NATUROPATHIC DOCTOR IN ONTARIO
Navigating Brain Fog and Memory Changes in Perimenopause
Perimenopausal Changes to Cognitive Function
Cognitive Function in Perimenopause
Have you ever walked into a room and forgotten why? Lost your train of thought mid-sentence? Struggled to find the right word, even though it’s “on the tip of your tongue”?
If you’re in your late 30s or 40s and noticing more of these moments, you’re not alone—and no, you’re not losing your mind. Many women experience a frustrating sense of “brain fog” during perimenopause, a time of hormonal transition that affects much more than just your menstrual cycle.
We work with women every day who are worried about their cognitive clarity—and we want you to know that what you’re experiencing is real, common, and treatable. Let’s explore why this happens and what you can do to reclaim your mental sharpness.
What Is Brain Fog?
“Brain fog” isn’t a medical diagnosis, but it’s a term many women use to describe a collection of symptoms, including:
- Difficulty concentrating
- Forgetfulness
- Trouble finding words
- Slower processing speed
- Feeling mentally “foggy” or detached
This mental fatigue often comes on gradually and can feel unsettling—especially for high-performing women who are used to multitasking with ease.
Why Does Brain Fog Happen in Perimenopause?
The biggest driver is hormonal fluctuation, particularly of estrogen. Estrogen is more than a reproductive hormone—it plays a key role in brain health.
Estrogen helps to:
- Support neurotransmitter activity (especially serotonin and dopamine)
- Maintain brain cell communication
- Reduce inflammation in the brain
- Protect against oxidative stress
- Regulate blood flow and glucose metabolism in the brain
When estrogen levels begin to fluctuate (and eventually decline), these protective effects start to waver—leading to slower recall, poor focus, and mental fatigue.
In perimenopause, estrogen doesn’t just decline steadily—it spikes and crashes unpredictably. This inconsistency is what often triggers cognitive symptoms like word-finding difficulty and scattered thinking.
Progesterone Also Plays a Role
While estrogen gets a lot of attention, progesterone also influences cognitive health. It has a calming effect on the brain and helps regulate the stress response. Low progesterone, common in the early stages of perimenopause, can increase anxiety, disrupt sleep, and further impair cognitive clarity.
Add in rising cortisol levels (from stress or poor sleep), and you’ve got the perfect storm for brain fog.
Other Contributors to Cognitive Changes
Hormones are a major piece of the puzzle—but they’re not the only factor. Brain fog can also be influenced by:
- Poor sleep (which affects memory consolidation)
- Nutrient deficiencies (especially B vitamins, omega-3s, and iron)
- Chronic stress and high cortisol
- Blood sugar dysregulation
- Inflammation (which can cross the blood-brain barrier and affect neurotransmitters)
- Thyroid dysfunction, which is more common in midlife
This is why it’s important to take a whole-body approach when addressing brain fog—simply taking a supplement or trying a brain game won’t be enough if the underlying drivers aren’t addressed.
What You Can Do to Support Mental Clarity
At Sequence Wellness, we take a multifaceted approach to treating brain fog. Here’s how we help women get back to feeling mentally sharp:
1. Stabilize Hormone Fluctuations
We work to bring balance back to estrogen and progesterone—either through herbal support, targeted supplements, or hormone therapy if appropriate.
Natural options may include:
- Phytoestrogens from flaxseed, red clover, or soy
- Chasteberry (Vitex) to support progesterone balance
- DIM or calcium D-glucarate to support estrogen detox
- Adaptogens like ashwagandha or rhodiola to regulate stress hormones
We also use functional hormone testing when needed (e.g., DUTCH testing) to assess patterns and create a personalized protocol.
2. Support Brain Health Through Nutrition
Cognitive function depends on a steady supply of nutrients, blood sugar stability, and reduced inflammation.
Key strategies include:
- Omega-3s (from fish or supplements) to support memory and cognition
- B-complex vitamins, especially B6, B12, and folate, which are involved in neurotransmitter production
- Antioxidant-rich foods (berries, leafy greens, turmeric) to reduce oxidative stress
- Protein with every meal to support neurotransmitter synthesis
- Balancing blood sugar by limiting refined carbs and prioritizing fiber and healthy fats
3. Optimize Sleep
Sleep is essential for brain detox and memory consolidation. When we’re sleep-deprived, everything feels harder—thinking clearly, making decisions, even regulating emotions.
