As women get older, their ovaries produce less and less of the sex hormones estrogen and progesterone. With these hormone levels consistently dropping during this phase, periods start to become irregular and eventually cease.
This is menopause, which is officially defined as the “permanent cessation of menstruation resulting from the loss of ovarian follicular activity” by the World Health Organization (WHO) (1).
Menopause typically starts between the age of 45 and 55 however this will vary from person to person, and can begin earlier or later for some.
Menopause is not always an easy transition for a woman as hormonal shifts can affect the body in sometimes uncomfortable ways.
Common symptoms associated with menopause may include hot flushes, insomnia, vaginal dryness, night sweats, and weight gain. Some less obvious menopausal symptoms may be mental and emotional such as anxiety, brain fog, and depression.
How does menopause affect your brain?
Research indicates that an estimated 20% of women experience depression at some point during the menopausal years and as much of 60% of middle-aged women report experiencing issues with cognition (2)(3).
No, it's not all in your head if you can't think straight, feel rather blue or like you're, slightly, losing your mind.
Studies show that one year after menstruation stops, memory, fine motor skills, attention and working memory can be lower than during the pre-menopausal years.
The shifts in hormones, estrogen and progesterone, are what are said to influence mood and cognitive function in menopausal women by altering chemicals in the brain.
Lower progesterone in particular is associated with higher perceived stress and an increased risk of depression and anxiety (4).
This is because progesterone is a calming hormone that stabilizes the HPA axis and promotes the function of GABA, our main inhibitory neurotransmitter. Because of these mechanisms of action, changes in progesterone levels can alter mood and sense of well-being.
Estrogen is also an influential hormone on mood as it exerts anti-inflammatory and neuroprotective effects and modulates the function of serotonin (5)(6). When estrogen declines, this can promote the development of perimenopausal mood disorders (7).
But hormones may not be the only things responsible for these changes in cognitive function and mood. Disrupted sleep as well as increased stress can also be felt during menopause and contribute to increased anxiety, brain fog, and mood swings.
Though it may seem like menopause is all doom and gloom, the good news it that not every woman experiences the full range of side effects and even if you do experience symptoms, there are ways to reduce menopausal symptoms and improve your daily quality of life.
4 health practices to support mental and emotional health during Menopause
Mediterranean diet
If there is one diet that has been shown to exert benefits during menopause, it's the Mediterranean diet. Why? Well there are a multitude of factors that make this style of eating particularly supportive for aging and preventative towards chronic diseases.
The Mediterranean diet, rich in antioxidants, anti-inflammatory agents, and fiber, has been shown to reduce cardiovascular and breast cancer risk factors as well as improve blood pressure, bone mineral density, cholesterol, blood glucose levels, mood and symptoms of depression (4).
A study found that the Mediterranean diet is comparable to pharmacological interventions in terms of reducing the risk of obesity and cardiovascular and metabolic events (5).
The standard American diet that is high in sugar and fat has been shown to increase the risk of menopausal symptoms such as hot flushes and night sweats while the Mediterranean diet rich in fruits and vegetables was shown to decrease the likelihood of these symptoms (6).
The Mediterranean way of eating may be an effective strategy for improving menopausal symptoms and outcomes that is without side effects. The best part is that this diet is non restrictive and easy to follow for most, which increases adherence and positive results.
Sleep
As mentioned, sleep disturbances can occur with the transition into menopause. In fact, up to 60% of postmenopausal women report experiencing some sort of sleep issue (7).
Declining levels of both estrogen and progesterone have been indirectly associated with disrupted sleep patterns (8).
Sleep isn't just important in order to feel rested, it's a central part of optimizing health and improving mental and emotional wellness.
So what can you do to get a good night's sleep? Here are some tips to get you started:
- Stay away from caffeine and stimulants after noon.
- Follow a regular sleep and wake schedule.
- Establish a bedtime routine, without the use of electronics.
- Avoid using your phone, TV, or computer within at-least one hour of going to bed. The blue light emitted from these devices can interfere with melatonin production and make it harder to fall asleep.
- Keep your bedroom at a comfortable temperature.
- Exercise during the day, not near bedtime.
- Avoid eating heavy meals within an hour or two of bedtime.
Mindfulness
Mindfulness is becoming the talk of the town as practices such as meditation and stillness are being adopted by more and more individuals.
Instilling mindfulness into your day to day life can benefit your health in many ways including lowering cortisol levels, improving sleep, reducing stress and anxiety, and enhancing wellbeing.
Though mindfulness won't necessarily remove your menopausal symptoms, research indicates that adopting mindfulness practices may mitigate symptoms associated with menopause (9).
A study that followed menopausal women during eight weeks of mindfulness meditation training noticed improved sleep quality, quality of life, and attention levels, and a reduction in the severity of insomnia as well as menopausal symptoms (10).
Mindfulness doesn't have to look like sitting cross legged on a hill or going to a fancy retreat, you can start to practice it right where you are by simply being present and connecting with your body.
Supplement
Of course diet and lifestyle habits are always the first to address and modify when it comes to any health concern, but supplements can play an important supporting role in further helping the body to find balance. Today we discuss some potential supplements that may help to improve the transition of menopause.
Ashwagandha
As an Ayurvedic adaptogenic herb, ashwagandha is well known for its stress relieving effects, and it may also offer benefits for women going through menopause.
A study found that ashwagandha root extract increased estrogen levels and relieved mild to moderate symptoms in perimenopause women (11).
Ashwagandha may help to offer benefits related to stress and anxiety by reducing cortisol levels while reducing menopausal symptoms by stimulating estrogen.
Vitex (chasteberry)
This herb is often recommended as a natural remedy for female and hormone related symptoms and conditions such as PMS, irregular periods, infertility, and also menopause.
One study indicated that the use of a herbal formula including vitex among women suffering from menopausal symptoms reported a significant reduction in hot flushes and night sweats resulting in improved sleep (12).
It's important to note that vitex isn't known as a fast acting herb, and it can take several weeks to feel the full effects and determine if it is right for you.
St. John's Wort
St. John's Wort has been used traditionally to treat symptoms of mild-to-moderate depression and low mood (13)(14). It has been shown to act similarly to anti-depressants by increasing mood regulating brain chemicals, like noradrenaline, dopamine and serotonin (15).
St John’s wort may also contain phytoestrogens, plant compounds that imitate estrogen in the body, which may explain how it can benefit menopause in a variety of ways, not just psychologically (16).
This herb may provide relief for perimenopausal and menopausal women by improving symptoms like hot flashes, mood issues, sleep problems and overall quality of life (17).
Always check in with your health care provider before choosing to supplement with St. John's Wort as it can interact with medications and supplements.
About the Author
Laurence Annez