Menopause metamorphosis: Menopause brain

Menopause brain…We say it like it’s a bad thing. We laugh it off as if it’s a joke when deep down we wonder if we’re losing our mind. It’s not a joke. And it’s not a loss either. It’s actually an update. During perimenopause and menopause every system in our body gets a giant hormonal update over the course of a decade or so.  And just like when we update our computers or our phones, it takes time to learn the new systems. Things might look a little different on the home page than what we’re used to. The drop down menus change.  That’s our Work IN today. We’re looking at how and why a woman’s brain changes through menopause.

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Transcript

Ep 173 Menopause brain

Menopause brain…We say it like it’s a bad thing. We laugh it off as if it’s a joke when deep down we wonder if we’re losing our mind. It’s not a joke. And it’s not a loss either. It’s actually an update. During perimenopause and menopause every system in our body gets a giant hormonal update over the course of a decade or so.  And just like when we update our computers or our phones, it takes time to learn the new systems. Things might look a little different on the home page than what we’re used to. The drop down menus change.  That’s our Work IN today. We’re looking at how and why a woman’s brain changes through menopause.

Menopause isn’t the only time the brain changes. It happens in the other 2 major transitions as well, puberty and the onset of menstruation and during pregnancy. All driven by levels of estrogen and other hormones as well.And that makes sense because we need different things in different seasons of our lives. We need our brain to be ready to do different things for us. Just think about all the things mothers need to be on top of when they’re raising kids. Now when the nest is empty why would you need to spend the energy to maintain all the same neural connections? It’s really expensive metabolically so of course the body and brain is going to reorganize. But in the moment that reorganization can feel scary.  And I think that as we go through today you’ll be able to see more of how all these things are connected and maybe feel a little better about the whole transition.

Here’s what we need to understand first.

The typical symptoms that we associate with menopause, hot flashes, night sweats, insomnia, memory lapses, depression, anxiety, those symptoms don't start in the ovaries. They actually start in the brain.

This is because of the connection through the HPA/HPG axis.

We’ve talked about the HPA axis, that's the hypothalamus Pituitary Adrenal axis, the system that is responsible for our stress response and all the stress hormones  that are associated with fight or flight. The HPG is the Hypothalamus Pituitary Gonadal axis and it connects the HYpothalamus pituitary glands with the ovaries in women and presumably the testes in men. 

Hypothalamus -> charge of regulating body temperature + signaling the production of hormones from the pituitary

Pituitary gland ->. 

follicle stimulating hormone (FSH) — which is involved in the reproductive system

luteinising hormone — which is also involved in the reproductive system

prolactin — which controls breast milk production

growth hormone — which regulates growth

adrenocorticotrophic hormone (ACTH) — which tells the adrenal glands to make hormones

thyroid stimulating hormone (TSH) — which tells the thyroid gland to make hormones

Your pituitary gland also stores and releases:

oxytocin — which is involved in childbirth and breastfeeding

vasopressin — which helps control the amount of salt and water in your body

These hormones affect your:

metabolism

blood pressure

reproduction

other vital body functions and other important endocrine glands like

thyroid gland

adrenal glands

reproductive glands — ovaries and testes

Connect all of this to the ovaries and ovarian health. Because this is a network there’s a lot of interplay within it. In other words levels of estrogen and progesterone coming from the ovaries are going to affect other things in the other direction.

According to Dr. Lisa Mosconi, author of The Menopause Brain “the health of the ovaries is linked to the health of the brain and the other way around.” Estrogen, particularly estradiol, is key for energy production in the brain.  “At the cellular level, estrogen literally pushes neurons to burn glucose to make energy. If your estrogen is high, your brain energy is high. When your estrogen declines, though, your neurons start slowing down and age faster.” This was found independent of chronological age. 

Some of our most common menopause symptoms: night sweats or depression, anxiety, brain fog, memory lapses are very likely caused by energy changes in the brain. 

Although this is probably the most understudied area of health despite its inevitability for 51% of the population of the planet so this is just a theory at this point. What we do know based on some studies is that there is actually also some structural adaptation that happens in the brain through the menopause transition that could explain many of the major symptoms women experience until post menopause when those adaptations seem to resolve including changes in gray matter volume. In other words the brain seems to kind of get used to the lower levels of estrogen.

