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Your Brain on Menopause

Hormone surges and dips throughout menopause affect your brain as well as the rest of your body. Here's what happens and why, and how to cope.
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WebMD Feature
Reviewed by Louise Chang, MD

You have this incredible best friend named Hannah. And you have been through it all, together - marriage, pregnancy, parenting, job promotions, job loss, spousal problems, maybe even divorce. There isn't anything that you and Hannah haven't shared in your lifelong friendship. You couldn't be closer if you were sisters.

Then one day you meet Hannah for lunch. You're wearing this brand new blue sweater and you can't wait to get her opinion on it. But when you ask her how she likes it, she says it's nice -- but comments that she likes you better in pink.

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KABOOM! In an instant, your best friend turns into the wicked witch of the West! You're feeling hurt beyond belief, immediately convinced she's always been jealous of you, and, totally certain that the only reason she said you look better in pink is because you actually look better in blue! Within moments you work yourself up into believing she was never really your friend at all.

What's going on? It's just your brain -- on menopause! A time when everything can seem topsy-turvey, when you cry at the drop of a hat, when every single molehill looks like a mountain, and, yes, a time when even a seemingly innocent comment from a good friend can leave you screaming mad or unbearably hurt.

Menopause Hormones Affect the Brain, Too

But what's happening, and why? In a word, the answer is "hormones."

"The constant change of hormone levels during this time can have a troubling effect on emotions ... leaving some women to feel irritable and even depressed," reports the American College of Obstetricians and Gynecologists.

Indeed, while everyone thinks of hormones as the chemicals that drive our reproductive system, in truth, there are receptors for both estrogen and progesterone throughout our body.

When these hormone levels begin to decline, as they do in the months and years leading up to menopause, every system that has these hormone receptors registers the change, and that includes your brain.

And while most of us can recite chapter and verse about what happens to our uterus or ovaries around this time (including problems like irregular bleeding or declining fertility), we hear very little about what happens when the hormone receptors in our brain begin running on empty!

What does happen? A disruption in an entire chain of biochemical activity, which in turn affects the production of mood-regulating chemicals, including serotonin and endorphins.

The end result: Mood swings, temper tantrums, depression, surprising highs followed by equally unexpected lows -- and none of it seems to make any sense.

"Your ovaries are failing and trying to keep up estrogen production. Some days they overshoot it, other days they can't produce enough," says Darlene Lockwood, MD, assistant professor at the University of California in San Francisco.

Each time your hormones do a little dance, your brain chemistry has to compensate. When the change is small, that compensation occurs quickly, and you hardly notice any symptoms.

But when it's more dramatic, an entire range of unexpected behaviors can come alive: You burst into tears when the bakery is out of rye bread. You weep uncontrollably during a greeting card commercial. You find that one minute you're loving your son's new girlfriend and the next you have an overwhelming urge to push her face into a cream pie. And nothing seems to make any sense.

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