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BRAIN
Your B.R.A.I.N. toolkit
Five ways to finally make sense of perimenopause
B
BalanceSound · Breathwork · Mindfulness
R
RecordSymptoms · Cycle · Libido · Notes
A
AdvocateData · Evidence · Questions prepared
I
InformSymptoms · Treatments · Supplements
N
NavigateTrends · Correlations · Patterns
Created by a researcher and professor — backed by peer-reviewed science, built from lived experience.
What you can do here
B
🎵
Balance — Sound therapy
6 hormone-synced sessions
Layerable nature sounds
Breathwork & mindfulness
Nervous system support
B · Balance
R
🌫️
Record — Daily tracker
Mood, fog, sleep, energy, libido
Hot flashes & cycle tracking
Ovulation signals
Add your own symptoms
R · Record
A
📋
Advocate — Clinician report
Symptom & cycle summary
Supplement list for your Dr./GP
Questions to ask prepared
Evidence to prevent dismissal
A · Advocate
I
🧭
Inform — Understand & learn
What is happening and why
HRT, BHRT & other treatments
Daily habits with the science
Evidence-rated supplements
I · Inform
N
☀️
Navigate — Insights & patterns
Brain fog trend chart
Sleep vs fog correlation
Cycle & symptom patterns
Updates as you log
N · Navigate
Daily hormonal & cycle check-in
Track your symptoms daily to build a picture for your Dr./GP. NICE Guideline NG23 states perimenopause should be diagnosed on symptoms alone.
How are your hormones today?
Tracking today:
🌫️ Brain fog · 🌊 Mood · 🌙 Sleep quality · 🌡️ Hot flashes · ⚡ Energy · 💗 Libido · 🔴 Menstrual flow · 🌕 Ovulation signals · 📅 Cycle day · 📝 Notes
Scale: 1 = barely noticeable · 3 = affecting your day · 5 = very difficult/drastically changed (applies to all symptoms including libido)
🌫️ Brain fog
-
🌊 Mood
-
🌙 Sleep
-
🌡️ Hot flashes
-
⚡ Energy
-
💗 Libido
-
Cycle tracking
Day 1 is the first day of full bleeding. Irregular cycles are completely normal in perimenopause.
🔴 Period flow today
📅 Tap the day your last period started
🌕 Ovulation signals
Signs: clear stretchy discharge, pelvic twinge, slight temperature rise, energy peak. In perimenopause ovulation becomes irregular.
📝 Optional notes
Your own symptoms
Add anything not listed above
Perimenopause has over 40 known symptoms. Add your own to track — skin changes, hair thinning, or anything else you are experiencing.
Common ones women add
No custom symptoms added yet. Tap a suggestion above or type your own.
Other notes
Optional · saves with check-in
Anything else worth noting — medication changes, stressful events, unusual symptoms, how you felt overall.
This week
Patterns
Last 7 days
Log a few days to start seeing patterns here.
B · Balance
Guided breathwork
Why breathwork works: Slow, controlled breathing directly activates the vagus nerve — shifting your nervous system from fight-or-flight to rest. This is measurable within minutes via heart rate variability.
Mindfulness and breathwork regulate the nervous system that amplifies every perimenopause symptom — not by replacing hormones, but by shifting your baseline from fight-or-flight toward rest.
