Brain Fog in Perimenopause: What Every Woman Over 35 Needs to Know

A few months ago, something started happening that genuinely scared me.

I’d be mid-sentence, talking to someone, telling a story, completely normal conversation, and the word would just vanish. I knew what I was trying to say. I could describe it. But the actual word? Gone. Like reaching for something that had been on the same shelf for years, and your hand just closes on air.

The thought that followed wasn’t “I’m tired.” It wasn’t “I’m stressed.” It went straight to: Is this the beginning of something I can’t come back from?

I’d been hearing so much about dementia and Alzheimer’s, especially the research on women’s risk during perimenopause. And there it was: that sinking feeling. That quiet, terrifying question I was almost afraid to say out loud, because saying it out loud makes it feel real.

“Your brain is not betraying you. But it might be sending you a signal. And the worst thing you can do is call it mom brain and move on.”

If you’ve ever had a moment like that, a word that wouldn’t come, a room you walked into with no idea why, a name you’ve known for twenty years that just blanked, you are not alone. And you are in the right place.

Because what I’ve learned since that moment changed how I think about my health entirely. And I want to give you the same information.

What Is “Mom Brain”, And Why That Label Is Failing You

We all know what mom brain means. It’s that fuzzy, forgetful, can’t-find-my-keys feeling. We’ve been taught to treat it like a badge of honor, or at worst, the punchline to a joke. “Sorry, total mom brain moment.” Laugh it off. Move on.

Here’s the problem: mom brain is a description. It is not a diagnosis.

It’s the cognitive equivalent of saying your knee hurts and calling it “knee-itis.” You’ve named the symptom. You’ve explained nothing. And you’ve given yourself zero information about what to actually do about it.

Brain fog, word-finding difficulty, memory lapses, and mental fatigue in women over 35 are not random acts of parenthood. They can be symptoms. And symptoms have causes. And causes in most cases have solutions.

Here’s what most women don’t know: women are disproportionately affected by cognitive decline and Alzheimer’s disease. Not because we’re weaker. Not simply because we live longer. But because we have a biology that includes a hormonal transition in midlife — and if we’re not paying attention, that transition can quietly accelerate brain aging during the exact window when intervention matters most.

That window starts in perimenopause. Which for many women begins in their late 30s or early 40s often a full decade before a single hot flash shows up.

“Mom brain is what we call it when we don’t have better language. Today, I want to give you better language, and the levers to pull.”

What I Actually Did When I Got Scared Enough to Listen

I didn’t spiral into a midnight Google rabbit hole. But I did decide to get intentional.

First, I started a real conversation with my healthcare provider about where I was hormonally. I got labs done. My estrogen, progesterone, and testosterone were all low — which, it turns out, was likely connected to years of under-fueling my body. I ended up starting a low dose of HRT and actually understanding what was happening in my biology during this transition.

Then I dialed in my sleep — and I mean actually dialed it in, not just “getting more hours.” I looked hard at the habits that were silently wrecking my sleep quality: eating too close to bedtime, TV on, phone in hand, laptop open, all running simultaneously until my eyes closed. I deleted apps off my phone to remove the temptation. I made space for a real wind-down.

I also upped my creatine after learning what the research actually says about its role in brain health for women. I invested in higher-quality supplementation — a solid gut supplement and a women’s foundational stack from Metagenics. (Links in the show notes for the podcast version of this.)

And I started paying close attention to the research — Dr. Gabrielle Lyon on the muscle-brain connection, Dr. Stacy Sims on what perimenopause actually does to the female brain, and Dr. Rhonda Patrick, founder of FoundMyFitness and one of the most rigorous science communicators working in this space right now.

What I found is that there’s no single magic bullet. But there is a framework. And everything we do inside The Strong(HER) Way — the training, the nutrition, the identity work, the stress management — maps directly onto what the research says protects the brain. That wasn’t a coincidence. It was the design.

The 5 Pillars of Brain Health for Women Over 35

Let’s get into the actual framework. These five pillars are not separate conversations, they are one interconnected system. But understanding each one gives you a lever to pull starting today.

01 Hormones

Estrogen is a brain hormone. What happens to it in perimenopause matters.

Let’s start with the one your doctor may not have had a real conversation with you about.

Estrogen is not just a reproductive hormone. It’s a brain hormone. It influences memory, mood, verbal fluency (your ability to find words quickly), and the health of the neurons themselves. When estrogen starts fluctuating during perimenopause, your brain feels it.

