Menopause can impact your mood, confidence and mental health. Learn why hormonal changes affect your brain and how to recognise the signs.
How Menopause Affects Your Mental Health
For many midlife women, menopause is more than a few hot flushes. It can feel like someone has been in and rewired your brain, bit by bit, while you were asleep. One day you feel calm and capable, the next you are tearful, anxious or just not yourself. The “never quite sure how it will be today” feeling adds to the challenge.
Your brain is not broken. You are not losing your marbles, You have not lost the plot. It’s probably not early onset dementia. Your brain chemistry is changing.
Why Hormones Affect More Than Periods
Oestrogen, progesterone and testosterone do far more than control your menstrual cycle. They influence hundreds of bodily functions, including how your brain manages mood, focus, memory and stress.
When these hormones start to fluctuate and decline, your neurotransmitters — the chemical messengers that control your emotions — can go off balance.
Think of Your Brain as an Orchestra
Imagine your neurotransmitters as an orchestra, with oestrogen, progesterone and testosterone acting as the conductors.
When the conductors are present, everything works in harmony. You are in sync, harmonies are happening, life is swinging along.
But when they start to leave the building, the orchestra gets out of tune. The violins (serotonin) play too softly, the drums (dopamine) lose their rhythm, and the flutes (GABA) barely make a sound. The percussion section is getting a bit unruly, not listening to the woodwind and completely ignoring the brass section who have started on a different piece of music completely.
That is why even high-functioning, capable women can suddenly feel anxious, irritable, forgetful or flat. The orchestra is still there but the musicians are out of sync, confused, missing the beat and unable to find the rhythm. It just needs a new kind of direction.
Some Examples Of The Brain Chemistry Behind the Mood Swings
- Serotonin supports mood, sleep and emotional stability. Low oestrogen can reduce serotonin, leading to low mood or anxiety.
- Dopamine drives motivation and pleasure. Lower levels can leave you feeling flat or disinterested.
- GABA helps calm the nervous system. When progesterone dips, you might struggle to relax or switch off at night.
- Cortisol, the stress hormone, can stay high when life feels relentless, feeding fatigue, brain fog and irritability.
What That Looks Like in Real Life
Research shows that up to 80% of women experience psychological symptoms (poor mental health) during menopause. These symptoms are often at their worst during perimenopause, the years leading up to the menopause, and that imbalance and fluctuation of oestrogen can be a real challenge for the human brain that likes stability and rhythm.
Common signs might include:
- Anxiety or panic
- Low mood or tearfulness
- Loss of confidence
- Sleep problems
- Brain fog and forgetfulness
- Feeling detached or “not yourself”
- Tired but wired and unable to relax, with constant churning feeling of “high alert”.
For some, these changes can lead to serious distress. Women aged 45 to 54 currently have the highest rates of depression and suicide in the UK, and similar patterns are seen in the US.
This is not weakness or “just hormones.” It is biology. And it deserves understanding, and a recognition and respect that every woman will have a different experience, unique to them and their own personal circumstances.
For some women these symptoms can be debilitating, even making them question their ability to continue with work, whilst for others it might be disrupted sleep from time to time and nothing more major. It really can differ incredibly and so we need to make sure we are never trivialising or judging or suggesting that someone else’s experience is not valid. Menopause hits us all in quite different ways and that feeling of isolation, being on our own, lonely, the only one to be feeling this way can make matters even worse.
Coming Next: What You Can Do to Feel Better
In the next post, I’ll share practical ways to calm your nervous system, support your brain chemistry and protect your mental health during menopause. Whether you want to or are able to include Hormone Replacement Therapy (HRT) as part of your strategy or not, there are things we can all do that are related to our lifestyle choices, from food and movement to sleep and connection, that really can help.