Why is My Memory Failing in Perimenopause and Menopause?

You’re at a party with friends and you’re having difficulty remembering their names. You have trouble remembering where you put your house and car keys. You forget the birthday of your sister or best friend. You go to the store and you can’t remember what you were going to buy.

You haven’t lost your mind! Welcome to the brain fog that often accompanies perimenopause and menopause. In fact, research indicates that perimenopausal and menopausal women are more than three times more likely to say they have memory problems than are premenopausal women. Around 60 percent of perimenopausal and postmenopausal women report more memory problems than to premenopausal women. The most common complaints are trouble remembering numbers or words, needing memory aids, and forgetting why one was doing a certain activity.

A real fear some women have at this point is that their failing memory is a sign of dementia or Alzheimer’s disease. The brain fog itself isn't. In the large SWAN study, memory and learning scores dipped in perimenopause and then bounced back to premenopausal levels after menopause (Greendale et al., Neurology, 2009). But midlife is turning out to matter for later brain health. A 2026 study in Nature Medicine found blood proteins tied to inflammation and brain aging rise after menopause, tracking hormones more than age, and in women followed for years afterward, higher levels went with a modestly higher risk of Alzheimer's. The researchers are clear this doesn't mean menopause causes dementia.

So what can you do? Less than the headlines suggest, and more than nothing. The Lancet Commission estimates about 45 percent of dementia worldwide is linked to 14 risk factors that can be changed, including inactivity, high blood pressure, high LDL cholesterol, untreated hearing loss, smoking and loneliness (Livingston et al., The Lancet, 2024). Specific diets have been harder to prove. A 3-year randomized trial found the MIND diet did no better for thinking scores than a control diet (Barnes et al., NEJM, 2023).

Why is my memory failing?

The main culprit for memory problems associated with perimenopause and menopause is fluctuating and declining estrogen levels. Changing estrogen levels have two main effects on the brain and memory.

One is the fact that estrogen plays a significant role in mood, attention, language skills, memory, and other brain processes. When levels of the hormone change, so does your ability to operate at your best in these areas.

Another is the impact of estrogen on symptoms that have a less direct effect on memory, such as sleep disturbances, hot flashes, night sweats, and depression. For example, if you have a lot of hot flashes during menopause, you may be more likely to experience a loss of memory for words. In a study of women who wore monitors to detect their hot flashes, those who had the most episodes (19.5 was the average number per day) had the worst test results for verbal memory.

If you are having trouble falling asleep, staying asleep, and feeling rested after sleep, then your ability to remember things can be adversely affected. The same goes if you are experiencing hot flashes, night sweats, and depression.

This combination of factors can cast a measurable and frustrating cloud on your ability to think clearly or remember things

How to improve memory during perimenopause and menopause

Here are a few lifestyle changes you can make to enhance your memory during these trying times.

Exercise your brain. Research suggests that aerobic exercise produces new nerve cells in the brain. This in turn can help with memory and thinking. Participate in 30 minutes of physical exercise at least five days a week.

Practice good sleep routines. Although sleep problems are often part of perimenopause and menopause, you can establish a bedtime routine that can help you get more restful sleep. Remove all distractions from your bedroom (and that includes electronic devices), go to bed and get up at the same time every day, avoid caffeine and alcohol close to bedtime, engage in some relaxing behavior (e.g., soothing music, deep breathing, meditation, hot bath), and be sure the temperature and bed clothes are comfortable.

Feed your brain. Foods rich in omega-3 fatty acids, such as cold water fatty fish (e.g., tuna, sardines, herring, salmon), walnuts, kiwi, and flaxseeds can help with memory and learning. If you're not a big fan of fish, a supplement is a great option. Also include lots of foods with folic acid, such as leafy greens and orange juice, which is necessary for optimal brain function.

Try phosphatidylcholine. This compound provides choline, a member of the B-complex family. Research suggests higher blood levels of this nutrient can improve cognitive flexibility. Thus far it appears phosphatidylcholine supports the production of neurotransmitters that promote cognition, reduce brain inflammation, and helps brain membranes. You can get phosphatidylcholine as a supplement or from foods such as raw organic dairy products, wheat germ, cruciferous vegetables, egg yolks, and soybeans.

Try memory tricks. Sometimes it’s necessary to try different memory tricks to help you remember certain information. For example, if you find if challenging to remember names, associate a name with an image or something memorable for you. For example, if you are introduced to Patty at an event, you might think of St. Patty’s day. If a new employee named William is hired in your office, you might think of a famous William, such as William Shakespeare.

Destress. Along with the physical and emotional changes that occur during perimenopause, menopause, and postmenopause, women during this time of life often face additional stressors. Coping with teenagers, caring for an elderly parent, and career challenges come to mind. Juggling many responsibilities can create a great deal of stress. Cortisol is produced under stress, and the accumulation of this hormone can damage the part of the brain involved in memory and learning. Therefore, it’s important to engage in stress-reducing activities, such as exercise, dancing, singing, playing music, meditation, and other activities.

Mind-body medicine. Research suggests mind-body techniques can be quite helpful in cognitive problems associated with declining estrogen levels and the appearance of hot flashes, sleep problems, and night sweats. You may notice improvement with your memory and concentration if you practice meditation, deep breathing, yoga, and visualization.

Bottom line

If you begin to experience some challenges with memory and concentration during perimenopause and in the following years, don’t panic! Estrogen decline is a factor, but sleep quality, depression, and the presence of hot flashes and night sweats also can play a role as well. Lifestyle changes can be helpful in getting you through memory hurdles during menopausal transition.