What’s that word again?!

I’m an avid reader and a writer who prides herself on a quite decent command of the English language. So imagine my frustration: deep in conversation with a close friend, struggling to find the precise word to convey my thoughts. That nuanced noun or apt adjective evades me, dangling just out of reach at the wispy edges of my cognition until I just give up and use the next best but totally unsatisfactory turn of phrase. Super frustrating!! (The word came the next morning: it was "validation"! 😏)

Now that's annoying enough over coffee. But when it starts happening in board meetings and team huddles, in the middle of giving a lecture or a patient consultation, that's when it stops being funny. Losing your thread mid-sentence, buying time with "sorry, where was I?", over-preparing for presentations you'd have winged two years ago. You quietly start to wonder if something is seriously wrong. This isn't just about forgetting where you put your keys or looking for the phone that's right in your hand. (Of course that hasn't happened to me! 🤦🏾‍♀️)

Brain fog.

The research describes it as “difficulty with word retrieval, processing speed, verbal memory, attention, and working memory.” But for women who have built careers, led teams, held everything together, brain fog impacts identity as much as function. Your self-worth is wired to your competence. So the fog doesn't just slow you down. It shakes your confidence, your professional identity, and sometimes your sense of who you are. Many of us mask it through over-preparing, perfectionism, and rigid routines. Some withdraw from opportunities they'd have grabbed before.

About 60% of women report cognitive changes during the menopause transition. Interestingly, the SWAN study found that cognitive processing speed declined more rapidly in Black women compared to White women during midlife. Black women were also less likely to report cognitive symptoms, which doesn't mean they experience them less. It likely means they're less likely to raise it with a doctor, whether because of cultural expectations around strength, mistrust of medical settings, or simply not having the language or permission to name it.

Recent research confirms measurable structural changes in the brain during perimenopause: grey matter volume decreases in the regions responsible for memory, decision-making, and word retrieval.

The reassuring part: these changes are typically mild, variable, and distinct from dementia. Fog often peaks in late perimenopause and improves within 12-24 months after the final period as the brain adapts to its new steady state.

Your brain is not breaking. It is recalibrating.

Next time, I want to talk about what's actually driving the fog, because it's not just one thing. And understanding your particular combination of causes is the first step to clearing it.