Menopause & Perimenopause
Perimenopause Brain Fog or Dementia? Pay Attention to the Pattern
I went blank in front of a room of executives. After 15 years in healthcare, I knew what dementia looks like, and it still scared me. Here’s the pattern to watch.
By Tyre Richards, BSHA, MBA · Published
I’ve stood in front of a room full of C-suite executives and completely lost the words I wanted to say.
The slide was right there. I knew the material. I’d prepared for that meeting, and everyone at the table expected me to know what came next. Then my mind went blank.
When you’ve built a career on thinking quickly, speaking clearly, and keeping several thoughts moving at once, a moment like that shakes you. I recovered and finished the presentation. But the fear followed me out of the room.
What just happened to me?
As soon as I could, I called a friend and talked it through with her. Here’s the part that might surprise you: I’d spent 15 years in healthcare, much of it working with dementia patients. I knew the difference between what happened to me in that room and what dementia actually looks like. I’d explained it to worried families more times than I can count.
It’s still scary when it happens to you.
So let me share what I know.
During perimenopause and menopause, many women have trouble concentrating, finding the right word, and remembering things. Poor sleep, stress, hot flashes, anxiety, and depression can make it worse. Research has also found small but measurable changes in verbal memory as women move through the menopause transition.
We call it brain fog. It’s frustrating, and it can be embarrassing. It can also leave a woman quietly wondering whether she’s seeing the beginning of dementia.
The pattern tells you a lot.
Menopause-related brain fog tends to come and go. You might have a rough day after a terrible night’s sleep, then feel much sharper later in the week. You lose your train of thought, blank on a familiar word, or need more reminders than you used to. But you can usually still handle your responsibilities and familiar tasks, even when it takes more effort.
Dementia is more often progressive, and it starts to interfere with daily life. Someone may miss payments again and again, get confused in a familiar place, ask the same question without remembering the answer, or lose the ability to do something she’s done for years. Other people often start to notice.
No single symptom gives you the answer. Memory and focus problems can also come from medication side effects, thyroid conditions, low vitamin B12, depression, alcohol, or a sleep disorder. For me, part of the answer was getting my thyroid checked and making some hormone adjustments. Your answer may be different, and that’s exactly why an evaluation matters.
If you’re worried, keep a short record for a few weeks. Write down what happened and whether it affected your ability to function. Note any changes in sleep, mood, menstrual cycles, or other symptoms. Bring that record to your appointment, along with a full list of your medications and supplements.
If you or someone near you has sudden confusion, new trouble speaking, drooping on one side of the face, or weakness on one side of the body, call 911.
If you’ve had a moment like mine, in a meeting, in the grocery store, or at your own kitchen counter, you don’t have to carry it alone. Notice the pattern. Write it down. Then talk with someone qualified to help you make sense of it.
A quiet place to begin
Full disclosure, I founded Sovra Health because I wanted women to have the kind of care I needed. If changes in focus, sleep, energy, or other midlife symptoms are affecting your life, Sovra Her offers online, clinician-led care for women in perimenopause and menopause. You start with your symptoms, health history, and goals, and a licensed clinician helps you sort out what deserves a closer look and which options might fit you.
Sources and further reading
This article provides general educational information. It is not a substitute for individualized medical, mental health, legal, or financial advice.