Brain fog isn't just annoying, it’s one of the most disruptive symptoms of midlife. And according to Dr. Heather Hirsch on The Tamsen Show, it’s also one of the most misunderstood.
In two separate studies, one at Harvard and one at her current practice, Dr. Hirsch found brain fog was the #1 symptom impacting women’s quality of life. Not hot flashes. Not night sweats. Brain fog.
“We’ve been told it’s normal to feel ‘off’ or forgetful, but estrogen actually plays a major role in how your brain functions,” she said. Estrogen helps regulate serotonin and supports memory and cognition. When it drops, the brain’s chemistry, and performance, can shift dramatically.
The challenge? Many women are misdiagnosed with depression or prescribed antidepressants when the root cause is hormonal. And because hormone therapy isn’t FDA-approved for mood, most providers don’t offer it as a solution, even though it can be one of the most effective treatments.
This isn’t just frustrating. It’s dangerous. Dr. Hirsch cited the long-term consequences of misdiagnosis, from unnecessary psychiatric meds to delayed care for bone and heart health.
“I would love to see a randomized control trial comparing SSRIs to estrogen for mood changes,” she said, but in the meantime, she urges women to advocate for themselves.
If you’ve been handed a prescription but never had a conversation about estrogen, this episode is for you.
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