The “Tip of the Tongue” Phenomenon: Why You Can’t Find Simple Words in Perimenopause
The "Tip of the Tongue" Phenomenon: Why You Can't Find Simple Words in Perimenopause
Understanding why word-finding difficulty happens, and why it's not what you fear.
5 min readYou're introducing a colleague you've worked with for three years. You open your mouth, and her name is simply gone. Not fuzzy. Not uncertain. Vanished. You smile through the pause, gesture vaguely, and your brain finally releases the word five minutes later, when it no longer matters.
Or you're in a meeting, mid-sentence, reaching for a word you've used a thousand times. A common word. And there's just... nothing. A blank space where language should be.
This feels like the beginning of something serious.
Let's address that fear directly.
Is Forgetting Words in Perimenopause a Sign of Dementia?
Word-finding difficulty is one of the most commonly reported symptoms during perimenopause. It is also one of the most misunderstood. Many women experiencing this phenomenon spend months quietly terrified that they're watching the early signs of dementia. They're not.
Why does perimenopause cause word-finding difficulty? Research suggests that fluctuating estrogen levels may temporarily disrupt the brain's glucose metabolism, affecting the energy available for rapid word retrieval. This creates a retrieval lag, where words take longer to access, rather than memory loss. The knowledge itself remains intact.
Your vocabulary hasn't shrunk. Your intelligence is fully intact. The retrieval system is simply working with less consistent fuel.
This distinction matters enormously.
Brain Fog vs Dementia: The Difference Between Lag and Loss
Here is the reframe that changes everything:
Cognitive lag means slower retrieval. The word exists. The memory is stored. The pathway to reach it takes longer than it used to, or occasionally glitches.
Cognitive loss means the information is gone. Erased. No longer accessible because it no longer exists.
Cognitive loss means the information is gone.
What you're experiencing is lag, not loss.
What most women experience during perimenopause is lag, not loss. The word you couldn't find in the meeting? You remembered it later. The name that vanished? It came back. This pattern of delayed retrieval followed by eventual recall is the hallmark of a temporary processing slowdown, not a permanent deletion.
The difference between these two experiences is not subtle. It's the difference between a slow internet connection and a hard drive that's been wiped.
Why Does Perimenopause Affect Word Recall?
Your brain is remarkably energy-hungry. Though it accounts for only about 2% of your body weight, it's estimated to consume roughly 20% of your daily glucose. Every thought, every memory retrieval, every word you speak requires fuel.
Estrogen plays a supporting role in how efficiently your brain metabolizes that fuel. When estrogen levels are stable, energy delivery tends to be consistent. When estrogen fluctuates, as it does during perimenopause (sometimes dramatically, within the span of days), that energy delivery can become inconsistent.
How fluctuating estrogen may affect brain energy availability
Think of it like a dimmer switch. The lights don't go out, but the voltage fluctuates. Sometimes the room is bright and clear. Sometimes it dims for a moment before coming back.
During those dimmer moments, tasks that require rapid-fire processing (like retrieving a specific word under social pressure) may take longer. The system isn't broken. It's adapting to a new electrical reality.
This is also why the difficulty often feels worse when you're tired, stressed, or under time pressure. Those conditions already tax your brain's energy budget. Add hormonal fluctuation to the mix, and the retrieval lag becomes more noticeable.
Does Word-Finding Difficulty Get Better After Menopause?
The perimenopause transition: fluctuation, then adaptation
For most women, these cognitive symptoms are most noticeable during the transition itself, when hormonal fluctuation is at its peak. Research suggests that many women report improvement after menopause, once hormone levels stabilize at their new baseline and the brain has adapted accordingly.
This isn't a trajectory of decline. It's a period of adjustment.
Why Forgetting Words Feels So Frightening
Knowing the biology doesn't erase the experience.
It's embarrassing to lose a word in front of people. It's frightening to feel your brain hesitate when it used to be quick. It's disorienting to not trust a mind you've always relied on.
And it's especially difficult in a culture that treats cognitive changes in midlife women as either a punchline or a crisis.
Your frustration is valid. Your fear makes sense. And neither of those feelings means something is seriously wrong.
You are not less intelligent than you were. You are not losing yourself. You are navigating a biological transition that affects systems you were never taught to expect would change.
What Comes Next
This article isn't going to end with a fix, because there isn't a quick one. And anyone who promises otherwise is oversimplifying.
What there is, instead, is an invitation.
The more you understand about how your brain uses energy, the less frightening these moments become. The more you recognize lag for what it is, the easier it becomes to wait out the pause without panic. And the more we talk about this openly, the less isolated any of us have to feel when the word just won't come.
Your brain is still yours. It's still working. It's just working with different inputs than it used to.
That's worth understanding.
This article is for educational purposes only and is not intended to diagnose, treat, or replace professional medical advice. If you have concerns about cognitive changes, please consult a qualified healthcare provider.