A 2025 systematic review of 19 RCTs found mindfulness improves sleep quality and stress in menopausal women
A 2024 RCT: yoga twice weekly for 10 weeks reduced somatic symptoms by 50–65%
Slow breathing at ≤6 breaths/min raises heart rate variability within minutes
Meditation reduces cortisol and increases serotonin — directly relevant to mood
Note: NAMS 2023 does not recommend mindfulness for hot flashes specifically, but evidence for mood, anxiety and sleep is stronger. NAMS 2023 source
🔲
Box breathing
4-4-4-4 pattern — calms the nervous system fast
Anxiety · Stress
🌙
4-7-8 sleep breath
Extended exhale activates parasympathetic rest
Sleep onset
🌊
Coherent breathing
5 breaths/min — maximum HRV and vagal tone
HRV · Vagal
🧘
Body scan
Progressive relaxation from head to toe
Sleep · Tension
❄️
Hot flash breath
Cooling nasal breath to reduce heat response
Hot flashes
🎶
Humming breath
Bhramari — vagus nerve stimulation through vibration
Vagal toning
Sound therapy sessions
🎵
0:00
🔈50%
🌫️
Brain fog lift
Neptune bowl — clear resonance for mental clarity
Clarity · Focus
🌊
Hot flash calm
Solfeggio 417 Hz — frequency of transformation
417 Hz · Release
🌙
Sleep onset
Moon bowl with binaural beats — deep rest
Binaural · Delta
🌿
Anxiety release
Dhanistha 555 Hz — nervous system settling
555 Hz · Calm
☀️
Mood lift
Venus bowl — biorhythm harmonics for emotional balance
Venus · Harmony
🔥
Perimenopause rage
Ganesha bowl — deep grounding to discharge intensity
Grounding · Deep
Why these sessions work: Oestrogen directly regulates how your brain processes sound. As it declines, the nervous system becomes hyperreactive — these sessions use that same pathway to support regulation.
Layer nature sounds
Natural soundscapes measurably reduce cortisol. Add beneath any session or use standalone.
🌧️
Rain at night
Nervous system calm
Parasympathetic
🌲
Forest birdsong
Grounding and clarity
Grounding
🌊
Ocean waves
Mood and stress relief
Rhythm
🔥
Crackling fire
Focus and comfort
Warmth
💧
Flowing stream
Anxiety relief
Anxiety
⛈️
Thunder storm
For intense moments
Release
Evidence-rated supplements
Toggle to track: Tap any row and switch I take this to Yes to log it. Your supplement list feeds directly into your clinician report so your Dr./GP sees exactly what you are taking.
SupplementEvidenceDoseI take this
Magnesium glycinate
Sleep, anxiety, brain fog
200-400mg
No
Ashwagandha
Stress, hot flashes, focus
300mg x2/d
No
Omega-3 (EPA/DHA)
Mood, cognition, brain fog
1-2g/day
No
Magnesium threonate
Brain fog, memory, sleep depth
1.5-2g/day
No
Vitamin D3 + K2
Bone density, mood, immunity
2000-4000 IU
No
Lion's mane mushroom
Brain fog, memory, concentration
500mg-1g
No
Black cohosh
Hot flashes, mood
20-40mg
No
Evidence key: Green = strong clinical evidence. Gold = emerging/promising. Always discuss with your Dr./GP before starting, especially if taking HRT or other medications.
Your clinician report
Log at least 2 weeks to generate a meaningful report.
Appointment prep
Your symptom data, ready for your Dr./GP. Walk in with evidence, not just words.
Most impactful symptom
Based on your logs
Log symptoms to see
Supplements taking
Currently logged
None logged yet
Days tracked
Total
0 days
Avg brain fog score
Past 7 days
No data yet
NICE Guideline NG23 (updated 2024): For women aged 45+, perimenopause should be diagnosed on symptoms alone — blood tests are not required. Quote this to your Dr./GP if needed.
Questions to ask your Dr./GP
Tap any category to expand. Screenshot or print before your appointment.
💊
About HRT and hormones
+
Am I a good candidate for HRT based on my symptoms and history?
What form of oestrogen would you recommend — patch, gel, or spray?
What type of progesterone would you prescribe — micronised or synthetic?
Can I try testosterone for brain fog or low libido?
How long can I safely take HRT?
How will we monitor how it's working?
What are the risks specifically for someone with my history?
🌫️
About brain fog and cognitive symptoms
+
Could my memory and concentration issues be related to perimenopause?
Should I be concerned about dementia, or is this expected and temporary?
Would HRT help my brain fog based on the evidence?
Should I have my thyroid, vitamin D, B12, or iron checked?
Are there referrals you'd recommend for cognitive support?
📋
About diagnosis and testing
+
NICE Guideline NG23 states that for women aged 45+, perimenopause should be diagnosed on symptoms alone. Can we proceed on this basis?
If you want to do a blood test, I understand FSH levels fluctuate significantly — how will you account for that?
Could any of my symptoms have another cause we should rule out?
What bone density screening do you recommend given my oestrogen decline?
