While you might know what happens to your body, no one really talks about what happens to your brain during menopause. We tend to zero in on physical symptoms like hot flashes and irregular periods, which are caused by changing hormones. But these hormones can also impact how you think, react, sleep, and so on.
Of course, one way to know you're entering menopause, which typically starts around age 51, is a lack of periods. "Since our periods can fluctuate during perimenopause (the phase when the ovaries start to produce less estrogen), you know you’ve truly hit menopause after you go 12 months without a period," Dr. Anna Cabeca, DO, FACOG, an author and triple board-certified doctor, tells Bustle.
Along with the end of your period, menopause can bring about weight changes, vaginal dryness, fatigue, and decreased libido, Cabeca says, as well as mental changes like brain fog and overwhelm. "It’s a power-packed combo of physical challenges and mental stressors," she says. And again, it all stems back to hormonal changes.
"Menopause is when the ovaries stop functioning and in turn, stop producing estrogen," Dr. Tristan Bickman, a board-certified OB/GYN and author, tells Bustle. "Brain fog is a common symptom," which is why many people complain about feeling "out of it" or fatigued. "The hormonal changes can affect the hippocampus," she says, "which is a structure in the brain related to memory."
Hormonal changes, as well as resulting hot flashes, can also make sleep hard to come by, which further impacts the brain. "One of the major problems for women in the perimenopause and menopause is sleep disturbance," Mary Jane Minkin, MD, a clinical professor of obstetrics, gynecology, and reproductive sciences at the Yale School of Medicine, tells Bustle. You might feel exhausted by 10 p.m. and fall asleep, she says, then wake up at 1 a.m., and repeat that annoying sleep/wake cycle throughout the night.
"This disrupted sleep can lead to many problems with memory and mood," Minkin says, which would be enough to bother anyone. But when you add in fluctuating estrogen and progesterone levels, and the impact that'll have on serotonin in the brain, that's when you'll get the mood swings associated with menopause. This can look and feel a lot like an overreaction to life's little problems. Think crying easily, feeling super angry, and lashing out for no reason.
"Many researchers [...] have shown that the lower estrogen levels themselves contribute to mood swings and memory issues," Minkin says. "The brain has tons of what we call estrogen receptors, which can misbehave when estrogen levels are low. The good news is that many of these researchers point out that once women are well through the menopause transition, the mood swings do get better."
In the meantime, there are plenty of ways to ease symptoms of menopause, and the impact it can have on how you think or feel. "Support systems may help some women," Dr. Shaughanassee Williams Vines, DNP, a doctorally prepared advanced practiced nurse and founder of HealthyHer Center for Women's Care, tells Bustle. "Therapy may help women dealing with mood changes. Some antidepressants have also been used widely in menopause symptom management," especially since these changes can lead to anxiety and depression.
Other people choose to try hormone replace therapy, Williams Vines says, or complementary or alternative treatments. "It really varies upon the person and the conversation they have with their health provider," she says. "However, all women should be made to feel [understood] and not like an outlier. This is a normal, natural process [...] Every woman has the right to feel how she does during this process, and she should be supported and given the proper resources."
It can also help to remember it will pass. Menopause and its symptoms don't last forever. So if it results in feelings of brain fog, a lack of sleep, mood swings, or memory issues, keep in mind it's all natural, and it's all temporary.
Dr. Anna Cabeca, DO, FACOG, author and triple board-certified doctor
Dr. Tristan Bickman, author and board-certified OBGYN
Mary Jane Minkin, MD, clinical professor of obstetrics, gynecology, and reproductive sciences at the Yale School of Medicine
Dr. Shaughanassee Williams Vines, DNP, doctorally prepared Advanced Practiced Nurse and founder of HealthyHer Center for Women's Care