The Menopause Brain

by Lisa Mosconi

women are: Twice as likely as men to be diagnosed with an anxiety disorder or depression. Twice as likely to develop Alzheimer’s disease. Three times more likely to develop an autoimmune disorder, including those that attack the brain, such as multiple sclerosis. Four times more likely to suffer from headaches and migraines. More likely to develop brain tumors such as meningiomas. More likely to be killed by a stroke.

a woman in her fifties is twice as likely to develop anxiety, depression, or even dementia in the course of her lifetime as she is to develop breast cancer.

Some of the most common emotional changes associated with menopause include irritability, anxiety, and a diminished ability to deal with life’s everyday hassles. Feelings of sadness, fatigue, lack of motivation, and difficulty concentrating can also arise, along with emotional flatness, trouble getting motivated, or a sense of overwhelm.

More than half of all perimenopausal women sleep less than seven hours a night. For context, over 70 percent of premenopausal women sleep more than that—a significant jump. One in three perimenopausal women have trouble not only falling asleep but also staying asleep, waking up multiple times per night.

According to recent statistics, over 60 percent of all perimenopausal and postmenopausal women struggle with brain fog.

even during this phase, women outperform men on those very same cognitive tests measuring memory, fluency, and some forms of attention. That’s true both before and after menopause.

the highly specialized HPG and brain-estrogen networks ensure that our brains and ovaries are closely connected, on an hour-to-hour basis, and that this connection has wide-ranging effects not only on the body but also on our emotions, sensations, and ability to think and remember.

the health of the ovaries is linked to the health of the brain, and the health of the brain is linked to the health of the ovaries.

Perimenopause: Most women indeed grow unhappy in the three years or so building up to menopause. After menopause: Life satisfaction tends to remain low for two to three years after the final menstrual period, but then increases well past baseline and remains steadily higher over time.

Multiple studies indicate that contentment is relatively high in young adulthood but slowly drops and hits a low point at about age fifty (the average age of menopause). Then it steadily climbs to new heights later in life. Believe it or not, by the time we’re in our sixties, it’s statistically probable that we’ll never have been happier.

American anthropologist Margaret Mead called it “menopausal zest”—the rush of physical and psychological energy some women experience after menopause.

As Oprah Winfrey once said: “So many women I’ve talked to see menopause as a blessing. I’ve discovered that this is your moment to reinvent yourself after years of focusing on the needs of everyone else.”

self-transcendence. Or, as some may put it, “giving fewer f***s.”

postmenopausal women are the ultimate empaths.

grandmother hypothesis proposes that ceasing reproduction around age fifty, and living to tell the tale, allowed older women to devote care and resources to their children’s children rather than birthing and nurturing new ones themselves. Since the process of childbirth becomes riskier with age, this seems like it might be nature’s way of leveraging a savvy bet.

having had a blood clot is considered a “soft” contraindication that requires further evaluation.

The route of HRT administration can also make a difference, as the risk of stroke and blood clots is lower with transdermal routes.

you have agency over your lifestyle, environment, and beliefs. These factors can play a significant role in shaping your experience of menopause.

brisk walking for 30 minutes three times a week was effective at reducing insomnia, irritability, and fatigue in midlife women.

In practical terms, walking 6,000 or more steps per day is associated with a decreased risk of heart disease and diabetes in women ages forty and over. Augmenting that target toward 9,000 to 10,000 steps may lower your risk of dementia, too.

engaging in one hour a day of low-intensity physical activities has a favorable effect on menopause symptoms and overall quality of life.

the Mediterranean diet is considered plant-centric, without being overly restrictive. Fresh vegetables and fruit, whole grains, legumes, and a variety of nuts and seeds are the stars of the show. Small amounts of seafood, eggs, or poultry are other typical entrées, while dairy and red meat are consumed sparingly and in moderation. Unrefined plant oils, like extra-virgin olive oil and flax oil, are the condiment of choice, paired with local vinegar or a squeeze of lemon juice. Bouquets of herbs and spices are used to flavor foods instead of table salt. Meals are often accompanied by a glass of red wine and finished off with a fragrant espresso—both rich sources of antioxidants. Desserts, including handmade pastries and artisanal gelato (made with high-quality ingredients), are not a daily event but are eaten with gusto on weekends or special occasions.

you want to be sure extracts are standardized to contain a certain percentage (typically 25 percent) of ginkgo flavone glycosides, the herb’s active constituents.

purchase products indicating testing by either the U.S. Pharmacopeial (USP) Convention Dietary Supplement Verification Program or ConsumerLab.com.

chronic stress is actually bankrupting your hormones.

Cortisol, our number one stress hormone, works in tandem with our sex hormones. That’s because the body relies on the same molecule, called pregnenolone, to make both sex hormones and stress hormones, and sometimes it has to make a choice as to the lucky recipient.

This hormonal sleight-of-hand can in turn promote hot flashes, anxiety, and even the potential for depression. Additionally, menopause itself, depending on how you wear it, can become a chronic stressor in your life, especially when left unattended.

self-care is not selfish. You matter, too. Nobody can pour from an empty cup.

women’s brains act a bit differently from men’s. Research shows that as cortisol and adrenaline flood the bloodstream, women’s brains release a shot of the love hormone, oxytocin, which works to be the calm amid the storm. Scientists suspect that the release of oxytocin may be behind women’s unique impulse to tend and befriend, rather than fight or flee, when under stress.

Journey into Stillness (audiobook) by Ramdesh Kaur, Meditation for Beginners by Jack Kornfield, and Wherever You Go, There You Are by Jon Kabat-Zinn (both available in several formats).

EWG Skin Deep (www.ewg.org/skindeep) or Campaign for Safe Cosmetics (www.safecosmetics.org) for more information on companies that use clean ingredients and have eco-friendly policies.

Women are often measured by things we cannot and should not be expected to control—whether it’s our age, every inch of our silhouette, or our menstruation status. But none of those measurements will ever reflect who you are or what you’re made of. Your experiences, thoughts, actions, and accomplishments are the only worthy indicators of what’s inside your mind and heart. And the only metric that’s worth remembering about midlife is that it is precisely what the term implies: the middle. If this phase of life starts with a deep respect for what your brain and body can achieve and have achieved, then you are poised to usher in the kickoff of even richer and more fulfilling seasons ahead.

the Japanese word for menopause is konenki. Literally translated, ko means renewal and regeneration, nen means year or years, and ki means season or energy.