Menopause brain fog decoded: hormones, inflammation and how to get your clarity back

12 Feb

A whole-body approach to hormones, inflammation and cognitive clarity, with my go to nutrition and supplement strategy.

If you’re a midlife woman who has found yourself saying things like, “I just don’t feel like myself anymore”, “my brain feels fuzzy all the time” or “why did I come into this room, I think I’m going mad”, believe me, you are not alone.

I’m going to help you understand why your brain feels underpowered, what hormones, inflammation and energy metabolism have to do with it, and most importantly, what you can do differently from today to support yourself and improve your memory.

By the end, you will understand why menopause, autoimmune disease and brain health are inseparable and how a targeted, systems-led framework can bring clarity to that frustrating fog.

Woman sat on sofa struggling with brain fog

This is not “just getting older”

Maybe you believe your symptoms are just part of getting older, perimenopause or stress and that you should just push on through. Maybe you’ve heard the phrase “it’s just the menopause” and just about managed to take it in before your mind went blank… again. But that’s not the whole story.

Midlife is often when women find themselves at the peak of their careers, managing busy households, teenagers’ demands and supporting ageing parents. Even just writing that feels a lot, but when you’re living it all through a veil of what feels like thick 5am winter fog it’s a big challenge.

I often see women at this stage of their lives, taking on multiple roles and challenges and getting frustrated that their body (or rather, their brain) seems to be letting them down. The familiar symptoms of pain, fatigue, brain fog, poor concentration, mood changes, anxiety and overwhelm are key signals, and very often, they are coming from the brain.

Menopause is a hormonal AND neurological transition

This is the ‘ah-ha’ moment for many women.

Oestrogen is not just a reproductive hormone, it is aneuromodulator. This means it influences glucose uptake in the brain (our brain’s main energy source), mitochondrial energy production (the energy production factories themselves), neurotransmitter signalling (brainsignalling chemicals) and, quite crucially, inflammation control (key for anyone with an autoimmune condition).

Both oestrogen and progesterone can be considered neuroprotective hormones, with receptors found in different brain regions important for cognition

Brain imaging has shown measurable changes in brain energy during the menopausal transition, long before periods stop, together with changes in the ability to form and strengthen brain connections (synaptic plasticity). [1]

As oestrogen fluctuates and declines during perimenopause, the brain becomes less efficient at using glucose for fuel. Women’s experiences of cognitive changes differ, but brain fog tends to be worse in women who also struggle with sleep disruption, higher inflammation (hello my autoimmune friends), mood changes and hot flushes. [2]

So the question becomes, how do we support the brain through this transition...?

Welcome to the ‘BRAIN’ framework

A full spectrum, food-first approach to support your brain through this transition and provide you what it needs.

B. Balance blood sugar and brain fuel

If there is one lever that can rapidly improve or rapidly derail cognition, it is blood sugar regulation.

The brain represents only around 2% of body weight, yet it consumes close to 20% of our total energy at rest. It’s an incredibly metabolically demanding tissue and cannot store much fuel, relying instead on a steady, tightly-regulated supply of glucose delivered across the blood brain barrier.

When blood sugar spikes and crashes, so does brain performance.

Women in perimenopause often say they feel “wired but tired”, shaky mid morning, foggy mid afternoon, then wide awake at 3 am; this is all linked to unstable fuel delivery.

Declining oestrogen unfortunately compounds this picture. Oestradiol plays a direct role in brain glucose metabolism. It increases the expression of glucose transporters (GLUT1 at the blood brain barrier and GLUT3 in neurons), allowing glucose to move efficiently from the bloodstream into brain cells. It also enhances how cells break down glucose for energy (glycolysis) by upregulating certain key enzymes (hexokinase), and it supports the cells to actually make energy from glucose. Putting it simply, oestrogen helps the brain access and use its fuel more efficiently. [3]

Now, if we layer on top insulin resistance from excess sugar over time…

Higher fasting insulin and greater blood sugar variability have been associated with worse executive function, memory and processing speed, even in midlife adults without diabetes. Chronic high blood sugar also increases oxidative stress and inflammatory signalling in the brain. In Alzheimer’s research, insulin resistance is increasingly recognised as a significant risk factor. [4]

The simplest way to improve cognitive stability is to stabilise glucose.

Start with protein at every meal. Protein slows gastric emptying, supports your fullness hormones and blunts post-meal glucose spikes. A bowl of cornflakes with banana is not a balanced breakfast, however nostalgic it may feel. Adding eggs, Greek yoghurt, smoked salmon, tofu or a protein-rich smoothie completely changes your metabolic response.

