Why You’re Not Losing Your Mind: Understanding Cognitive Changes in Perimenopause
You walk into a room and forget why. You reread the same sentence over and over, wondering why it won’t stick. You start a sentence with confidence and suddenly—blank. It’s unsettling, frustrating, and at times, scary. If this sounds familiar, I want you to know: you’re not alone, and you’re not losing your mind.
For many women in their 40s and 50s, these cognitive shifts appear without warning. You might pride yourself on being sharp, organized, and articulate—and now suddenly, you’re questioning yourself in the middle of a thought. It can feel disorienting, especially if you’ve always relied on your mental clarity to carry you through work, family, and daily life.
But here’s the truth: these changes are common during perimenopause, and while they’re disruptive, they’re not a sign that something is wrong with you. In fact, your brain is responding to a very real, very natural hormonal transition.
In this blog post, we’ll explore what’s really going on with your memory and focus, why it’s happening, and—most importantly—what you can do about it. You’re not broken. You’re changing. And with the right support, you don’t have to go through it alone.
What Are Cognitive Changes in Perimenopause?
If you’ve been feeling mentally foggy, forgetful, or slower than usual, there’s a name for it—and it’s not “losing your mind.” Many women experience what’s often referred to as “menopause brain fog” during perimenopause, and it’s a legitimate, research-backed phenomenon.
These cognitive changes can show up in subtle ways at first. Maybe you:
Struggle to find the right word in conversation
Forget why you opened a new browser tab
Walk into a room and can’t remember why
Feel like your mind is racing but you can’t focus on one thing
Miss an appointment you swear you wrote down
This mental fog can be unsettling—especially if you’ve always been sharp, quick, and on top of things. It’s not just annoying; it can shake your confidence.
What’s important to know is that these changes aren’t a flaw in your character or capability. They’re a reflection of what’s happening in your brain and body as you move through perimenopause, the transition period leading up to menopause. And while it might feel like everything is shifting (because in many ways, it is), it doesn’t mean clarity, focus, or confidence are gone for good.
Why Is This Happening?
Cognitive changes during perimenopause are largely linked to the hormonal fluctuations that come with this life stage. Specifically, the decline in estrogen levels plays a major role in how your brain functions. Estrogen doesn’t just affect your reproductive system; it also supports neurotransmitters in the brain that help with mood, memory, and cognitive function.
During perimenopause, your body’s estrogen production becomes erratic. Some days you might have more estrogen than others, which affects how your brain works—sometimes leading to difficulty concentrating, poor memory, and the sensation of mental fatigue. This can make simple tasks seem more challenging than usual, creating frustration or feelings of self-doubt.
Additionally, sleep disturbances are common in perimenopause, thanks to hormonal changes and other symptoms like night sweats. Poor sleep can further exacerbate cognitive issues, leading to grogginess and mental fog the next day.
Stress levels also tend to rise during perimenopause, whether from the physical changes, life transitions, or added responsibilities. Chronic stress affects the hippocampus, a part of the brain that plays a key role in memory formation and emotional regulation, which can worsen cognitive symptoms.
So, while it may feel like you're losing focus or not as sharp, the truth is that your brain is adapting to a significant hormonal shift—and it's doing its best to keep up with the changes.
How to Tell the Difference Between Normal Changes and When to Seek Help
It’s one thing to forget a name or misplace your keys occasionally—but when those moments start to stack up, you may wonder: Is this normal? Or is something more serious going on?
Here’s the reassuring news: most cognitive changes in perimenopause are temporary, manageable, and completely normal. That said, it’s also important to know when your experience might benefit from more focused support or medical evaluation.
So what’s typical during perimenopause?
Occasional forgetfulness (like misplacing your phone or missing an appointment)
Difficulty focusing or staying present in conversations
Slower word recall or tip-of-the-tongue moments
Feeling mentally “fuzzy” or easily distracted
These symptoms are frustrating, but they usually come and go with hormonal fluctuations and are often linked to other factors like poor sleep, increased stress, or emotional overwhelm.
When should you reach out for additional support?
If cognitive changes begin to interfere with your ability to function at work or at home
If you’re noticing sudden or severe memory loss
If you're struggling with intense mood changes or depression alongside brain fog
If you have a family history of early-onset dementia and feel concerned
Therapy can be a valuable space to process these fears and determine your next steps. You don’t need to self-diagnose or navigate this alone—support is available, and it’s okay to ask for it.
