Brain fog: The menopause symptom impacting women at work

A recent TV special highlighting the challenges of menopause showed the difficulties faced by many women around "brain fog" at work. Kathy Abernethy looks at how employers can support female employees to thrive through education and awareness.

The brain is the supercomputer that generates all thoughts, memories, dreams, emotions and ideas. No wonder, then, that brain fog can be such a disruptive and distressing impact of menopause for working women.

Thanks to recent media attention, such as Channel 4's Davina McCall: Sex, Mind and the Menopause, there's now increased awareness that declining oestrogen levels during the menopausal years can be associated with sudden forgetfulness and a lack of concentration. Some call it "cotton wool brain". More commonly it's "brain fog".

Despite the menopause discussion growing louder, many women still feel reluctant to talk about their symptoms in the workplace. Recent research from Peppy showed that just 22% of workers have spoken about menopause at work.

Given the residual stigma that still surrounds the topic of mental health, it's little wonder that hot flushes, rather than brain fog and other psychological impacts of menopause, are the symptoms society associates with this particular health journey. It's time to uncover the truth about brain fog, and for employers to take action.

What is brain fog?

Brain fog can feel similar to the effects of sleep deprivation or stress, and does not mean structural changes in the brain.

It has also been linked to stress, lack of sleep and - more lately in the press - long Covid. But now more attention is being paid to brain fog as a consequence of menopause, contributed to by fluctuating hormonal levels and worsened by other menopausal symptoms such as sleep issues.

In a study of 500 people, Peppy revealed that over 78% of people had experienced brain fog as an effect of menopause. Other common emotion-related symptoms include insomnia, anxiety, low mood and fatigue.

This means that brain fog - and the forgetfulness, self-doubt and imposter syndrome that may come with it - is an issue for workplaces to take seriously.

What's more, brain fog and other symptoms of menopause are not just limited to a short period of people's lives. They can begin months, or even years, before periods stop (known as the perimenopause - which typically starts in a woman's forties), and persist for an average of four years or more.

How does brain fog impact work?

The latest statistics show that one in four women consider leaving their job as a result of their menopausal symptoms - and one in 10 actually do.

Brain fog is just one of the many symptoms causing women with years of experience under their belts to drop out from the workplace. Some call it the menopause brain drain.

Practically, brain fog can cause people to forget what they are saying mid-sentence (or even mid-presentation). It can turn a seemingly simple task into one that takes hours, impacting employees' concentration and productivity at work.

Psychologically and emotionally, it can create immense stress in anticipation of meetings and deadlines, or even cause people not to speak up for fear they will lose their train of thought. All of this leads to more pressure, more stress and more anxiety; it can become a vicious cycle.

As a result of brain fog, colleagues may doubt their abilities, value and performance in the workplace, which can have a knock-on impact on the recruitment and retention of female talent.

From taking sick days to considering changing jobs or leaving the workplace altogether, the knock-on effect of brain fog has severe implications for employees and their employers.

What can employers do about brain fog?

Over the past few years, there has been a surge of companies drawing up specific menopause polices and offering menopause support.

In fact, research by REBA and Howdens has cited menopause as a top-emerging benefit in 2022. This is positive, but more can be done.

Starting a conversation around menopause can be challenging, which is why company-wide training and education is so important. For colleagues and line managers, the best first step is to ask how they are, and what they need - whether that's more breaks, more time before meetings, flexible working or someone to talk to. Crucially, line managers should understand the pathway of support.

Many organisations have successfully appointed menopause champions, or virtual or in-person "menopause cafés", as a practical way to raise awareness, break down stigma and encourage open conversations. This not only supports women, but also ensures the male workforce are educated and empowered, too.

As with any mental health-related issue, managers and HR teams should familiarise themselves with the signs of anxiety to help them spot when someone may be struggling. If an employee's behaviour seems different, for example they are missing deadlines, it's good to check in.

One major obstacle for people experiencing brain fog and other menopause symptoms is a general lack of awareness. Many don't recognise the signs, think there's something seriously wrong, or don't know where to turn for help.

Specialist support

This is where specialist menopause and mental wellbeing support can be invaluable. There are digital solutions available, for example, that enable colleagues to have conversations anonymously in private.

As well as confidential, expert advice, organisations should give employees access to trusted resources so they can access the latest news and information, without having to fall down a rabbit hole on Google.

This might include advice on HRT, which is proven to help with menopausal symptoms, as well as tips on improving stress, diet, and sleep, which can also help ease memory and concentration problems.

Having a culture of openness and inclusivity, where all employees feel they can talk about and seek support for their physical and mental health, can go a long way.

It needs to be clear that discussing symptoms - whether brain fog or something else - is a personal choice.

It starts with increased awareness - helping employees and those around them understand why they are suffering from brain fog, how to manage it, and that they're not going mad - and continues with practical guidance and expert support. This will help employers reap the rewards of a happier, healthier and more diverse workforce.