🌙
About sleep, mood and mental health
+
My sleep has significantly deteriorated — what options do we have beyond sleep hygiene?
I've been experiencing what I can only describe as rage and emotional instability — could this be hormonal?
Should I be referred for CBT or mindfulness-based therapy alongside any medication?
I want to avoid antidepressants if possible — what are the evidence-based non-antidepressant options?
💗
About libido and sexual health
+
My libido has significantly decreased — I understand this is a common hormonal symptom. What are my options?
Can you prescribe testosterone specifically for low libido? I understand this is a licensed treatment.
I'm experiencing vaginal dryness and discomfort — would local vaginal oestrogen help, and is it safe?
Understanding your symptoms
Tap any symptom to understand the science behind it, what helps, and when to see your Dr./GP.
🌫️
Brain fog
Memory, concentration and word-finding linked to oestrogen decline.
Most common
🌡️
Hot flashes
Sudden heat waves from the brain's thermostat losing oestrogen calibration.
Vasomotor
🌙
Sleep disruption
Night sweats, racing mind and early waking cascade from hormonal shifts.
35-60% of women
🌊
Mood and rage
Oestrogen modulates serotonin and dopamine — when it drops, mood destabilises.
Neurotransmitters
⚡
Fatigue
Deep tiredness combining disrupted sleep, hormonal and adrenal changes.
Energy
🧠
Memory lapses
Oestrogen receptors in the hippocampus — memory is directly affected.
Cognitive
🦴
Joint pain
Oestrogen's anti-inflammatory role declines, allowing inflammation to rise.
Musculoskeletal
💓
Palpitations
Heart rhythm irregularities — common, often unrecognised, usually benign.
Common + benign
💗
Low libido
Testosterone and oestrogen both decline. Biological, not psychological. Score 1 if unchanged, 5 if severely impacted.
Hormonal
🌸
Skin changes
Clogged pores, bumps, sagging, dryness and thinning — oestrogen's role in collagen production is significant.
Collagen
💇
Hair thinning
Oestrogen and testosterone both affect hair follicle cycling — thinning is a very common but often underdiscussed symptom.
Hormonal
💧
Vaginal & urinary changes
Dryness, discomfort, UTIs and bladder changes — oestrogen receptors throughout the genitourinary system mean these symptoms are direct and treatable.
GSM
Daily habits
Evidence-backed daily habits
Research-backed daily practices. Tick what you manage today — no streaks, no guilt.
🥗
Mediterranean diet
Brain-protective eating pattern
Today
Omega-3 rich, fresh vegetables, wholegrains, fish, olive oil. Supports heart and brain health as oestrogen's cardioprotective effect declines.
Source: Nutrition and Cognitive Health: A Life Course Approach
🏃
150 min movement per week
Walking, cycling, swimming, strength training
Today
45-60 min of moderate exercise improves memory, focus and problem-solving. Strength training especially important — women lose muscle mass during perimenopause.
Source: Physical Activity and Health During the Menopausal Transition
😴
Sleep hygiene
7-9 hours — most underrated brain treatment
Today
Cool bedroom, no caffeine after 2pm, consistent schedule. Hot flashes worsen in warm rooms. 35-60% of menopausal women experience disrupted sleep.
Source: Sleep Problems and Menopause — NICE
🧘
10-20 min mindfulness
Daily practice with proven cognitive benefits
Today
10-20 min daily improves focus and reduces cortisol — the stress hormone that compounds brain fog. The sound sessions support this.
Source: Mindfulness-based Programs and Cognitive Function
🧩
Brain training
Puzzles, learning, reading, conversation
Today
Builds cognitive reserve. Crosswords, learning new skills, reading — all improve attention and memory especially when oestrogen's neuroprotective role is reduced.
Source: Prevention of Cognitive Impairment in Midlife Women
💧
Hydration + reduce caffeine
Especially important with hot flashes
Today
Dehydration worsens brain fog. Hot flashes increase fluid loss. Caffeine after 2pm disrupts sleep architecture. Alcohol worsens brain fog and can trigger hot flashes.
Clinical treatment
Clinical treatment options
Perimenopause is manageable. Below are the main clinical treatment categories. Guidance evolves — always check sources and discuss with your Dr./GP.
