npj Women's Health
The study compared self-reported cognitive symptoms with performance on online cognitive tasks in a large community cohort. Brain fog and memory concerns were more commonly reported in peri- and postmenopause than before menopause, but objective task performance differed only minimally between groups.
That supports taking brain fog seriously without assuming one simple cause. Mood, sleep, stress, vasomotor symptoms, and other health factors may sit together, so visit notes should capture what changed and how it affects daily life.