Welcome to our Doctor’s Q&A corner!

Today, Dr Virdi will be answering questions on Mood, Sleep and Cognitive Changes during pero-menopause and menopause.

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Question: "Is brain fog or memory difficulty normal, and when should I be concerned? Could my mood changes or anxiety be related to hormonal shifts? What can I do to improve sleep quality during this stage?”

Answer:

Is brain fog or memory difficulty normal, and when should I be concerned?

Brain fog and reduced concentration are common symptoms during perimenopause and menopause. They can vary in severity, from mild and manageable lapses—like walking into a room and forgetting why—to more disruptive issues, such as struggling to keep track of important tasks at work or responsibilities at home. These symptoms can understandably feel distressing and may affect confidence, work performance, and relationships.

Lifestyle measures are always the first step in managing menopausal symptoms. Prioritising good sleep, regular physical activity, balanced nutrition, and stress management can make a meaningful difference. However, if cognitive symptoms become more troublesome, hormone replacement therapy (HRT) can be very effective for some people and is worth discussing with your GP.

It’s important to seek further medical advice if symptoms are persistent, worsening, or not improving with treatment. In particular, progressive memory difficulties—especially those noticed by family members or affecting daily functioning—should be assessed more thoroughly. In these cases, it’s advisable to consult your GP to rule out other causes.

”Could my mood changes or anxiety be related to hormonal shifts?”

Yes —mood changes and anxiety are common during perimenopause and menopause. Many women experience symptoms such as low mood, tearfulness, irritability, and increased anxiety. These changes are often linked to fluctuating hormone levels, particularly oestrogen, which can affect brain chemistry and emotional regulation.

As with other menopausal symptoms, lifestyle measures are the first step. Regular exercise, good sleep, a balanced diet, and stress management can all help support mood and overall wellbeing.

If symptoms persist or begin to have a significant impact on daily life, it’s important to seek medical advice. Hormone replacement therapy (HRT) can be helpful for some women, as it works to stabilise hormone levels and reduce these fluctuations. This can be discussed with your GP, who can guide you on the most appropriate options.

“What can I do to improve sleep quality during this stage?”

Sleep disturbances are common during perimenopause and menopause, but there are several ways to improve sleep quality.

Start with good sleep hygiene. Aim to keep a regular sleep schedule and create a calm, comfortable environment—ideally a dark, quiet, and cool bedroom. Try to avoid screens or TV in the hour before bed, as blue light can interfere with your natural sleep cycle. Relaxing routines such as a warm bath or shower before bedtime can also help signal to your body that it’s time to wind down.

Some over-the-counter supplements, such as magnesium, may support sleep in certain individuals. Melatonin can also help regulate the sleep–wake cycle, although it’s best used with guidance from a healthcare professional.

It’s generally advisable to avoid regular use of prescribed sleeping tablets where possible, as they can be habit-forming and are not a long-term solution.

If sleep problems persist, it’s important to recognise that chronic insomnia can take time to improve and often requires a consistent, gradual approach. If symptoms are ongoing or significantly affecting your daily life, consider speaking with your GP to explore further support and treatment options.