Researchers are finding that there may be what they’re calling a “critical window”, a period during perimenopause and early menopause when hormonal support, if appropriate for your situation, may matter significantly for long-term brain health. The science is still evolving, and this is a conversation to have with your healthcare team, not a prescription.

What I will say is this: do not let anyone minimize your brain symptoms during this season of life by calling them “just aging.” Word-finding issues, brain fog, mood instability, anxiety that comes out of nowhere. These can be neurological symptoms of hormonal change. Not weakness. Biology.

What to do: Get informed about where you are in your hormonal journey. Get labs done. Track your cognitive symptoms, not just the hot flashes. And find a provider who will collaborate with you, not hand you a pamphlet and send you home.

02 Sleep

Your brain takes out the trash while you sleep. Quality matters more than hours.

Your brain has a cleaning system. It’s called the glymphatic system, and it runs primarily during deep sleep. What it’s doing is flushing metabolic waste products out of your brain tissue including beta-amyloid, one of the proteins associated with Alzheimer’s disease.

Sleep is not passive recovery. It is active brain maintenance. Your brain is literally taking out the trash while you’re unconscious. And if you’re not getting quality sleep? The trash doesn’t get taken out.

Here’s where it gets personal. My sleep wasn’t just short some nights. It was shallow and fragmented. TV on, phone in hand, laptop open. I was technically going to bed. But my nervous system was nowhere near ready to drop into the deep sleep where real brain maintenance happens.

The nighttime media spiral isn’t laziness. For a lot of us, it’s the first quiet moment we’ve had all day. Our brain doesn’t want to give it up. I get it, I’ve lived it. But even one or two nights of poor sleep creates measurable effects on memory, word retrieval, and mood. Stack that on top of a perimenopausal hormonal shift already disrupting sleep architecture? You have a recipe for brain fog that no amount of coffee is going to fix.

What to do: Start with input control before bed. Screens off 30 to 60 minutes before you want to be asleep not because it has to be perfect, but because your brain needs a runway to land on before it can do its cleaning work.

03 Muscle & Movement

Strength training is brain training. The research is unambiguous.

Your strength training sessions are not just building a stronger body. They are building a stronger brain. I want you to feel the full weight of that (pun fully intended) the next time you’re tempted to skip a workout.

Dr. Gabrielle Lyon, founder of Muscle-Centric Medicine, has spoken publicly about research from her postdoctoral work showing that better body composition specifically more muscle mass and lower body fat correlates with better brain volume. Not just fitness performance. Brain volume.

When your muscles contract during resistance training, they release chemical messengers called myokines that travel to your brain and support the growth and maintenance of brain cells. One of these is BDNF ( brain-derived neurotrophic factor) sometimes described as fertilizer for the brain. Exercise is one of the most powerful ways to trigger it.

This is exactly why we train to build inside The Strong(HER) Way not to shrink. When you’re training just to burn calories, you’re missing about 90% of what exercise actually does for your long-term health. Including your brain health.

Dr. Lyon also talks about “muscle span”. Which is the idea that the years you spend with healthy skeletal muscle are years your body, metabolism, and cognitive function are protected. The muscle you build in your 30s, 40s, and 50s is not vanity. It is infrastructure. For your brain as much as your body.

What to do: Strength train consistently with progressive overload. Meaning you’re gradually challenging your body more over time. Not from a place of punishment. From a place of understanding that this is protective. Two to three full-body resistance sessions a week is enough to move the needle on the brain-protective signaling your body is waiting to produce.

04 Nutrition & Supplementation

Your brain has specific nutritional needs. Most general advice misses them.

What you eat and what you supplement matters for your brain in ways specific to women that most general nutrition advice completely misses.

Start with protein. Your brain needs amino acids to produce neurotransmitters like dopamine, serotonin, acetylcholine (the chemicals that regulate mood, focus, and memory). If you’re chronically under-eating protein, you are not giving your brain the raw materials it needs to function.

Then there’s creatine. Most women still associate it with a big tub of powder at the gym. Here’s what the research actually shows: creatine isn’t just an energy source for muscles. It’s an energy source for your brain. Your neurons use ATP, the same energy currency your muscles use during a hard workout, and creatine helps your brain regenerate ATP quickly. That matters for memory, processing speed, and cognitive performance under stress and sleep deprivation.

Dr. Rhonda Patrick, biochemist and founder of FoundMyFitness, has spoken extensively about creatine’s role in brain energy metabolism. Women in particular tend to have lower baseline creatine levels than men, which means we may actually see stronger cognitive benefits from supplementation.

