Why Can't I Remember Words Anymore?

Perimenopause Brain Fog, Explained

By Dr. Gillian Goddard

You know the word. You can practically see the word. You've used the word hundreds of times...

And yet, suddenly, your brain has decided that word no longer exists.

If you're in your 40s and finding yourself struggling with word recall, losing your train of thought or feeling generally less cognitively sharp, you're not imagining it.

Cognitive changes are very common during perimenopause.

And hormones can be part of the reason why.

Does perimenopause cause brain fog?

It can.

Our brains have a lot of estrogen receptors.

During the late reproductive stage and perimenopause, estrogen doesn't simply decline in a nice, straight line. It can spike and drop and spike and drop.

And here's the interesting part: it's often the change itself that creates symptoms.

Our bodies like stability.

Large fluctuations in estrogen can affect neurotransmission and executive function in the brain—processes that are important for things like word recall.

So there is a biological reason you might suddenly find yourself standing in your kitchen saying:

“You know. The thing. The thing you use to drain pasta.”

Colander.

The word was colander.

Is perimenopause brain fog permanent?

This is the part of the conversation I think women really need to hear:

These cognitive changes appear to be temporary.

Researchers have followed women's cognitive function before, during and after perimenopause.

Normally, when you give someone the same cognitive tests repeatedly, you'd expect their scores to improve simply because they've taken the test before.

During perimenopause, women don't show that same expected improvement.

But after menopause, once estrogen levels are no longer fluctuating wildly and instead remain low, women begin improving on the tests again.

That tells us something important.

We're not necessarily watching cognition permanently decline. We're seeing a temporary change that corresponds with a period of significant hormonal fluctuation.

Does forgetting words mean I have early dementia? This is a fear I hear from women. And I understand why.

When you've spent decades trusting your brain and suddenly it doesn't seem to cooperate in quite the same way, it can be frightening.

But the cognitive changes that commonly occur during perimenopause are typically not early dementia.

And I think knowing that can take some of the fear out of the experience.

Why does no one warn women about this?

For a long time, the menopause conversation focused heavily on the most obvious physical symptoms.

Hot flashes. Night sweats. Period changes.

Those symptoms matter.

But women experience many other changes during the transition, and we're increasingly talking about those too.

Brain fog is one of them.

Women aren't suddenly becoming less intelligent in their 40s. Their brains are navigating a period of significant hormonal change.

That's a very different story.

What should I do if I'm experiencing brain fog?

Don't automatically assume every cognitive symptom is hormonal.

There are many things that can affect cognition, attention and memory, which is why significant or concerning changes are worth discussing with your healthcare provider.

But if you're going through the late reproductive stage or perimenopause and you've noticed that words suddenly feel harder to retrieve, know that you're not the only one experiencing it.

And, importantly, the data we have suggests these cognitive changes don't last forever.

The Plainspeak Answer

Can perimenopause cause brain fog and difficulty remembering words? Yes.

Fluctuations in estrogen can affect neurotransmission and executive function, which can make word recall more difficult during perimenopause.

And perhaps the most reassuring part: these cognitive changes appear to be temporary rather than permanent.