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Forgetful, Scattered or Disorganized at Work? It Could Be Perimenopause

“Brain fog” is real, and it’s temporary. Here’s what you can do about it.

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Graphic of woman running to work letting all of her belongings fly all over the place.
Elen Winata
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So, I’m writing an update to colleagues about a meeting. It was a meeting on the phone. It takes what feels like a full ten minutes to come up with the obvious phrase “phone meeting.” It takes another fifteen minutes to stop feeling like I am losing my mind.

Trouble multitasking, feeling at a loss for words, short-term memory loss, irritability. Cognitive symptoms during the menopausal transition, known as perimenopause, may mimic the impairment found in neurodegenerative disease, noted neurologist Gayatri Devi, last year in the journal Obstetrics & Gynecology. In her case report, two female patients had been misdiagnosed with Alzheimer’s and dementia, respectively. Brain scans and other tests, along with a review of their histories, identified the true culprit.

Blame the decline of estrogen stimulation of the brain, says M. Allyson Brown, an ob/gyn with Axia Women’s Health in Pottstown, Pa. “People think about hormones and they only think about reproductive function,” she says. “We forget that other body systems respond to hormone fluctuations, too.”

Thankfully, the effects of so-called brain fog are temporary, correcting themselves as the body adjusts to the dip in estrogen. The condition often responds to short-term hormone treatment in the meantime, say health experts. But feeling like you’re not firing on all cylinders is especially challenging at work, where you only have one job: demonstrate your competence. (It’s such a sensitive issue that other sisters coping with menopause-related cognitive changes asked me not use their real names.)

*Stephanie Moore, 64, an independent media producer, says she’d be at a gig setting up only to find she’d left key equipment at home. And she lost the ability to remember people’s names — even people she knew well.

For * Robin Bennett, 57, a middle-school teacher, “It was like knowledge was in my head but the passageway to my mouth was blocked.… It left me looking like I wasn’t knowledgeable.” Because her father had dementia, Robin was petrified she was getting it, too.

“It’s a difficult topic,” Brown says. “People don’t want to say, ‘Oh man, I can’t think straight.’ Nobody wants their boss or coworkers thinking, ‘Oh, she’s having hot flashes, I bet she can’t get her job done.’”

You can absolutely get the job done. Think of brain fog as a difficulty, not a disability. Be proactive about putting strategies in place to help you cope.

Put your self-care on steroids.
Relaxation and stress-reduction techniques, including deep-breathing exercises and massage, a healthy lifestyle with good nutrition and daily exercise and enjoyable, self-nurturing activities may all be helpful, according to the North American Menopause Society (

Write everything down.
Instead of just outlining lesson plans, Bennett started writing full scripts of what she’d teach to remember important points. “I had to have the paper to teach the class without faltering,” she says.

Establish a central command post.
For Moore, it’s the calendar in her kitchen. “I write everything — everything — on it,” she says. It helps her track tasks and avoid double-booking appointments. “I won’t commit to anything until I check it.” Make to-do appointments with yourself on your calendar app. Flag emails that need follow-up, and assign a deadline for each.

Keep a notebook handy.
I log reminders and tasks in a monogrammed notebook in my purse. I keep another at the office for meeting notes. The notes and reminder features on your smartphone can serve the same purpose. But they won’t work unless you train yourself to check them.

Minimize clutter.
“I got organized so I could locate where I put things,” says Bennett. It’s easier to find things if you know where to look for them. Plus, order reduces stress and we could all use less at work.

Communicate competence nonverbally.
A colleague of mine says that even when she isn’t feeling so sharp, she’ll dress sharp to show she means business. “It’s a way to telegraph professional presence,” she says.

Consider sharing limited information with your manager.
Your employer may be able to provide you with support if tactfully made aware of your challenge. Otherwise, higher-ups may misinterpret a change in your behavior as a performance issue.

Keep moving.
“Aerobic exercise is proven to have good effects on brain and brain function,” says Brown. “Exercise is key for helping maintain those neurons.” Take advantage of onsite workout rooms or exercise classes near your job. Some fitness centers have 30-minute classes during the lunch hour. If you don’t want to get super sweaty try yoga, Barre or Pilates classes. Researchers at Texas State University found that study participants had improved working memory after six sessions of yoga. If you have a place to shower afterward, spinning or swimming are great ways to get a vigorous workout in a short amount of time.

Lunch on brain food.
Get lots of fruits and vegetables, some whole grains and lean meat and go easy on the fats. And load up on antioxidant foods like berries. Antioxidants reduce inflammation and improve your brain-cell signaling, according to the Women in Balance Institute. Season your cooking with turmeric, garlic, rosemary and cayenne, which also have antioxidant properties.

Manage stress by protecting your work-life balance.
You might leave work at the same time each day, only answer emergency emails during off-hours or request to work from home occasionally. Get to bed on time.

Talk to your doctor.
Discuss your symptoms and ask questions about hormone therapy. Brown says, “I’ve had women who have chosen to take some testosterone for the sake of giving their libido a boost and feel that they’ve gotten a little better mental acuity.”

Embrace the new normal.
“Certain things you just have to accept. It’s stressful trying to deny it,” says Moore. “Stop worrying that you’re going off the deep end, because you’re not,” Brown says. “Half of your friends are going through the same thing.” Be gentle with yourself.