Gut health belongs in this conversation too. The gut-brain axis is a real and well-researched pathway. The state of your microbiome influences inflammation, neurotransmitter production, and mood. This isn’t woo. It’s neuroscience.

What to do: Prioritize protein at every meal. Aim for 30 to 40 grams per meal as a brain-feeding strategy, not a diet rule. Consider creatine if you aren’t already taking it (talk to your provider about dosing). And invest in supplement quality, not just quantity.

05 Stress Management

Chronic cortisol damages your memory center. This is not optional self-care.

Cortisol, your primary stress hormone in short bursts is protective. Your brain actually uses it. But chronic elevated cortisol aka the kind that comes from running a business, raising kids, managing a household, and performing at a high level day after day without adequate recovery can be neurotoxic over time.

It can damage the hippocampus, which is your memory center. It disrupts sleep architecture. It interferes with the hormonal balance we just talked about.

This is why stress management (which for high-achieving women can feel like an unaffordable luxury) is not optional. It is brain protection. When we talk about a sustainable, healthy lifestyle inside The Strong(HER) Way, this is part of what we mean. Your nervous system is not a background player. It is running the show.

What to do: Identify your non-negotiable recovery practices. Not the ones you do when you have time. The ones you protect like appointments. Movement, rest, margin, joy. These are not soft skills. They are brain health strategies.

Why Piecemeal Fixes Don’t Work

Here’s the thing that connects all five pillars: they are not separate conversations. They are one system.

Chronic stress tanks your sleep. Poor sleep disrupts your hormones. Hormonal imbalance impairs your body’s ability to build and maintain muscle. Under-muscled bodies produce fewer neuro-protective myokines. And poor nutrition means your brain is running on fumes while all of this is happening simultaneously.

You cannot supplement your way out of a sleep problem. You cannot train your way out of a chronic stress response. This is why the inside-out approach we take inside The Strong(HER) Way actually works because it addresses the whole system, not just the loudest symptom.

“They are one system. And that’s why piecemeal fixes don’t work.”

Why the Window You’re In Right Now Matters

The perimenopausal years when estrogen is fluctuating and the brain is most vulnerable are also the years when lifestyle intervention is most protective. Researchers call it a critical window for a reason.

The things you do now, in your 30s, 40s, and 50s, are not just about how you feel today. They are laying down the architecture of your brain for your 60s, 70s, and beyond.

If you keep calling it mom brain and moving on, you’re not wrong. But you might be leaving some of the most valuable time on the table skipping the part where you ask: what is this a symptom of, and what can I actually do about it?

That is the question that changes things.

What’s Actually Available to You

Imagine being 58, 68 years old and sharp. Not “sharp for your age.” Just clear. Present. Walking into a room knowing exactly why you’re there.

Imagine being the woman in your family who modeled what it looks like to take brain health seriously who didn’t shrug it off, but asked better questions and took real action.

Imagine having the cognitive energy to show up fully for your kids, your clients, your work, and yourself not running on cortisol, caffeine, and prayers, but actually resourced.

That is what’s available to you. Not from a pill. Not from a program that promises to fix everything in 30 days. From building the right systems, consistently, over time. From treating your body and your brain like the asset it actually is.

“She’s not a different category of person from you. She just decided to do something with the information she had.”

Your Next Step

If this landed for you, if you recognized yourself anywhere in this story, take one step today. Not all five pillars at once. Just one.

If you want to build the whole system the training, nutrition, and the mindset work that makes all of it sustainable The Fit + Fueled coaching program is built specifically for women who are done doing this the hard way.

→Explore Fit + Fueled at thestrongherway.com/fitandfuel

Not ready for the full program yet? Start with the Fit and Fueled Foundation, a $27 micro course that gives you the foundational framework to start making better decisions today without overhauling your entire life.

→Start with the Foundation at thestrongherway.com/fit-and-fueled-foundation

Either way make the move. Your brain is worth it. And so is the version of you who shows up fully present, clear, and strong well into the decades ahead.

Resources Mentioned

• Dr. Gabrielle Lyon — Muscle-Centric Medicine: drgabriellelyon.com

• Dr. Stacy Sims — Women’s performance research: drstacysims.com

• Dr. Rhonda Patrick — FoundMyFitness: foundmyfitness.com

• Listen to the full podcast episode on Apple or wherever you get your podcasts!

• Connect with us on Instagram @thestrongherway & @alishacarlson_

Disclaimer

This post is for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider regarding hormone therapy, supplementation, or any health concerns.

The Strong(HER) Way • thestrongherway.com