You walk into a room with zero idea why you’re there. You’ve misplaced your keys—again. You can’t remember the name of a friend you’ve known for years. For women in perimenopause and menopause, memory or brain slips are common. An estimated 44% to 62% of women experience menopause memory loss or brain fog during this transition (1).
“I hear women complain that they have to make lists because if they don’t write it down, they won’t remember it,” says Deb Matthew, M.D., a physician specializing in hormonal imbalances.
When does menopause memory loss cross the line from normal to concerning? While forgetfulness is a common menopause symptom, it’s important to know when it could signal a more serious issue like dementia.
About the Experts
Deb Matthew, M.D., is a board-certified integrative medicine physician specializing in hormonal imbalances. She is the author of This Is Not Normal: A Busy Woman’s Guide to Symptoms of Hormone Imbalance. Lisa Genova, Ph.D., is a Harvard-trained neuroscientist, author of Remember: The Science of Memory & the Art of Forgetting, and an expert at Roon.
Perimenopause, Estrogen Decline, and Memory Loss
The hormonal shifts that start in perimenopause are the driving force behind normal menopause memory loss. In the years leading up to menopause, estrogen, progesterone, and testosterone levels fluctuate before culminating in a steady decline.
Estrogen plays a key role in cognitive function, influencing brain regions like the prefrontal cortex and hippocampus, which control how you think, feel, and reason (2). It also acts as a neuroprotective hormone, so as estrogen levels drop, so does mental sharpness (3, 4). Estrogen is also essential for sleep; poor sleep impacts cognition (5).
Estrogen decline also affects dopamine, which regulates mood and cognitive function. When estrogen drops, the release of dopamine is disrupted, leading to short-term memory issues, difficulty with executive function, and verbal recall challenges (6).
Progesterone helps regulate mood, improve cognition, and decrease brain inflammation (6, 7). It also promotes relaxation and restful sleep. A decline in progesterone levels can lead to insomnia and other sleep problems, which can lead to cognitive and memory issues.
What Menopause Memory Loss Looks Like
Menopause memory loss tends to come in short bursts, during which you lose focus or get distracted (8). For example, you might lose focus mid-conversation or get distracted during an everyday task. You might forget where you put your keys, but after some searching, you find them.
Common signs of menopause-related forgetfulness include:
You struggle to focus while you watch TV or read.
You lose track of your phone.
You get confused about time or place.
You get upset more readily.
You recall the name of a long-time work colleague.
Neuroscientist and author Lisa Genova, Ph. D., says some of what we think of as menopausal forgetfulness may stem from mental overload: Juggling work, caregiving, and daily responsibilities can drive up cortisol, your body’s primary stress hormone. Since estrogen helps regulate cortisol, its decline during menopause can amplify stress-related memory issues. (9).
With so much on your plate, it’s not that you don’t remember where you put your keys—you didn’t notice where you put them in the first place. “Because we’re so distracted and so busy and multitasking, we don’t give tasks like this the moment’s worth of attention needed to form a memory,” Genova says. “So we didn’t actually forget anything. We never formed the memory to begin with.”
Dementia symptoms during menopause
Most are due to a decline in estrogen, whereas dementia is progressive. It’s caused by a lack of blood flow to the brain or protein-like plaque that builds up in your brain (8).
The other difference between typical menopause brain fog and the type of cognitive decline associated with dementia is how long the episodes last. Menopause-related brain fog might lead you to forget where you put your keys. With dementia, you might place them somewhere unusual—like wrapped in a scarf in your sock drawer—and have no memory of doing so.
Signs that your memory issues may be more than menopause:
Getting lost in familiar places like your neighborhood
Struggling to follow conversations
Difficulty understanding directions, time, or numbers
Trouble following multi-step instructions like a recipe
Menopause Memory Loss
Signs of Dementia
You can’t find your keys, but later, they turn up in your coat pocket or the kitchen counter — and you remember putting them there.
You misplace your keys and find them in a strange place where they’re not supposed to be, like inside the refrigerator or medicine cabinet. You have no recollection of putting them there.
You can’t remember which level you parked your car in the garage or which row in the lot, but after looking for a bit, you find it.
You may not remember where you parked your car; even if you use your car alarm to locate it, you may not recognize it.
You briefly have trouble recalling someone’s name, that book or TV show your friend recommended, or the name of the new taco place you want to try.
Sometimes—or often—you have trouble remembering the words for simple everyday items: sock, dog, phone, bicycle, spoon, pen.
When you get home from the grocery store, you realize you forgot to buy necessary items.
You go to the grocery store and can’t remember why you’re there or what essential items are on the shelves.
