Your Brain on Hormones: Why Menopause Messes With Your Head (ADHD, PMDD & Brain Fog)

You walk into a room and completely forget why you're there. Again.

You're in the middle of a sentence when the word you need just... disappears. The simplest thing, and it's gone.

Or maybe you're sitting at your desk staring at your screen, reading the same paragraph three times because nothing's sinking in. 

And anxiety starts to rear its ugly head :( Rages become commonplace.  

"Is this just me?" you wonder. "Am I losing it?"

No. You're absolutely not. But your brain is going through something very real, and it has everything to do with your hormones! 

I know! I have been there and really struggled. But now I am coping well with ADHD and no longer have PMDD, and am thriving even in perimenopause (aged 51)! 

🧠 What perimenopause and menopause actually do to your brain

Here's what hardly anyone tells you: oestrogen isn't just about your periods or hot flushes. It's absolutely crucial for your brain function. 

Oestrogen helps your brain cells communicate with each other. It supports energy production in your brain, and protects your memory centres. It even influences how your brain regulates mood, focus, and sleep.

So when oestrogen starts dropping during perimenopause (which can begin in your 40s or even late 30s), your brain notices. Big time.

That's why brain fog during menopause is so common. It's not in your head, well, it is, but you know what I mean. It's real, it's measurable, and it makes perfect sense when you understand what's happening.

The symptoms that catch people off guard

1. You can't concentrate like you used to

Tasks that were second nature suddenly feel exhausting. You sit down to write an email and it takes three times longer than it should, and you lose track of conversations halfway through.

2. Your memory feels unreliable

Names escape you, and you forget appointments even though you swore you'd remember. You walk into the kitchen and stand there thinking "what did I come in here for?"

3. Words hide from you

Not complicated technical terms, but even just normal, everyday words. You'll be describing something and have to say "you know, the thing... the thingy" because the actual word won't come.

4. Everything feels overwhelming

Your brain just feels... full. Like you're running too many tabs at once and nothing's loading properly. Small decisions feel impossible. Your mental energy runs out by lunchtime.

5. You feel anxious or on edge

Your mind races, you catastrophise more, and little things that wouldn't normally bother you suddenly feel massive. You might even wonder if you've developed anxiety out of nowhere.

💔 The brain-heart connection you need to know about

Here's something that doesn't get talked about enough: what's happening in your brain during menopause is connected to your heart health too.

Oestrogen helps keep your blood vessels flexible and healthy, and it supports good cholesterol levels. When it drops, your risk for heart disease increases, and that same cardiovascular change affects blood flow to your brain.

Less blood flow means less oxygen and nutrients getting to your brain cells. That can make brain fog worse, affect your memory, and even increase your long-term risk of cognitive decline.

This is why looking after your heart during perimenopause and menopause is very important, because it isn't just about your heart but about your brain too.

🎭 When it's not just menopause

Sometimes what looks like "just menopause brain fog" is actually something more complex, especially if you've got other things going on.

If like me, you have ADHD

Perimenopause can make ADHD symptoms significantly worse. The drop in oestrogen affects dopamine, the same brain chemical that's already lower in people with ADHD.

You might find your focus is even more scattered. Your working memory gets worse. Tasks you'd developed coping strategies for suddenly feel impossible again. If you're on ADHD medication, you might notice it's not working as well as it used to. Or some women only realise they have ADHD in perimenopause as the symptoms become less masked. 

If you struggle with PMDD

PMDD (Premenstrual Dysphoric Disorder) is like PMS's much more intense cousin. It causes severe mood swings, depression, anxiety, rage, and brain fog in the week or two before your period. I had it from 14 to a few years ago, it was hellish. And you are more likely to have it, if you have ADHD. 

During perimenopause, when your hormones are all over the place, PMDD symptoms can become even more unpredictable and intense. You might have longer windows of feeling awful, or find the symptoms don't follow your cycle anymore because your cycle itself has gone haywire. Or your mild PMS may become more like PMDD, so you feel untethered. 

The brain fog, the mood crashes, the rage that comes out of nowhere - these aren't character flaws, they are your brain struggling with wildly fluctuating hormone levels.

🌱 Your brain can feel much better than this!

The great news: Your brain is incredibly adaptable, even during hormonal chaos, and the choices you make now genuinely make a difference.

1. Feed your brain properly

Your brain needs omega-3 fatty acids from oily fish like salmon and mackerel. It thrives on antioxidants from berries, dark leafy greens, and colourful vegetables. B vitamins from wholegrains, eggs, and legumes support neurotransmitter production. And various key minerals. 

Every meal is an opportunity to support your brain through this transition.

2. Move your body regularly

Exercise increases blood flow to your brain, it supports the production of BDNF, which is like fertiliser for your brain cells, and it helps balance hormones and reduces inflammation.

Even a 20-minute walk makes a measurable difference to brain fog! Weight training becomes a priority. 

3. Prioritise sleep like your brain depends on it

Because it does. Deep sleep is when your brain clears out metabolic waste and consolidates memories. Poor sleep makes every menopause symptom worse, especially brain fog. Support for good sleep is needed. 

If night sweats are wrecking your sleep, that's also not something to just put up with, it would benefit from treatment in the clinic. 

4. Manage your blood sugar

When your blood sugar crashes, so does your brain function. Eating regular meals with protein and healthy fats keeps your energy and focus steady.

Skipping meals or living on toast and coffee will make brain fog significantly worse.

5. Support your gut-brain connection

Your gut produces neurotransmitters that affect your mood and cognition. A healthy gut microbiome supports a healthy brain.

Include fermented foods, plenty of fibre, and consider a good quality probiotic. Gut testing may prove invaluable. 

6. Consider strategic supplementation

Omega-3s, magnesium, B vitamins, and vitamin D all support brain health. But quality matters enormously, and what you need depends on your individual situation.

7. Talk to your GP about HRT

Hormone replacement therapy isn't right for everyone, but for many women, it's genuinely life-changing for brain fog and cognitive symptoms. At this stage there needs to be more studies whether it reduces long term risk of dementia but many women find it supportive. That said, I see clients who feel worse on HRT and there are natural ways of addressing perimenopause too. 

🎯 The bottom line

Brain fog and other perimenopausal symptoms plus worsening ADHD and PMDD symptoms during perimenopause and menopause aren’t something you just have to tolerate. It's not proof that you're "past it" or losing your edge, it’s your brain navigating a massive hormonal shift, and with the right support, you can come out the other side sharper than before.

If you're struggling with brain fog, memory issues, (peri)menopausal symptoms, ADHD, PMDD or feeling like your brain just isn't working the way it used to, let's talk about what's actually going on and what would help.

Click here to book a chat.

We'll look at your symptoms, your hormones, your diet, and create a plan that actually makes sense for your life, because you deserve to feel mentally sharp again instead of just "okay for your age” !

Kirsten