Why can't I remember anything?

The word is in there. Your brain is just busy looking for sharks.

There is a particular moment in perimenopause when you forget something completely ordinary and think, Oh shit. Is this dementia?

You can't remember why you walked into the room. You lose the word halfway through a sentence. You call your children by every name except their own, and occasionally the dog's. You read the same paragraph three times and still have no idea what it said.

The information is still in there. Your brain has just developed a delay, and it's taking its sweet bloody time to retrieve anything.

That's brain fog.

Brain fog is a catch-all for a cluster of symptoms: forgetfulness, poor concentration, losing words, slower thinking and that slightly spacey feeling of being a step behind yourself.

Some days it's like thinking through a bowl of mushy peas. You know your brain works. It just won't do it on command.

For women in their 40s and 50s, perimenopause is often a big part of the picture.

Oestrogen is only part of the story

Changes in memory, attention and word-finding are commonly reported through the menopause transition, and hormonal changes affect the parts of the brain involved in memory. But if we put it all down to falling oestrogen, we miss most of what's going on.

Look at what else this stage of life is asking of you.

Your sleep is all over the place. Night sweats wake you at 2am. Anxiety has turned up uninvited. You've got teenagers or adult children who still take up an extraordinary amount of brain space, parents who are getting older, and a job, a household and possibly a business to run. All while trying to remember where you put your phone.

And then we add stress.

Your stressed brain isn't interested in the lady's blue swimsuit

Imagine you're swimming at the beach and someone yells "SHARK!"

You're not going to look across the water and think, That lady's blue swimsuit is lovely. Did the kids put sunscreen on? Does my arse look big in this?

You're going to swim.

Your attention narrows to the one thing that matters: get out of the water. Broad, curious, meandering thinking is no use when something is trying to eat you. That's your brain doing its job.

The problem is that most of us aren't dealing with actual sharks.

Our sharks are deadlines, arguments, money worries, ageing parents, children who need us, the phone that never stops and the seventeen unfinished things running quietly in the background.

When stress is constant, your brain stays in shark mode. It keeps scanning for danger and putting whatever feels urgent first. Concentration, flexible thinking and finding the right word all get harder, because your brain has quietly decided they can wait.

So when someone tells me their memory has gone to pot, I'm interested in their brain. I'm equally interested in how much their whole system is being asked to carry.

How are you sleeping?

Sleep is when your brain files the day. It sorts what you learned, lays down memories and resets your emotional thermostat for tomorrow. Skip it and the filing piles up.

A poorly slept brain feels remarkably like a broken one. You concentrate less, react slower, reach for words and come up empty, and simple tasks take twice the effort.

Perimenopause sets up a perfect storm. Hormonal shifts disrupt sleep. Hot flushes wake you. Stress wakes you. The bad night leaves you foggier, moodier and less able to handle stress the next day, which makes the next night harder again.

So before you decide your brain is failing you, my first question is a simple one.

How are you sleeping?

Your brain has company

We tend to talk about the brain as the CEO upstairs, running everything else. In reality it's listening to the rest of you all day long.

Your body, your gut, your emotions, your hormones, your environment and your history all feed information upward. Your head's job is to translate it.

And the head is terribly dramatic. You forget one word, and within three seconds it has you booked into a memory clinic. It won't let the truth get in the way of a good story.

So instead of jumping straight to "What's wrong with my brain?", widen the questions.

What am I sensing in my body?
What am I feeling?
What am I moving towards, or pulling away from?
And then: what else could this mean?

Your head gets a voice. It just shouldn't be the only voice in the room.

Feed the thing

Your brain runs on fuel, and it notices when you skip meals.

Start with actual food. Protein at breakfast, around 30 grams: eggs, Greek yoghurt, last night's leftover chicken. Healthy fats through the day: olive oil, avocado, nuts, oily fish a couple of times a week. Something colourful on the plate at lunch and dinner. A glass of water before the second coffee.

Then look at the pattern. If breakfast is a long black and a prayer, followed by nothing until 1pm, the 3pm slump is no mystery. If you're grazing on crackers and muesli bars all day without a proper meal, your energy will lurch up and down right along with them.

Keep the coffee.

Just give it some company.

When to get it checked

Brain fog is common in perimenopause. Hormones still shouldn't automatically get the blame for every change.

If your fog is persistent or getting worse, see your GP and ask for bloods: iron studies, B12 and folate, thyroid function and vitamin D. Medications, alcohol, mood and other health conditions can all play a part too.

Memory problems that are getting worse quickly, that interfere with everyday life, or that come with other neurological changes need a proper medical assessment. Don't sit on those.

Where to start

Pick one thing and start there.

• Protect your sleep. Same bedtime most nights, phone out of the bedroom.

• Eat a protein breakfast before the coffee does all the talking.

• Get outside and move for 20 minutes.

• Give your brain stretches of time with one tab and one task.

• Notice how much stress you're carrying, and what you could put down.

Most of the time, the fog is your brain putting first what it thinks matters most.

The trouble is, right now it thinks everything is a shark.

If you're reading this nodding along, book an initial consult. We'll look at your sleep, your stress load and your plate, and work out what your fog is actually made of.

Not ready to book? Grab my free checklist, What's Driving Your Anxiety Today?.It walks you through the hidden everyday triggers that keep your brain on shark watch.