We help women improve sleep quality through:
- Sleep hygiene coaching
- Herbal or nutrient support (like magnesium or GABA)
- Stress reduction tools
- Hormone balancing to reduce night sweats and early wakings
4. Move Your Body
Exercise has a profound impact on brain health. It increases blood flow, supports mood, and stimulates the release of BDNF (brain-derived neurotrophic factor), which promotes the growth of new brain cells.
Both aerobic exercise (like walking, running, or swimming) and resistance training have been shown to improve cognitive performance in midlife women.
Even just 20–30 minutes per day of movement can make a noticeable difference.
5. Calm the Stress Response
When cortisol is constantly elevated, it interferes with memory and learning. We work with clients to build sustainable stress-management practices like:
- Deep breathing and breathwork
- Gentle yoga or stretching
- Meditation or mindfulness
- Nature walks or digital breaks
- Supportive boundaries and rest
Sometimes, managing stress means doing less—not more.
Should You Be Worried About Dementia?
While it’s normal to be concerned about memory lapses, perimenopausal brain fog is usually temporary and reversible—not a sign of early dementia.
That said, this is also a critical window to invest in your brain health. The habits and choices you make now can influence your risk of cognitive decline later in life. Supporting hormones, sleep, stress, and inflammation lays the foundation for long-term mental clarity.
When to Seek Help
If brain fog is interfering with your work, relationships, or daily function—don’t brush it off. You don’t need to wait until it “gets bad enough” or try to power through it on your own.
At Sequence Wellness, we specialize in helping women in perimenopause identify the root causes of brain fog and design treatment plans that bring real relief—not just temporary fixes.
You Deserve to Feel Clear-Headed Again
Your mind is one of your most powerful tools. When it feels cloudy, it affects every part of your life. But with the right support, your clarity, focus, and confidence can return.
If brain fog has become part of your daily reality, book a consultation with Sequence Wellness today. We’ll help you uncover the root causes and guide you back to feeling mentally sharp and present.
Dr. Sarah Goulding, Naturopathic Doctor
Dr. Sarah Goulding is a licensed naturopathic doctor in Ottawa Ontario and has a BSc in neuroscience and biology from Dalhousie University (2004), and did her 4-year naturopathic training at the Canadian College of Naturopathic Medicine (2010). She’s since accumulated over a decade of clinical experience, and refined her practice to focus on women’s health and digestion. She is licensed and registered as a Naturopathic Doctor in Ontario by The College of Naturopaths of Ontario (CONO) and is a member of the Canadian Association of Naturopathic Doctors (CAND) and the Ontario Association of Naturopathic Doctors (OAND).
Dr. Sarah Goulding blends science and compassion, and acts as a personal health researcher to help you navigate your health. Tools that she uses include nutrition, supplements and botanicals, bioidentical hormones, and lifestyle modifications. The closer you get to the root cause, the gentler the therapies needed to resolve the issue.
Dr. Elizabeth Miller, Naturopathic Doctor
Dr. Miller completed her doctor or naturopathic medicine degree at the Canadian College of Naturopathic Medicine, and holds a Master’s and Bachelor’s of science in Human Health and Nutrition from the University of Guelph. Her extensive knowledge of nutrition and her strong foundation in scientific research allows for a very thorough approach to your care. She is licensed and registered as a Naturopathic Doctor in Ontario by The College of Naturopaths of Ontario (CONO) and is a member of the Canadian Association of Naturopathic Doctors (CAND) and the Ontario Association of Naturopathic Doctors (OAND).
She is passionate about teaching holistic health to help women understand their bodies and get to the root cause of their health issues. Her areas of special interest include women’s health, hormonal health, gastrointestinal health, and pediatrics.
Dr. Janna Fung, Naturopathic Doctor
Dr. Janna Fung is a licensed naturopathic doctor with a special interest in dermatology and women’s health. She has a passion for evidence based preventative medicine and strives to empower patients with the knowledge to achieve their optimal health. She understands collaborations is the only way to develop realistic sustainable health/wellness results and strives to develop individualized health goals with patients.