A couple things to keep in mind: 

Any major hormone upheaval may be a trigger and exacerbate other hormone related or dependent diseases. 

And some of the more disturbing cognitive symptoms through perimenopause like brain fog and memory loss don’t seem to be permanent long term. (statistically) Subjectively that might feel different to you.

There still is no irrefutable proof when it comes to memory and cognition that menopause alone causes and is responsible for all of the worst symptoms we associate with this transition. In other words it’s not necessarily the only thing going on. This is evidenced by the fact that no 2 women experience the same thing. And there are significant lifestyle levers that have powerful influence on all these adaptations as well.

According to Dr. Mosconi there are things we can do to avoid most of the symptoms with those lifestyle changes. 

2 ways to avoid menopause symptoms. 

The first thing is to pay attention to our diet. The Mediterranean diet is high in healthy fats (great for the brain) and lots of phytoestrogens from nuts, seeds, fruits and vegetables and by default great fiber and clean protein has been shown to help improve symptoms. We’re going to talk about the gut health connection and diet in more detail next week. How and what we eat plays a major role in our hormone balance no matter what season of life we’re in.

The other major lever we have is to lower stress levels. And maybe you’re thinking, duh, or here she goes again but it bears repeating because now you maybe be able to see how that HPG axis that we talked about overlaps with the HPA axis and our stress response.

Our adrenals produce adrenaline and cortisol in response from signals from the hypothalamus and pituitary gland to trigger our fight/flight response as well as to regulate metabolism, blood pressure, immune system and blood sugar to name a few. What you might not know however is that they take over some estrogen production after the ovaries retire. Not at the same level of course but they do try to fill in the gap at a much lower level. 

There are actually 3 types of estrogen produced by the ovaries; the main one is estradiol during childbearing years, estriol is produced during pregnancy. After menopause the body makes  estrone which is produced primarily by fat. (that’s right, there might be a real reason our body composition changes so quickly. It might be that the body needs more fat for the estrone) but that doesn’t just happen. The adrenals pick up the slack. (The A in the HPA) The process starts in the adrenal glands where they produce a hormone called androstenedione which is a precursor to estrone and kicks off the process in fat cells.  

Why is that important? Because estrogen has a non reproductive role in our overall health: Cholesterol levels.

Blood sugar levels.

Bone and muscle mass.

Circulation and blood flow.

Collagen production and moisture in your skin.

Brain function, including your ability to focus. 

It’s kind of cool that we’re designed like this with this backup mechanism but the important thing to understand is that the adrenals also make cortisol which is inversely related to estrogen. In other words, when you’re stressed out the body isn’t going to bother with any kind of estrogen production and if the adrenals are already overloaded with excessive cortisol production it’s not going to have a lot left for estrogen. This is true pre and peri menopause  as well. Because before menopause the adrenals play a supporting role in our sex hormone balance.

So we can make this transition easier on every system in the body including the brain by finding ways to lower our stress. 

What might that look like? 

Eating better

Exercise

Active recovery

Regular resilience practices like yoga, meditation, breathing techniques, TRE, Tapping

Improving and Protecting sleep habits

Journaling

Building connections with others

All of those things make a difference down to a cellular level. The first step is an understanding and awareness of what’s going on in your body and knowing that you aren’t going crazy, you aren’t losing your mind, this is simply a new chapter. If nothing else we as women of some wisdom need to extend a little grace to ourselves. There’s a reason that we stick around after menopause when most mammals don’t. We have a third of our lives left to live and thrive and every reason to celebrate that and the freedom that goes with it.

Thanks for listening! If you’re looking for ways to handle that midlife menopausal stress, physically, mentally and emotionally head over to savagegracecoaching.com/theworkin you’ll find all the show notes for this and other episode in the menopause metamorphosis series plus lots of free resources. And if you’re in a place where you are ready for more and you live in the Dayton Ohio area I’m taking private clients for trauma informed yoga and trauma release exercise. So you can book a discovery call and we can have a real life conversation. And of course I’d be ever so grateful if you would take a moment to like and subscribe to this podcast wherever you’re listening. 

Thanks again everyone and as always stop working out and start working IN.