Who is at risk for menopause memory loss vs. dementia
Most women who are in their 40s and 50s are at risk for menopause memory loss (10). After age 60, the risk for both cognitive decline and dementia in women increases (10). Still, some factors do increase your risk for dementia during menopause:
Early onset menopause: A 2023 study found that women who reach menopause before age 40 have a higher risk of all-cause dementia compared to those experiencing menopause after age 50 (11).
Family history: Women with a family history of dementia have a higher risk of developing the condition when menopause sets in (12).
Chronic health conditions: Sleep problems like sleep apnea, mental health issues, chronic pain, and metabolic syndrome can increase the risk of dementia for menopausal women (13).
Lifestyle factors: Poor diet, lack of exercise, smoking, high cholesterol, high blood pressure, diabetes, and heart disease also increase your risk of dementia when you enter menopause (14).
Hearing loss: Untreated hearing loss can lead to cognitive loss. “Women who don’t use hearing aids get cognitively isolated because they’re not hearing what’s going on,” Genova says.
Race: The Study of Women’s Health Across the Nation (SWAN) tracked around 3,000 women for 17 years to explore the connection between menopause and dementia risk (15). It found Black and Hispanic women reach menopause earlier than white, Chinese, and Japanese women (15). It also noted Black women are less likely to be formally diagnosed with dementia, even though they may exhibit the same or more severe symptoms as white adults (16, 17).
Menopause Memory Loss Prevention and Treatment
Two of the most powerful strategies to protect against memory loss from menopause are sleep and stress management.
Reduce stress
When stressed, the extra cortisol created in your body disrupts your ability to maintain cellular health and stability. The cortisol blocks the actions of an enzyme that strengthens telomeres. They are protein and DNA that protect your cells from deterioration when dividing. In regular cellular division, the telomeres shorten, but telomerase (the enzyme) builds them back up. Excess cortisol reduces the enzyme’s activity, speeds up telomere shortening, increases inflammation, and reduces cellular energy production (18, 19, 20).
Get better sleep
A poor night of sleep can impact brain function, memory formation, attention, and focus. “If you don’t get a good night’s sleep, the next day, you are exhausted, and one of the things you can’t do well when you’re exhausted is pay attention,” she says.
You need attention to create memory formations in your hippocampus, which converts short-term memory to long-term memory (21).
Diet and exercise
A well-balanced diet and a consistent exercise routine are great for overall brain health. The Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet may protect the brain, slow cognitive decline, and boost short-term memory. Genova recommends the following guidelines for a Mediterranean diet: (22)
Brightly colored fruits and vegetables, especially green leafy veggies
Healthy fats, like olive oil
Omega-3 fatty acids from wild-caught salmon or other fatty fish, flaxseeds, algal oil
Legumes, beans, and nuts
Foods rich in vitamin D, including fish, mushrooms and eggs
Foods rich in vitamin B12, including fish and seafood, eggs, nutritional yeast, and plain yogurt
Supplements are another potential way to boost menopause memory loss. Vitamins B, C, and D. Omega-3 oils and magnesium have also improved memory and cognition (23, 24).
Exercise is excellent for the brain for two main reasons. Moving your body can help you sleep better and nourish the brain by providing blood flow and oxygen. Aim for about 150 minutes of aerobic activity weekly, which translates to five 30-minute daily walks (25).
Hormone replacement therapy for menopause memory loss
Hormone replacement therapy (HRT, also called menopause hormone therapy or MHT) may help women manage their perimenopause memory loss. Recent research suggests that the estrogen boost from HRT may also help prevent cognitive decline.
One 2021 study of nearly 400,000 women found that HRT reduced the risk of dementia (26).
A 2023 review found that initiating HRT during perimenopause or early postmenopause may slow cognitive decline, while starting it later can be ineffective and even increase the risk (27).
A 2024 study involving 20 women, published in Frontiers, found that progesterone alone doesn’t affect cognitive function (28). It needs to be combined with estrogen to impact memory loss and cognition (28).
HRT has been shown to improve cognition and memory for women with the APOE4 gene (a marker for Alzheimer’s) (29).
The Bottom Line
Menopause memory loss—often experienced as brain fog—is a common, frustrating symptom driven by declining estrogen and progesterone levels. These memory lapses are usually temporary and not a sign of dementia. However, women who have early-onset menopause are at a higher risk for dementia. Diet, exercise, and other healthy lifestyle habits can protect the brain and support cognitive function. Hormone Replacement Therapy (HRT) may also help, especially if it’s started early in menopause. See your doctor if memory problems are severely impacting your daily life.
Stephanie Anderson Witmer is a freelance journalist and content creator based in Pennsylvania. She's written health and lifestyle stories for Women's Health, Redbook, Prevention, Good Housekeeping, USA Today, Better Homes & Gardens, Giddy, Parade, Yoga Journal, and more.
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