How Therapy Can Help
When you’re in the thick of perimenopause, the mental and emotional toll can be just as intense as the physical changes. You may feel like you’re constantly trying to keep up—managing brain fog, juggling responsibilities, and trying to stay connected to yourself in the midst of it all.
That’s where therapy comes in.
Working with a therapist who understands the unique challenges of perimenopause can make a world of difference. In our sessions, we’ll explore not just the symptoms you’re experiencing, but how those symptoms are showing up in your daily life, your relationships, and your self-worth. You’ll have space to process the frustration, fear, or grief that often comes with these changes—without judgment.
As your therapist, I also provide psychoeducation, helping you understand why these cognitive shifts are happening. When you know what’s going on in your body and brain, it becomes easier to respond with compassion instead of criticism.
We’ll work together to identify patterns (often using tools like a symptom tracker), reduce the impact of stress and overwhelm, and develop realistic coping strategies that meet your needs right now—not the version of you from ten years ago.
This isn’t about “fixing” you. It’s about supporting you—mind, body, and spirit—through one of life’s most under-recognized transitions. You don’t have to figure it all out on your own.
Practical Tips to Cope With Brain Fog
Cognitive changes during perimenopause can feel incredibly disorienting—but there are ways to ease the fog and reclaim some mental clarity. These small, supportive shifts can help you feel more grounded, focused, and in control of your day-to-day life.
Here are a few gentle, realistic tips you can start with:
Prioritize Sleep: Sleep disruptions are common during perimenopause, and they wreak havoc on memory and concentration. Start by creating a wind-down routine and consider limiting screens, caffeine, and alcohol before bed.
Write It Down: Use planners, sticky notes, voice memos, or apps—whatever works. Writing things down isn’t a failure; it’s a powerful way to support your brain when it’s running on low mental bandwidth.
Practice Mindfulness: Even five minutes of deep breathing or grounding exercises can help reset your nervous system and calm mental overwhelm. Mindfulness also supports memory and emotional regulation.
Nourish Your Body: Hydration, protein, healthy fats, and nutrient-dense foods all play a role in supporting brain health. What nourishes your body also supports your mind.
Move Your Body: Regular, gentle movement like walking, stretching, or yoga increases blood flow to the brain, improves mood, and sharpens focus.
Do One Thing at a Time: Multitasking becomes harder during perimenopause. Try slowing down and focusing on one task at a time—your brain will thank you for it.
Remember: you don’t have to do all of these perfectly (or at all). The goal isn’t productivity—it’s supporting yourself with care and intention, one moment at a time.
If you’ve been feeling like you’re falling apart, please know: you’re not. What you’re going through is real—and it’s valid. These changes aren’t in your head, and they’re not a reflection of your worth, intelligence, or capability. They are part of a deeply human process, one that most women are never taught to expect, let alone how to navigate with compassion.
Cognitive shifts in perimenopause can be unsettling, but they do not define you. Your memory lapses, your moments of fog, your pauses in conversation—none of these take away from the incredible strength you carry or the depth of wisdom you’ve built over a lifetime.
This season may feel unfamiliar, but it’s not permanent—and you don’t have to walk through it alone. With the right support, education, and tools, it’s possible to feel like yourself again. Not your old self—but your whole self. The version of you that’s rooted in truth, not perfection. In clarity, not pressure.
At The New Change, my goal is to walk alongside you as you move through the unknown with grace, honesty, and resilience. You deserve care that sees your full humanity and helps you feel empowered in the midst of transition.
If any part of this post resonated with you—if you’ve been feeling foggy, frustrated, or unsure of what’s happening inside your own mind—I want to remind you: you don’t have to keep pushing through it alone.
At The New Change, I specialize in supporting women through the emotional and cognitive shifts of perimenopause and menopause. Together, we can create a space where your experience is not only validated but also understood and supported with compassion, evidence-based tools, and care tailored to you.
Ready to take the first step? You can schedule a free 15-minute consultation through the link in my bio or on my website.
Not quite ready for therapy? Download The Toolkit for Change, a free resource filled with practical tools like symptom trackers, self-reflection prompts, and wellness checklists to help you start feeling more in control—right now.