Perimenopause is manageable. Below are the main treatment categories — tap each to understand your options.
Important: This information is linked to authoritative sources that update regularly. Medical guidance evolves — always check the source date and discuss with your Dr./GP.
💊
Hormone Replacement Therapy (HRT)
The most effective treatment for perimenopause symptoms
+
HRT replaces oestrogen (and usually progesterone) that the body produces less of during perimenopause. It is the most effective treatment for hot flashes, night sweats, brain fog, mood instability, sleep disruption, and joint pain. It also protects bone density and has cardiovascular benefits when started within 10 years of the final period.
Forms available: patches, gels, sprays (oestrogen) + tablets, Mirena IUS, or vaginal pessaries (progesterone). Route of administration affects risk profile.
Key facts: For most healthy women under 60, benefits significantly outweigh risks. The 2002 WHI study that caused widespread fear was later found to be flawed — it used oral synthetic hormones in older women. Current guidance is substantially more positive.
Plant-derived hormones structurally identical to those the body produces
+
Bioidentical hormones are chemically identical to hormones produced by the human body. FDA-approved bioidentical options include oestradiol and micronised progesterone (Prometrium/Utrogestan) — these are prescribed regularly by menopause specialists and have a strong evidence base.
Important distinction: Regulated bioidentical hormones (prescribed by a Dr./GP) are evidence-based and safe. Compounded bioidentical hormone pellets or creams from specialist pharmacies are unregulated, untested for consistency, and not recommended by NAMS or NICE.
Micronised progesterone (bioidentical) has a better safety profile than synthetic progestogens — it is associated with lower breast cancer risk and fewer side effects.
Emerging evidence for brain fog, libido and energy in women
+
Testosterone is not just a male hormone — women produce it too, and levels decline significantly in perimenopause. Evidence supports testosterone supplementation for low libido in perimenopausal women. Emerging research also suggests benefits for brain fog, energy and mood, though this is less established.
Testosterone is a licensed treatment in many countries but is often not routinely offered. You can ask your Dr./GP for it by name. It is typically prescribed as a gel applied to the skin.
Several non-hormonal prescription medications have evidence for perimenopause symptoms. NAMS (2023) recommends these at Level I evidence:
Fezolinetant (Veozah) — FDA-approved 2023 for hot flashes. A neurokinin 3 receptor antagonist — works on the brain pathway that triggers hot flashes. SSRIs/SNRIs — e.g. paroxetine, venlafaxine. Reduce hot flashes and improve mood. Low doses effective. Gabapentin — evidence for hot flashes, sleep and anxiety. CBT — strong Level I evidence for mood, anxiety and hot flash management without medication.
These 7 supplements were selected based on the
NAMS 2023 Nonhormone Therapy Position Statement,
peer-reviewed systematic reviews, and clinical consensus among menopause specialists. Evidence ratings reflect current literature — not marketing claims. This list will evolve as evidence develops — always check sources and discuss with your Dr./GP.
How to use this table: Toggle I take this to mark which supplements you currently take. This logs them to your clinician report and your daily tracker, so your Dr./GP can see your full supplement picture alongside your symptoms.
SupplementEvidenceDoseTaking
Magnesium glycinate
Sleep · Anxiety · Brain fog
200-400mg
No
Vitamin D3 + K2
Bone · Mood · Immunity (NAMS recommended)
800-2000 IU
No
Omega-3 (EPA/DHA)
Mood · Cognition · Brain fog
1-2g/day
No
Ashwagandha
Stress · Hot flashes · Focus
300mg x2/d
No
Magnesium threonate
Brain fog · Memory · Sleep depth
1.5-2g/day
No
Lion's mane mushroom
Brain fog · Memory · Concentration
500mg-1g
No
Black cohosh
Hot flashes · Mood — NAMS: insufficient evidence
20-40mg
No
Evidence key: 🟢 Green = strong clinical evidence. 🟡 Gold = emerging evidence. Always discuss with your Dr./GP, especially if taking HRT or other medications. Source: NAMS 2023
Other supplements you take
Add anything not in the list above — vitamins, herbs, prescription supplements, protein powders, etc. These will appear in your clinician report.
