When the Words Just… Vanish
Have you ever walked into a room and completely forgotten why you were there? Or struggled to find a simple word mid-conversation — one you know you know — only to feel like it’s been wiped from your brain?
If this sounds familiar, you’re not alone. As a healthcare provider and a woman navigating perimenopause myself, I see (and feel) this symptom all the time: the mental fog, the blank moments, and the frustrating feeling of searching for thoughts that just won’t come.
Let’s talk about it.
What Is Happening in Your Brain?
During perimenopause, your estrogen levels fluctuate and since estrogen is deeply involved in brain function, including memory, focus, and verbal fluency, these dips and surges can take a toll.
In short: your brain is not broken. It’s trying to adapt to a hormonal rollercoaster.
Estrogen helps regulate:
Blood flow to the brain
Glucose metabolism (aka your brain’s fuel)
Neurotransmitter activity (including serotonin and dopamine)
When estrogen drops, the brain doesn't always get what it needs to perform at its best and that can show up as:
Forgetfulness
Difficulty concentrating
Word-finding problems
Slower mental processing
“I Literally Lost My Train of Thought…”
I can’t tell you how many times I’ve had a sentence trail off because I just lost the word. One time during an Urgent Care shift, I completely forgot the name of the otoscope — you know, “the thingy that you use to look in ears.” I stood there in front of another provider and the staff saying, “You know…the ear looker thing…the wall gadget…thing-a-ma-jig…” Total brain freeze. Eventually, someone rescued me with, “You mean the otoscope?” Yep. That.
Talk about frustrating, even embarrassing, especially for those of us juggling careers, families, and daily responsibilities.
And the worst part? Most of us were never taught this could be a normal (but fixable!) part of perimenopause.
So, What Can You Do About It?
Here’s the good news: you don’t have to live in a mental fog.
Some of the most effective strategies include:
Bioidentical Hormone Replacement Therapy (BHRT): Rebalancing hormones can help restore cognitive clarity for many women, and yes, the science backs this up.
Prioritize Sleep: Sleep disturbances from night sweats or insomnia can compound brain fog. Improving sleep hygiene or getting help with hormones can be a game-changer.
Fuel Your Brain: Nutrient-dense foods, omega-3s, and hydration all matter. Your brain needs consistent energy, especially during hormonal shifts.
Minimize Alcohol: Even a glass or two can feel like a cognitive wrecking ball during perimenopause (trust me, I learned the hard way).
Give Yourself Grace: This isn’t a personal failing or a sign of aging, it’s biology. Be kind to yourself.
You’re Not Losing Your Mind — Just Your Estrogen
If you’ve ever joked that you feel like you’re “going crazy” or losing your edge, I want you to know this:
You are still you. Your sharp, capable, amazing mind is still there, it just might need a little support.
And if no one ever told you this could be part of perimenopause? Same here. That’s exactly why I talk about it, because you deserve to know what’s really going on.
Final Thoughts
Brain fog. Word loss. “What was I saying again?” moments. They’re common, but that doesn’t mean you have to live with them.
If you’re experiencing these symptoms and wondering what’s normal (and what’s fixable), I offer free 15-minute consultations to help you figure out if hormone therapy could be right for you.
Let’s clear the fog together.