Pair this with fibre-rich plants. Fibre slows carbohydrate absorption and feeds the microbiome, which in turn improves insulin sensitivity. Aim for a diversity of vegetables, legumes, nuts, seeds and whole grains across the week.

Include healthy fats. Oily fish, nuts, seeds, avocado and extra virgin olive oil support satiety and reduce post prandial blood sugar swings.

What tends to worsen brain fog quickly?

Skipping meals
Under eating protein
Running on caffeine
Grabbing ultra-processed convenience foods when exhausted

Each of these increases blood sugar volatility and stress hormone output. Cortisol can temporarily raise blood glucose, but watch out, it comes at a cost to your mood and sleep.

For women juggling careers, busy family lives, autoimmune flares and rising costs, regular balanced meals can feel deceptively simple. Yet clinically, it is often the most powerful shift.

If you need structure and accountability around this, that is exactly why I created the Sugar Shift 2.0- all about teaching your metabolism to feel safe and steady again.

When the brain has reliable fuel, everything else becomes easier to build upon.

R. Reduce inflammation

Inflammation directly impairs neurotransmitter function and blood flow to the brain.

Inflammation is not inherently bad, it is a protective, intelligent response. The problem is when it becomes chronic and low grade, simmering quietly in the background for years.

Low grade inflammation directly impairs how our brain cells communicate and impacts brain blood flow. It alters how serotonin, dopamine and glutamate signal in the brain and it interferes with the very process that allows us to learn, focus and remember (synaptic plasticity). Research has repeatedly shown that raised inflammatory markers are associated with reduced attention, poorer memory and lower mood, even in otherwise healthy adults. [5]

Now layer menopause on top…

Oestrogen is one of the body’s natural anti-inflammatory regulators. It helps control certain blood cells in the brain (microglia) and helps keep inflammatory signalling in check. As oestrogen fluctuates and declines throughout perimenopause, neuroinflammation can increase, particularly in those who already have a higher background risk (eg. autoimmune disease or metabolic stress). [6]

So what drives this inflammatory load?

Common contributors include:

High sugar and ultra-processed foods, which promote blood sugar swings (see ‘B’) and oxidative stress
Gut imbalance, which increases intestinal permeability and activation of the immune system across the body
Chronic stress, which elevates cortisol and pro-inflammatory cytokines
Poor sleep, which independently raises inflammatory markers and reduces the brain’s ability to repair

All these factors can act to amplify each other: a disrupted gut microbiome can increase inflammatory signalling to the brain via the gut-brain axis; chronic stress alters microbial diversity; poor sleep worsens insulin resistance. This is why we need a broader approach than simply chasing after one symptom.

Food as an anti-inflammatory signal

The encouraging news is that food is one of the most powerful anti-inflammatory tools we have.

Polyphenol-rich, colourful vegetables and berries provide compounds that help control and calm inflammatory pathways and support blood vessel function, improving blood flow to the brain. Blueberries, blackberries, leafy greens, red cabbage and beetroot are not just “healthy”, they are neuroprotective.

Omega-3 rich fish such as salmon, sardines and mackerel provide EPA and DHA, which directly reduce the production of pro-inflammatory cytokines and support brain cell membrane fluidity. Research has shown associations with omega-3 intake and improved mood and reduced inflammatory burden. [7]

Spices such as turmeric offer a powerful, concentrated anti-inflammatory signal. Curcumin, the active compound in turmeric, has been shown to modulate key inflammatory pathways, including NF-κB, the central conductor of inflammation. By downregulating pro-inflammatory cytokines and reducing oxidative stress, curcumin may help protect neurons and support blood vessels within the brain. It also appears to help calm the brain’s immune cells if they become over excited. Even small, regular culinary doses of whole turmeric can contribute to a cumulative anti-inflammatory effect. Try my delicious turmeric latte recipe for a boost.

Extra virgin olive oil, a cornerstone of Mediterranean cuisine, contains oleocanthal and other phenolic compounds with measurable anti-inflammatory effects. Regular intake has been associated with improved cognitive outcomes in ageing populations.

Fermented foods such as kefir, live yoghurt and kimchi introduce beneficial microbes and support microbial diversity. The gut microbiome plays a central role in immune regulation and a more diverse microbiome is associated with lower inflammatory signalling and better stress resilience.

Fibre diversity is equally important. Different plant fibres feed different microbial species. A varied intake of legumes, nuts, seeds, whole grains, herbs and vegetables increases short chain fatty acid production, which has anti-inflammatory effects in both the gut and the brain.

