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.

Medically Reviewed by Louise Chang, MD
From the WebMD Archives

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.

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 progesteronethroughout 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.

Menopausal Mood Swings: What to Do

The very first thing you must realize is that no, you're not losing your mind. You may be acting crazy, feeling crazy, thinking crazy thoughts -- but basically, you're OK. And no, you don't have to force yourself to sit on the "naughty stool" until perimenopause is over.

But there are a few key things you can try that might make a huge difference. Among the most important: Reduce stress in your life.

How can this help? According to Harvard University stress expert Alice Domar, PhD, the effect of stress on hormone activity can be so profound that it is capable of inducing symptoms. Reducing stress can have the opposite effect.

In studies she conducted, Domar reports that women who participated in organized relaxation saw a 30% decrease in their hot flashes, plus a significant drop in tension, anxiety, even depression. They also reported fewer mood swings and more stable emotions overall.

The good news: Reducing even small stresses in your life -- or simply setting aside some time every day to relax and unwind -- can not only affect hormone balance but have a dramatic effect on your mood swings.

Another important suggestion: Whenever you do have an emotional upset, such as feeling very angry, step back, take a deep breath, and let a little time pass before you act on your dancing emotions. Chances are, when the mood swing passes -- as it always does -- you might not have the need to lash out at someone who probably doesn't deserve it.

At the same time, if the mood passes and you still feel the same way, then by all means do what you must to clear the air. While many problems can temporarily seem bigger than they are during this time of life, real problems can also occur. But taking a little time between action and reaction may be all you need to know the difference.

Sleep Your Way to Happier Menopause

While hormones influence your mood and your temper, what can make everything seem worse is a lack of sleep. And if getting a good night's rest seems to be getting harder during this time of life, you're not alone.

A study published in the journal Menopause in 2001 observed that "insomnia is a frequently reported complaint in menopausal women."

The reason: You may be sleeping - or wanting to sleep -- but your estrogen levels are still up dancing all night long. And that continual action can interrupt healthy sleep.

This, in turn, reduces both the quantity and quality of your sleep, and when that happens hormones can go further off kilter, filling your waking hours with even more symptoms, particularly emotion-based problems.

But there are ways to induce better midlife sleep and in doing so help control some menopause symptoms. According to natural health expert Susan Lark, MD, herb teas of valerian root taken 45 minutes before bedtime might induce a deeper and more restful sleep. Passionflower or chamomile tea may have a similar effect, she says.

What you should avoid: Hot and spicy foods, as well as caffeine, at least several hours before bedtime. They may keep you awake and increase hot flashes, even in your sleep.

And relaxation can also have a positive effect on sleep. Cornell University sleep expert Samuel Dunkell, MD, says that taking 20 to 30 minutes to engage in a particularly relaxing activity right before going to bed may help you fall into a deeper sleep faster -- and that means more and better quality rest can be yours.

Also, if hot flashes and "night sweats" are causing you to wake up, taking steps to sleep "cooler" can help. Sleepwear should be 50/50 cotton/polyester, and you should avoid nylon nighties or PJs. They can hold in body heat that may cause you to wake more easily if you do get a hot flash in your sleep.

Finally, sleeping with a window open and using light covers may provide the most help of all, since remaining cool during the night can help net you some better quality and more restful slumber. And that, in turn, may help control mood swings for a whole day.

Published July 2005.
Medically Updated August 2006.

Show Sources

SOURCES: Your Perfectly Pampered Menopause: Health, Beauty, and Lifestyle Advice for the Best Years of Your Life, by Colette Bouchez. New York: Broadway Books, 2005. American College of Obstetricians and Gynecologists: " Managing Menopause." Darlene Lockwood, MD, assistant professor, University of California, San Francisco. Alice Domar, PhD, director, Mind/Body Center for Women's Health, Beth Israel Deaconess Medical Center; assistant professor of obstetrics, gynecology and reproductive biology, Harvard Medical School. Menopause, November 2001; vol 8. Susan Lark, MD, nutrition and midlife health expert, Los Altos, Calif. Samuel Dunkell, MD, assistant professor of psychiatry, Cornell University Medical College, New York.

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