With Menopause, Brain-Healthy Behaviors Make a Difference

Women 35 and older may benefit during the menopause transition by engaging in six key brain-healthy behaviors, according to a recent AARP Research survey.  In separate online focus groups, women’s experiences highlighted a need for accessible, evidence-based information to help guide women through the menopause transition.

The six brain-healthy behaviors — maintaining a well-balanced diet, staying social, exercising, managing stress, regularly getting enough restorative sleep, and engaging in mentally stimulating activities — all have the potential to aid women as they approach, enter, and transition to postmenopause. Women who regularly undertake these brain-healthy behaviors tend to experience benefits to their mental health and well-being regardless of where they are in the menopause transition.

The protective benefits, however, are particularly pronounced during perimenopause, the time leading up to menopause, which typically begins in a woman’s mid-40s and lasts between two and eight years. (Menopause is the period when menstruation ceases and a woman has gone a full 12 months without a menstrual period or spotting.) It’s during perimenopause that women fare worse on mental health outcomes, compared to other women. Not only are they more likely to experience stress, brain fog, focus issues, fatigue, forgetfulness and other brain-related challenges, but they may also encounter such common symptoms as hot flashes, night sweats, joint and muscle pain, irritability, or weight gain. In the post-menopause stage, symptoms tend to ease, but many still experience them.

Brain-healthy behaviors are a tool

The good news is that women at all stages of menopause who engage in brain-healthy behaviors at least three times a week have better mental health outcomes and fewer brain-health challenges compared to women who engage in these behaviors less often.

Women who regularly adopt the brain-healthy behaviors at least three days per week have higher levels of mental well-being and lower levels of depression, anxiety, and stress compared to women overall.

Addressing brain fog

The benefits of brain-healthy behaviors are particularly evident with respect to the common complaint of brain fog. For U.S. women 35 or older, those who engage in all six brain-healthy behaviors at least three days per week are less likely to experience brain fog — even in perimenopause.

More than half of women (62%) experience brain fog at least sometimes when they engage in two brain-healthy behaviors at least three days per week. But when women engage in all six brain-healthy behaviors, less than a quarter (23%) experience brain fog.

For women in the perimenopause stage, the benefit of regularly adopting all six brain-healthy behaviors is striking, with 69% reporting brain fog when engaging in two behaviors three days a week compared to 44% reporting the symptom when engaging in all six behaviors three times a week.

Brain fog is an important factor to measure because its presence is tied to other mental health outcomes. Those who currently experience brain fog, regardless of the stage of menopause, have lower average mental well-being scores and higher levels of depression, anxiety, and stress.

As a follow-up to the survey research, online focus groups further explored women’s experiences with the menopause transition and how they felt about the care they received from medical providers. Women described their transition as confusing and unpredictable, marked by unexpected symptoms, inconsistent medical guidance, and little preparation for what to expect. 

What women told us about entering perimenopause

Focus group participants said they began menopause without the information they needed.  Many did not recognize that the symptoms they were experiencing were related to hormonal changes, instead attributing them to stress, aging, sleep issues, or other unrelated health concerns.  They also worried about how long symptoms would last and how mood changes might impact their relationships.

How women experience brain fog and cognitive changes

Many women in the focus groups reported feeling disoriented by what was happening to their bodies. Cognitive symptoms like brain fog, difficulty concentrating, and forgetfulness made them feel confused and overwhelmed. Women also reported receiving conflicting guidance about available treatments and the risks and benefits associated with those options.

Navigating the health care system

While the survey research showed that engagement in brain-healthy behaviors may ease perimenopause and menopause related symptoms, focus group participants reported wanting clear evidence-based guidance from their health practitioners. Conflicting or unclear information made it difficult to determine what advice was evidence-based, and many women encountered obstacles to receiving care. Many women also described feeling responsible for initiating conversations, evaluating options, and coordinating care on their own, often with limited guidance or follow-up.

Focus group participants described gaps across four areas: limited proactivity, insufficient empathy, inadequate clinician knowledge and patient education, and a lack of personalized treatment strategies.

What this means

Together, these findings point to a need for more accessible, evidence-based information about perimenopause and menopause to help women recognize symptoms and make informed decisions.  Clear and trusted resources can help guide women through the menopause transition with greater clarity, confidence, and support.

Methodology

The AARP survey focused on brain and mental health outcomes across the different stages of menopause (premenopause, perimenopause, and postmenopause), along with their relationship to engagement in brain-healthy behaviors.

The online survey of 1,413 women 35 or older was conducted June 17 to 30, 2025, and took an average of 12.7 minutes to complete. This sample of women represents a subset of the overall sample (n=3,596). The data were weighted based on the U.S. Census Bureau’s Current Population Survey and the American Community Survey.

The focus groups explored the experiences of women with perimenopause (n=38) or menopause (n=44) symptoms who had spoken with a health care professional about these symptoms in the previous six months.  The groups were conducted online from October 30 to November 10, 2025.

For more information, please contact Laura Mehegan at lmehegan@aarp.org. For media inquiries, contact External Relations at media@aarp.org.