However, a healthy microbiome doesn’t just lower inflammation, it also determines how effectively you respond to certain plant compounds that support the brain. Many polyphenols are metabolised by gut bacteria into bioactive forms, but without the right microbial partners, we can’t unlock their full benefit!

When we quieten down inflammation, this can be the first real shift that cuts out the background noise that has been blunting the brain all along.

A. Activity to nourish the brain

Movement is medicine for the brain.

One of the most powerful mechanisms behind this is a little chemical called ‘brain derived neurotrophic factor’, or BDNF. Think of BDNF as fertiliser for your brain cells. It supports the growth of new connections, protects existing brain cells and underpins learning, memory and emotional resilience.

BDNF is central to the brain’s ability to adapt and rewire. Levels naturally decline with age and research suggests they may drop more sharply across the menopausal transition, particularly in the context of lower oestrogen and higher inflammation. Lower BDNF has been associated with depression, cognitive decline and impaired memory. [8]

The encouraging part is that BDNF is highly responsive to lifestyle.

Aerobic exercise consistently increases circulating BDNF levels. Activities such as brisk walking, cycling, swimming or jogging enhance hippocampal function, the part of the brain involved in memory and spatial awareness. Even moderate-intensity exercise, performed regularly has been shown to raise BDNF and improve cognitive performance.

Strength training also stimulates BDNF production and brings additional benefits. Resistance work improves insulin sensitivity, reduces inflammatory load and supports mitochondrial health. Given what we have discussed about blood sugar and brain fuel, this ties in with another key foundation.

Daily movement improves blood flow to the brain. More oxygen and nutrients delivered to the brain means better performance and faster waste clearance. Over time, this can support resilience against cognitive decline.

Consistency matters more than intensity.

Even brisk walking counts, especially when done regularly. A 20-minute walk most days, a couple of strength sessions each week and moving your body in ways you genuinely enjoy can be enough to change the biochemical environment of your brain.

In a season of life where so much can feel unpredictable, movement is one of the most reliable ways to tell your nervous system and your brain cells that you are still building, not declining.

I. Intentional rest, relaxation and sleep

Sleep is not passive - it is active brain maintenance.

During deep sleep, the brain consolidates memory and clears metabolic waste through something called the glymphatic system. Synaptic connections formed during the day are refined and strengthened. This is also when BDNF release is enhanced, further supporting repair and neuroplasticity.

If sleep is short or fragmented, BDNF falls and inflammatory markers can rise. Chronic stress compounds this even further. Elevated cortisol suppresses BDNF and increases pro-inflammatory signalling, creating the exact environment that worsens brain fog, low mood and poor concentration.

Around menopause, several factors can disrupt sleep architecture: Declining progesterone reduces its natural calming, GABA-supportive effects. Oestrogen fluctuations affect temperature regulation, contributing to night sweats and hot flushes. Stress sensitivity often increases, driving that frustrating racing mind at 2 am.

This is why rest is not optional.

Deep sleep is when the brain repairs itself and releases more BDNF - the brain fertiliser. Chronic stress suppresses BDNF and increases inflammation. If we ignore sleep, we undermine every other intervention we may be working on.

So what to do?

Protect your sleep timing like your brain depends on it (‘cause it kind of does), try to go to bed and wake up at similar times, even at weekends (yes, really)... your brain thrives on rhythm.

Create a clear wind-down window in the evening, dim the lights, step away from email, avoid stimulating content and signal to your nervous system that the day is closing.

Support the ‘rest & digest’ arm of your nervous system before bed by trying some gentle yoga, slow breathing, mindfulness or even just ten minutes outside in natural light during the day can help recalibrate stress pathways.

But maybe, more than anything else, change the narrative - think of rest, not as something you do when everything else is done, but as essential ‘brain maintenance’.

Sleep and relaxation provide the foundational environment your brain needs to repair and improve resilience.

N. Nourish and challenge the mind

The brain is built from what you eat.

Let’s be clear here, neurotransmitters, cell membranes, myelin, mitochondrial enzymes, they all require specific nutrients, and a large proportion comes from the food we eat… so if it’s not in your diet, quite simply, it’s not in your brain!

Let’s start with acetylcholine, one of the key neurotransmitters for memory and focus. Choline is its primary building block. Choline rich foods such as liver, egg yolks, cod, poultry, shiitake mushrooms, soy foods and even cruciferous vegetables like broccoli and Brussels sprouts help supply the raw materials for this pathway. Low choline intake has been associated with poorer cognitive performance in several observational studies. [9]

Leafy greens, nuts, seeds and legumes provide B vitamins, particularly folate, B6 and B12, which are essential for methylation (a key biological process for DNA repair), neurotransmitter synthesis and brain energy metabolism. Without adequate B vitamins, the brain struggles to produce serotonin, dopamine and acetylcholine efficiently.