Add a supplement
Daily habits with the evidence behind them
Research-backed practices that support brain health during perimenopause. Tick what you manage today — no streaks, no guilt.
🥗
Mediterranean diet
Brain-protective eating pattern
Today
Omega-3 rich, fresh vegetables, wholegrains, fish, olive oil. Supports heart and brain health as oestrogen's cardioprotective effect declines. Avoid fried foods, processed snacks and saturated fats.
Source: Nutrition and Cognitive Health: A Life Course Approach
🏃
150 min movement per week
Walking, cycling, swimming, strength training
Today
45-60 min of moderate exercise improves memory, focus and problem-solving. Strength training is especially important — women lose muscle mass during perimenopause.
Source: Physical Activity and Health During the Menopausal Transition
😴
Sleep hygiene
7-9 hours — the most underrated brain treatment
Today
Cool bedroom, no caffeine after 2pm, no alcohol, consistent sleep schedule. Hot flashes worsen in warm rooms. 35-60% of menopausal women experience disrupted sleep.
Source: Sleep Problems and Menopause — NICE
🧘
10-20 min mindfulness
Daily practice with proven cognitive benefits
Today
10-20 min daily improves focus and cognitive performance. Reduces cortisol — the stress hormone that compounds brain fog. The sound sessions in this app support this.
Source: Mindfulness-based Programs and Cognitive Function
🧩
Brain training activity
Puzzles, learning, reading, conversation
Today
Builds cognitive reserve. Crosswords, sudoku, learning new skills, reading — all improve attention, memory and processing speed especially when oestrogen's neuroprotective role is reduced.
Source: Prevention of Cognitive Impairment in Midlife Women
💧
Hydration + reduce caffeine
Especially important with hot flashes and night sweats
Today
Dehydration worsens brain fog. Hot flashes and night sweats increase fluid loss. Caffeine after 2pm disrupts sleep. Alcohol worsens brain fog, disrupts REM sleep and can trigger hot flashes.
Your patterns and trends
Calculated automatically from your logged data. Log daily for 2+ weeks to see meaningful patterns.
Log at least 3 days of symptoms to see your patterns here.
About this app
Why I built PerimenoBrain
From a researcher who has lived this
I'm a researcher and professor at a research university with degrees from Harvard and Oxford. I built this app while navigating perimenopause myself — alongside a late ADHD diagnosis — because I was stunned by how hard it was to find evidence-based information that wasn't buried in academic journals or diluted by wellness nonsense.
This app is what I wished existed: science you can trust, designed for a brain that's already working hard enough.
We do not collect, store, or sell any of your health information
Where is my data stored?
On your device only, in your browser
Device only
Does it go to a server?
Never. No internet connection needed.
No server
Is it sold to third parties?
Absolutely not. Ever.
Never
What if I clear my browser?
Data is erased — export monthly to be safe
Export first
📊 Your data dashboard
Everything stored on your device
📅 Daily logs
Symptoms, mood, cycle tracking
0 days
💊 Supplements tracked
What you're taking
0
✅ Habit check-ins
Daily wellness habits
0 days
🩸 Cycle tracking
Period start date
Not set
🏃 Sessions this week
App opens
0
⏱️ First used
When you started tracking
—
📱 PWA installed
Home screen install
No
📈 Feature usage
Which parts of the app you use most
🎵 Sound sessions played
0
🧘 Breathwork sessions
0
🌲 Nature sounds played
0
📝 Notes written
0
📊 Reports viewed
0
Important: Install this app to your home screen to protect your data from accidental browser clearing. Export your data monthly as a backup.
Install to your home screen
The safest way to use Perimenopause Brain
iPhone (Safari): Tap Share → Add to Home Screen → Add Android (Chrome): Tap ⋮ menu → Add to Home Screen → Add Desktop (Chrome): Click the install icon in the address bar → Install
Export and back up your data
Download everything as a JSON file
Your export contains all symptom logs, cycle data, supplement tracking, notes, and usage statistics. Import it to restore your data.
⚠️ Clear all data
Delete everything stored on this device
This will permanently delete all your symptom logs, cycle data, supplements, and settings. This cannot be undone.