How to talk to your doctor about midlife brain fog

What you may be experiencing is brain fog, a common occurrence among menopausal women.

It can be worrying – many women fear they are slipping into younger onset dementia – and you may struggle to explain it to your doctor. But we’re here to help. These tips and tools can make it easier to kick off the conversation and get the treatment that’s right for you.

Call brain fog by its name

Talking about brain fog can be tricky. Around menopause, brain fog can come and go, happen gradually or suddenly, and it can be hard to describe. But Dr Tessa King, a GP with a special interest in women’s health, says that providing details and examples of your experience is crucial.

“If you’re not performing as well at work, or if you’re having difficulty juggling the schedule of everyone at home, tell the doctor,” she says.

“You can say things like, ‘it feels like a physical fog around me’, or ‘my brain is not working with the same clarity as before’.

“Even using the word ‘brain fog’ can be helpful. The doctor will try to make sense of the symptoms so the more detail you can provide, the better.”

Associate Professor Caroline Gurvich, a clinical neuropsychologist and deputy director of HER Centre Australia, agrees. “Tell the doctor exactly what is happening. If you have difficulty remembering names or finding words, if you feel you can’t make decisions as efficiently as you used to, tell them that. You can also use the term ‘brain fog’.”

Brain fog can include:

• difficulty concentrating or focusing
• confusion
• poor memory
• forgetfulness
• not having the right words
• losing your ‘train of thought’
• slow thought processes.

Ask if your brain fog is related to menopause

Unlike hot flushes and night sweats, midlife brain fog isn’t a well-known symptom of menopause.

“Psychological symptoms are less spoken about, and women are less likely to link these symptoms to perimenopause,” says Associate Professor Gurvich.

It’s not yet known exactly what causes midlife brain fog – it could be menopausal hormone changes, day-to-day pressures that coincide with menopause, a combination of both or something else.

But given that many women experience brain fog around menopause, Associate Professor Gurvich says it can be helpful to discuss any brain fog symptoms that are bothering you with your doctor and explore treatment options.

“Menopausal hormone therapy (MHT), for example, can be helpful for some women. For other women, managing other symptoms, like disrupted sleep, may help improve their brain fog,” she says.

Get to know the wide-ranging symptoms of menopause, with our Perimenopause and menopause symptom checklist.

Prepare for your consultation

Writing down your brain fog symptoms in the lead-up to your appointment can be helpful, says Dr King. “We all have difficulty remembering things over time so making notes in a diary can be very useful. You might note how long the symptoms of brain fog have been going on, exactly what’s happening, and how often it’s happening.”

Associate Professor Gurvich also thinks keeping a journal is a great idea. “The more evidence you can gather, the easier it will be for the GP to understand what is going on,” she says.

You might find it easier to record your notes on your phone, including dates and times of symptoms, and how it’s impacting you.

What if you aren’t taken seriously?

Dr King says that women’s midlife psychological symptoms, like brain fog, can sometimes be dismissed by health professionals. “However, brain fog is becoming more accepted and understood in mainstream medicine and media,” she says.

“Sometimes, women worry that it’s something worse than it is. They become anxious and that can make their brain fog symptoms worse,” Dr King explains.

“If women feel that their brain fog is a symptom of perimenopause or menopause but it’s being dismissed, they should try to find a doctor that specialises in women’s health where their issues will be adequately addressed.”

You can search for a GP that has a special interest in menopause on the Australasian Menopause Society website.