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How Hormone Changes can Impact Your Mental Health

women's mental health awareness in hormone transition

If you find yourself struggling with mood swings, irritability, anxiety, and even depression during perimenopause and menopause, you’re not alone. Many women share these unpleasant symptoms during this transition, not that this would make it any better, but before we talk about solutions, let me assure you, that you are not crazy and many women feel the same. 

As we approach menopause, our body undergoes significant hormonal changes when our ovaries stop producing first progesterone and then estrogen, but also testosterone.

I was just talking to my friend Jacqueline Rose about estrogen for an interview for her Menopause Summit (coming up on 26th May 2024) and she said something really interesting: we only think of these hormones when it comes to our cycle and we relate them to fertility. Once we hit our 40s and start feeling all these weird symptoms and wondering what’s going on with our bodies, we can actually see how much more these hormones are doing in our body. 

Here are the most common mental health symptoms that women are struggling with in perimenopause and menopause:

  • Mood swings and irritability: thanks to declining levels of estrogen and progesterone, you can find yourself more prone to sudden feelings of frustration, anger, or impatience, sometimes for no obvious reason. 

  • Anxiety and panic attacks: heart palpitations, sweating, trembling, shortness of breath, a feeling of choking, chest pain, nausea, dizziness, chills or heat sensations, numbness or tingling sensations, feelings of unreality, fear of losing control. Low progesterone is the culprit here paired with increased levels of cortisol (our stress hormone) leading to increased worry and fear, making once manageable situations feel overwhelming. 

  • Brain fog and memory issues: fluctuating blood sugar levels and declining estrogen are the two main culprits here. You’ll see that if you get them back on track, your brain will thank you. 

  • Depression and feelings of sadness: many women experience depression or persistent feelings of sadness mostly towards the end of perimenopause and in menopause when estrogen levels start declining. But also low testosterone can play a role here. 

Let’s have a closer look at estrogen and how it impacts our mental health: we literally have estrogen receptors all over our body (and brain). Yes, you have guessed right, those estrogen receptors in our brain are the ones getting stressed out when estrogen levels fluctuate. Hello memory issues, brain fog and depression! This is also why women have an  increased risk of dementia and Alzheimer’s (at least partly). Oh and let’s not forget about those hormonal migraines or vascular headaches! 

How does it work? Estrogen impacts how your brain makes and uses mood-regulating neurotransmitters, like serotonin and dopamine. You’ve probably heard of these before: both play crucial roles in regulating your mood and emotions: serotonin supports happiness, well-being and a stable mood, whereas dopamine is our reward and motivation hormone or neurotransmitter.

As estrogen levels drop in perimenopause, fluctuations in these neurotransmitters mean you might find yourself more susceptible to mood swings and feelings of sadness. 

Estrogen is involved in SO many other nagging symptoms of perimenopause and menopause: I could go on for another hour, but let’s stick to the mental health and brain impact here…

Progesterone, our zen hormone, is mainly linked to increased anxiety, but it also helps with lowering inflammation, water retention, keeping our bowels moving and replacing that irritability by more zen. It also plays an important role in restful sleep and keeping our cortisol levels in check. 

Testosterone is often not considered much, but it’s a hormone that can have a profound impact on our self assertiveness, desire to do things and it impacts your (muscle) strength. Testosterone is a vitality hormone!

So you might wonder: once you’re in menopause or post menopause, will all this smoothen out? Will you be your normal self again?

It depends…

In menopause (once you haven’t had your period for 12 consecutive months), estrogen and progesterone stabilize at low levels. It’s only Postmenopause though when your estrogen levels have settled to a low but steady state. Although some symptoms of menopause may start to diminish, the emotional landscape can remain complex, with ongoing mood shifts. Many women continue to experience symptoms (especially low mood, energy, hot flashes, migraines and weight gain) but the good thing is that your hormone levels are not fluctuating so much anymore so this crazy kind of unpredictable thing goes away. 

Physically, it remains a challenge to preserve bone health, combat muscle loss, and mitigate the increased risk of chronic conditions like heart disease and type 2 diabetes. 

I admit that this doesn’t really sound very encouraging, so let’s talk about the solutions available to manage low hormone levels, enhancing overall well-being and resilience during this transition.  

Ways to Support Mental Health/Low Hormone Levels During Menopause:  

  1. Adopt a low carb diet high in protein and healthy fats: every meal should have fat, fiber and protein. (Check out my hormone balance cookbook to get your complete guide to eating for hormone balance and stable blood sugar levels that will help keep inflammation down)

  2. Eat fatty fish often and supplement with a high quality Omega 3: you wanna aim for a minimum of 650mg EPA & 350mg DHA. This is my favorite product in Europe from Copmed

  3. Support your adrenal glands - your adrenal glands will be taking over your progesterone and testosterone output once your ovaries are retired: Apply stress management techniques like breathwork or yoga, set boundaries and take herbs to nourish your adrenals (get my adrenal guide for my best tips and supplements to support your adrenal glands).

  4. Move your body daily and incorporate regular resistance training: Research shows resistance training can improve the effects of mental and emotional changes associated with menopause, but it also supports your muscle mass and bone renewal and weight lifting can help support testosterone levels.

  5. Get 7-9 hours of quality sleep every night to support overall mental well-being and resilience against menopause-related mood fluctuations. (Get my optimal sleep checklist if you want my best tips to support sleep) 

  6. Consider bioidentical hormone replacement therapy (BHRT) to optimize your hormone levels and feel like yourself again (contact me if you want help with this)

  7. Daily gratitude practice helps you focus on the positive in your life and transform negative thought patterns


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