Both menopause and mental health are getting more attention at the moment which is great! However, looking at them in relation to each other is still a bit of a gap which means many women are struggling with symptoms that are being misunderstood and misdiagnosed.
We also need to be clear on the terminology around menopause. Menopause marks the end of a woman’s menstrual cycles and is officially 12 months after her last period. It’s the years leading up to this, the ‘perimenopause’ when women can really struggle with a multitude of symptoms. Typically it starts in your mid-40’s but it can start as early as your mid-30’s!
Everyone has heard about the night sweats and hot flushes, but less talked about are the mental and emotional symptoms that can leave previously healthy, high functioning, active women feeling like they are living in someone else’s body not knowing what’s hit them!
Given that women make up 50% of the population and that menopause is inevitable for every woman, it’s concerning that there is still such a lack of information or misinformation, even amongst healthcare professionals, that means antidepressants are still a very common first line treatment approach with no consideration that it might be due to declining hormone levels.
Debilitating symptoms coupled with a lack of good support can make this a very lonely and isolating time in a woman’s life. We need to do better!
Menopause and mental health are connected
The transition to menopause has a significant impact on women’s brains with many symptoms being neurological in nature…even the more physical ones such as hot flushes and night sweats are actually triggered by changes in the part of the brain that regulates temperature.
The ovaries and the brain have a strong communication line between them. During perimenopause the conversation becomes distorted, hormone production becomes erratic, and all kinds of symptoms may surface that can leave you feeling like you’re going crazy.
The key hormones at play
Hormone imbalances can dictate symptom severity during perimenopause and beyond. And it’s not all about the sex hormones. Yes, they play a key role but there are others that can also have an impact on your mental health and you need to be paying attention to all of them.
Oestrogen – the big one! It can fluctuate wildly during perimenopause until it eventually declines when you reach menopause. With receptors throughout the brain, particularly in the areas responsible for cognition and emotion, it’s no wonder that women start to experience brain related symptoms during this time. Too too much can make you irritable and anxious while too little can make you depressed, foggy, and over-emotional.
Progesterone – nature’s tranquiliser! Progesterone promotes the neurotransmitter GABA which has a calming effect on the brain. As you start to skip ovulation during perimenopause, progesterone starts to fall which can trigger symptoms of anxiety, low mood, insomnia and even memory loss and brain fog.
Testosterone – super important for women too! Beyond its role in muscle mass and libido, low testosterone can cause low motivation and drive, poor concentration, lack of energy, low mood, irritability, and increased anxiety. Yet remarkably, testosterone is not licenced for women in the UK or NZ as part of hormone replacement therapy (HRT) in the same way that oestrogen and progesterone is.
Cortisol – your main stress hormone! Both high and low levels can influence neurotransmitters in the brain such as serotonin (the ‘happy’ one), dopamine (the ‘feel good’ one) and GABA (the ‘calming’ one). Imbalances can leave you feeling tired and wired, experiencing sleep disturbances, feeling anxious and overwhelmed or depressed, fatigued, and foggy.
Thyroid – makes every single cell in your body work! Too little, a common risk factor during perimenopause (especially if you’re stressed), and everything slows down including brain function. Cue fatigue, brain fog, memory loss, depression, and anxiety.
Insulin – your blood sugar regulator (and fat storage hormone)! Women are at greater risk of insulin resistance in perimenopause which means it’s less effective at getting sugar out of your blood and into your cells for energy, including your brain cells. This can have a huge impact on your mood, concentration, and energy levels.
As you can see there is a lot of overlap between the key hormones and symptoms. They are also very much interconnected, with levels of one hormone potentially impacting levels of another. This can make it tricky to know which one/ones may be out of whack.
Balance your hormones to support your mental health
As a woman you can’t avoid perimenopause but there are things within your control that can help to keep your hormones balanced, alleviate symptoms and reduce the impact on your day-to-day life and long term health.
Nourish your body
Now is the time to nourish your body with the right foods and nutrients to support your hormones, brain health and blood sugar balance. What you eat during this stage of life really matters! Focus on phytoestrogens (soy, flaxseeds) to help balance oestrogen levels, cruciferous vegetables (broccoli, cauliflower, cabbage) to support oestrogen detoxification, quality protein, healthy fats, wholegrains and lots of colourful veggies to balance blood sugar levels and support your brain.
Manage stress
Self-care is non-negotiable at this time! How well you manage your stress can determine how good or bad your symptoms are. Get some ‘me time’ every day! Whether it’s reading, walking in nature, meditation or taking some deep breaths, plan it in!
Prioritise sleep
Poor sleep can exacerbate all your other symptoms. It will increase cravings, make you not want to exercise and reduce your stress resilience. Focus on sleep hygiene. This is the time to stop treating sleep like a luxury!
Exercise well
How you exercise may need to change at this time. Ease up on the high intensity, include more restorative exercise to calm your body and mind, and increase strength and resistance training to build muscle mass and protect your bones. Moving more is important but over-exercising can be damaging so find the right balance for you.
Minimise toxins
Many of the products we use as women contain chemicals that can disrupt our hormones. From skin care and makeup to cleaning products to scented candles and air fresheners. As you replace these products, replace them with more natural brands.
Get tested
Get a full picture of how your key hormones are behaving as well as your gut health (an unhappy gut can have a big impact on your hormones and brain health). This can help you get to the root cause, find hidden underlying imbalances and get results much quicker.
Consider HRT
For some women HRT can be a game changer. The 2002 study that scared women about all the risks was badly designed, poorly analysted and based on synthetic HRT. Body identical HRT is a natural and safe option and the benefits can far outweigh any risks. Be informed so you can make the choice that is right for YOU!
If you suspect your mood related symptoms may be linked to your hormones or you’d like more information on the comprehensive tests I offer, please CONTACT me for more information on how I can help.
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