For decades, women in midlife have been told that brain fog—forgetfulness, losing words mid-sentence, struggling to concentrate—is “just part of ageing.” Yet the truth is, most cognitive assessments were designed for older populations or clinical conditions like dementia and head injury, not for women aged 40-60, navigating the menopausal transition.

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This gap has left millions of women without a validated way to measure what they experience daily: lapses in memory retrieval and difficulties with focus that can undermine confidence, productivity, and wellbeing.

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A 2023 study by Zhu and colleagues changed that. Researchers evaluated the Everyday Memory Questionnaire-Revised (EMQ-R), originally a 35-item tool developed for head injury, then refined into a 13-item version. They tested it specifically in women aged 40 to 60 going through the menopausal transition .

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417 women completed the questionnaire, grouped as pre-menopausal, peri-menopausal, or early post-menopausal. What the study revealed was striking:

• Perimenopausal women scored worse in memory retrieval than pre- and post-menopausal women.

• Attention scores did not significantly differ across groups, suggesting that the primary issue in midlife “brain fog” may be about retrieving information, not overall attention span .

 

This is crucial. Many of us fear that forgetting names, walking into a room and losing our train of thought, or rereading the same paragraph three times is the start of dementia. Yet these findings highlight that midlife brain fog has its own distinct pattern—and can now be assessed with reliability.

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Why It Matters

Research increasingly suggests that the menopausal transition is a critical neurological window. Oestrogen has powerful neuroprotective effects; as it declines, the brain’s ability to metabolise glucose for energy can drop by up to 30%. This is one reason why perimenopause and menopause are associated with increased risk of cognitive changes, and why some researchers suggest this stage could signal vulnerability to later dementia risk.

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But here’s the empowering part: brain fog does not equal brain decline. With the right tools, we can measure it, track it, and address it before it becomes a long-term issue.

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Introducing the Brain Fog Self-Check

At GenX Reset, we’ve adapted the validated 13-item EMQ-R questionnaire used in the Zhu et al. study to create a self-check tool for women aged 40 to 60. Each question asks how often, in the past month, you’ve experienced specific everyday lapses—like forgetting why you walked into a room or losing track of a conversation.

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You’ll rate yourself on a scale from 0 to 4 (from “once or less in the past month” to “once or more a day”). This gives you a score between 0 and 52.

 

What Does Your Score Mean?

• Low scores (below average): Brain fog is less likely to be impacting your daily life—but don’t ignore prevention. Supporting oestrogen metabolism, metabolic flexibility, and sleep are key to protecting long-term brain health.

• Average scores: You’re experiencing a “typical” level of brain fog for your stage. This still matters, because even average fog can undermine your work performance, relationships, and confidence.

• Above average scores: This suggests your attention and retrieval difficulties are more pronounced. It doesn’t mean dementia—but it does mean your brain needs support, now.

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The Next Step

This is where science meets action. If your score feels concerning—or you simply want clarity—our new Brain Fog Self-Check Quiz will help you understand where you stand. You’ll also receive tailored strategies from the GenX Metabolic Reset Guide to support your brain and metabolism together, because the two are inseparable.

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And in November, I’m running the Brain and Belly Reboot Live course—a 14-day program designed to help midlife women reboot their cognitive clarity and metabolic health in tandem.

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Take the quiz today. Know your score. And start your reset with the confidence that your brain is not broken—it just needs the right support.

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References

1. Zhu, C., Thomas, E. H., Li, Q., Arunogiri, S., Thomas, N., & Gurvich, C. (2023). Evaluation of the Everyday Memory Questionnaire-Revised in a menopausal population: Understanding the brain fog during menopause. Menopause. Advance online publication. https://doi.org/10.1097/GME.0000000000002256

2. Andy, C., Nerattini, M., Jett, S., Carlton, C., Zarate, C., Boneu, C., ... & Mosconi, L. (2024). Systematic review and meta-analysis of the effects of menopause hormone therapy on cognition. Frontiers in Endocrinology, 15, 1350318. https://doi.org/10.3389/fendo.2024.1350318

3. Ismail, Z., Crockford, J. F. E., Guan, D. X., et al. (2024). Menopausal symptom burden as a predictor of mid- to late-life cognitive function and mild behavioural impairment symptoms: A CAN-PROTECT study. medRxiv. https://doi.org/10.1101/2024.03.13.24304247