perimenopause Method. Having experienced debilitating periods, digestive issues, a sluggish thyroid, a pituitary tumor, and perimenopause symptoms in her late 30s, she knows exactly what it’s like to get dismissed by doctors and spend years searching for answers.
