Menopause and Mental Health

Our hormones change throughout our life, not just at menopause. However, around the time of the menopause we often suffer less predictable changes in hormone levels. Especially in the peri-menopause, hormone levels are swinging from one extreme to the other resulting in “hormonal chaos”. This causes fluctuating symptoms which are unpredictable without any clear triggers. Many women are used to ignoring their own needs, putting others first – children, partner, parents, friends, work. We have always powered through the changes of our monthly cycle but suddenly there is no anticipating when this might be and/or the symptoms persist and become far more troublesome.

A common way of thinking is that the menopause is a natural process and we should just cope with whatever that brings rather than seeing it as an opportunity to pay attention to the adjustments which are needed in our lives to navigate our hormonal changes with more ease. It is important to remember that nutrition and lifestyle are also important parts of the menopause puzzle.

Female hormones are not just involved in reproduction, they are connected with our moods and affect how our brains work.

It has been shown that up until puberty boys and girls have the same incidence of depression. At puberty when a girl’s ovaries start producing hormones in a cyclical fashion, the rate of depression increases. The lifetime incidence of depression in males in 1:10 and in females 1:4. Those more at risk are those with premenstrual mood changes, postnatal depression and peri-menopausal mood changes.

Hormones have been shown to have direct effects on brain chemistry that controls our mood which is why an imbalance in hormones results in changes in mood as well. Brain changes which take place in the peri-menopause occur as a result of differences in the levels of oestrogen and progesterone, affecting the temporal lobes and limbic areas resulting in irritability, anxiety, tearfulness, mood swings. Unresolved stress has a tendency to exacerbate that peri-menopausal hormone imbalance.

Symptoms of the peri-menopause may seemingly come out of nowhere and can include insomnia, palpitations, fatigue, brain fog, anxiety, tearfulness, loss of confidence and can occur before the classical symptoms of hot flushes, night sweats and vaginal dryness. It is common for women to recognise mood changes that are very uncharacteristic for them, such as anxiety, a feeling of overwhelm, when nothing else has changed, apart from their hormones!

Oestrogen interacts with oestrogen receptors throughout our body including in our brain, so is needed for optimal brain function. Oestrogen also boosts levels of certain chemicals in the brain which are associated with positive mood and cognitive function. However, there are disadvantages to having too much oestrogen, it’s all about the delicate balance between the hormones!

Progesterone has lovely natural calming effects by increasing the levels of the neurotransmitter GABA. The levels of progesterone tend to fall in peri-menopause before those of oestrogen leaving us oestrogen dominant. In these instances starting both oestrogen and progesterone HRT may exacerbate symptoms rather than relieve them. This might lead a woman to believe that HRT doesn’t suit her but it may indicate that simply she isn’t ready for oestrogen yet but would benefit from progesterone.

Both high oestrogen and low progesterone can cause anxiety and panic attacks

But it’s not just about oestrogen and progesterone. Testosterone, DHEA, cortisol and thyroid hormones also play a part.

Testosterone is in fact converted to oestrogen by a process called aromatisation. Low testosterone levels in women can result in a loss of confidence, low mood, low motivation, low libido, reduced strength and endurance, reduced bone density/osteoporosis.  Often DHEA levels are low as well and the symptoms of this are similar to those of low testosterone. It is natural for DHEA levels to reduce gradually over time from about age 25 onwards.

It is important to remember that there is so much we can do to balance our hormones at any time in our life without using hormone replacement therapies.

Our Bio-identical Hormone Replacement (BHRT) programme is designed to support you with a personalised plan to optimise your lifestyle and nutrition, assess where you are at currently by measuring your hormone levels. It may be that a prescription for bio-identical hormones is right for you to help you feel yourself again but is not necessarily needed long term once other areas return to balance.

Our aim is to guide you to:

  • connect to your emotions, your symptoms, to your wisdom and the power of community
  • consider toxic exposures which might exacerbate a hormonal imbalance
  • look at your gut health which is so important in detoxifying our hormones
  • balance blood sugars, thyroid function, adrenal function, work and life
  • optimise your self care

This is alongside assessing your requirements for hormones oestrogen, progesterone, testosterone, DHEA and pregnenalone and providing you with a personalised prescription.

Throughout the first 12 month programme of care there are regular reviews and support from our Happiness and Contentment Coach so we can ensure you are in optimal hormonal health.

Appointments for the BHRT clinic can be booked here