Omega-3 fatty acids, especially DHA, are structural components of neuronal membranes that are only available from our diet. In fact, the brain is around 60-70% DHA. They support BDNF signalling, reduce neuroinflammation and enhance brain connections. This is one reason oily fish features so prominently in cognitive longevity research. Vegans or vegetarians must supplement with a high quality provider - use my link here for 10% off Wiley’s Finest, one of my favourite clean omega-3 suppliers [10].

Grilled sardines with sundried tomatoes and lemon

Polyphenol-rich foods such as blueberries, dark chocolate and green tea provide antioxidant compounds that support mitochondrial function and reduce oxidative stress in the brain. These compounds help control inflammatory pathways and improve blood vessel function, enhancing blood flow to the brain.

Then there is a fascinating and rapidly evolving area of research around phytoestrogens and phytoSERMs.

We now know that the brain expresses different oestrogen receptors, including ER-beta, which plays a significant role in cognition, mood regulation and neuroprotection. As oestradiol declines during menopause, ER-beta signalling in the brain may reduce.

Certain plant compounds act as ‘phytoSERMs’, meaning they can selectively interact with oestrogen receptors in a specific way. Compounds found in whole soy foods (such as daidzein and genistein), are currently being studied for their ability to support ER-beta activity in the brain without exerting the same effects as standard oestrogen. Early research suggests potential benefits for cognition and vascular health, though this field is still developing. [11]

Food sources to highlight include organic whole and fermented soy foods such as tempeh, miso and edamame, alongside flaxseeds and other legumes. A diverse, plant-rich diet supports the gut microbes required to metabolise these compounds effectively.

This is an exciting area of research, still evolving, but it reinforces the concept that food and gut health are not ancillary to brain resilience, they are a foundational pillar.

Nourishment is not just nutritional - the brain loves novelty and challenge. Curiosity tells the brain it is still needed.

Learning a new skill, picking up a creative hobby, practising a language, playing music or even tackling puzzles stimulates brain connection and reinforces our neural networks. Mental stimulation has been associated with higher cognitive reserve and reduced risk of decline later in life, so it’s time to take up that new hobby you’ve been thinking about for the good of your brain!

What to do next…

If this article has resonated, share it with a friend who keeps saying, “something isn’t right” or feels like they are “losing their mind”.

If you’re fed up with hearing “it’s just menopause”, tired of piecing things together alone and want a personalised, science-led plan that helps makes sense of your symptoms in a manageable way, I would love to help. My Health Reset was created just for this and for those with more complex conditions I created my Get Empowered programme.

If you are ready to stop guessing and start understanding your body properly, click here to book a free call and let’s map this out together.

Fancy dipping your toe into the water of working with me join my Sugar Shift programme - a 28-day online reset to balance blood sugar, reduce inflammation and feel more in control. One of the main foundations of brain health - starts 23rd February 2026.

You’ll learn how to eat, live, and support your body in ways that reduce inflammation, calm your immune system and put you back in the driver’s seat.

Skipped to the bottom? In summary

Perimenopausal and menopausal brain fog, fatigue and cognitive overwhelm are not personal failures or your body breaking down on you, they are signals of a major neurological transition, not just a hormonal one.

Autoimmune disease amplifies the need for targeted brain support due to a higher background propensity for inflammation.

Use the BRAIN framework as your guide (you can also download my handy PDF guide below including my Top 5 brain-supportive supplements).

B – Balance blood sugar and brain fuel
Prioritise protein, fibre and healthy fats at every meal to stabilise glucose, support mitochondria and protect brain performance.
R – Reduce inflammation
Lower the inflammatory load through polyphenol-rich plants, omega-3 fats, extra virgin olive oil, turmeric, ginger, fermented foods and deep sleep.
A – Activity to nourish the brain
Use regular aerobic movement and strength training to increase BDNF, improve insulin sensitivity and enhance blood flow to the brain.
I – Intentional rest, relaxation and sleep
Protect your daily circadian rhythm, calm the nervous system and treat sleep as non-negotiable brain maintenance.
N – Nourish and challenge the mind
Feed the brain with choline, omega-3, B vitamins, polyphenols and phytoestrogen-rich whole foods, while staying curious and mentally engaged.

Take midlife as the moment you change direction and consciously build resilience for your future cognitive health.

Healing isn’t about restriction; it’s about giving your body what it truly needs. If you’re ready to stop guessing and start healing, book a free call today. Let’s get to the root of your symptoms - so you can regain your energy, health and life. Book in for a free chat below.

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