I know as women we have a lot on our plates. But over 20+years of working with women and their hormones, I have come across a common theme.
When women enter menopause, it is so much more than hot flashes (you all especially know this if you have gone through menopause, or read my newsletters; this is #35 already!).
It is how our hormones, or lack thereof, affect our brain.
All the menopausal ladies:
- Who can raise their hand if they feel overwhelmed easily, have trouble focusing, and multitask? Hard to get started (on almost anything), and feeling like you can’t make a decision as easily?
Of course, anyone at any age can feel this way sometimes for many different reasons.
But this article is about menopause and our brains.
Specifically, this is about the decline in estrogen during menopause.
Before we dive in, one important point: the brain is influenced by many hormones, including progesterone, testosterone, thyroid hormones, cortisol, and insulin, just to name a few.
But in this newsletter, I’m going to focus on one of the biggest players during menopause: estrogen. Estrogen has receptors throughout the brain and plays a remarkable role in how we think, learn, focus, remember, and process information every day.
In future articles, I will circle back around to other hormones that contribute to brain function.
Onward, estrogen!
Facts and learning can sometimes be a bit drab. A good story captures our attention, makes complex ideas easier to understand, and helps us remember what we've learned long after we've finished reading. Which is why I love a good story.
Meet Sherry.
She's 55 years old and went through menopause about three years ago. Her periods gradually became farther and farther apart, and she's pretty sure it's been at least a year since her last one. Honestly, she's happy not to deal with periods anymore after all those years.
What she wasn't expecting was what happened to her mind and emotions.
"Sherry, honey, where's my phone? Have you seen it?" Jack calls as he rummages through the living room.
Seriously? I just halfway cleaned this room before I got distracted watering the houseplants... while trying to find my own phone. How am I supposed to know where his phone is when I can't even find mine?
The dog's water bowl is empty. I should fill it... or ask Jack to.
Wait... was that the dryer?
What's that noise? Is that the Amazon driver? Let me look outside real quick.
Ugh, I walk by my craft room, which I used to love. And there are a bunch of unstarted, unfinished projects.
My phone's dinging. At least I found it... But who wants what now?
“Sherry, want to go out for dinner tonight? You seem so stressed. Let me take you out to dinner. Where do you want to go? You pick, Mexican, Japanese, Thai, you name it!”
Oh, Jack, you are so sweet, but if I have to make one more decision, I am going to lose it!
I have to leave, or I'll never make it to the grocery store before my hair appointment. Where's my shopping list? I should just keep it on my phone. Although half the time I can't even figure out how to use my email on this thing. Speaking of email, I probably have dozens I still need to answer.
I'm going to be late.
Come on, Sherry. Grab your phone and go.
Did I fill the dog's water bowl?
Just get in the car.
Go. Go. Go.
I feel like a mash-up of the White Rabbit from Alice in Wonderland and the Scarecrow from The Wizard of Oz. I'm late... and somewhere along the way, I lost my brain.
Drive.
Ding. Ding.
That phone again.
I glance down at the passenger seat while stopped at a light.
Perfect.
I grabbed Jack's phone instead of mine.
I'm so scattered... and I just can't seem to keep up anymore.
Why Is This Happening?
Short Answer: Hormones Affect Your Brain
Now, in my usual maximum-verbosity fashion: The Long Answer!
Meet Your CEO: Prefrontal Cortex
I know it sounds like a fancy cocktail or adult film flick. But your prefrontal cortex is in the front of your brain, sitting just behind your forehead.
Your prefrontal cortex is like your brain’s CEO, coordinating:
- Planning
- Focus
- Decision-making
- Impulse control
- Prioritization
- Your emotional response to things
- Working memory
Individually, these symptoms are frustrating. Together, they can make even an ordinary day feel completely overwhelming.
Estrogen:
Your brain is packed with estrogen receptors. Estrogen isn't just important for protecting your brain over time; it also helps your brain do its job every single day. And there is a tremendous number of estrogen receptors in your prefrontal cortex (your brain’s CEO/director/traffic controller/boss).
But what does estrogen do for the prefrontal cortex?
Estrogen helps support many of the functions that keep your prefrontal cortex running smoothly, including:
-
Glucose metabolism and insulin sensitivity:
- Helps the brain cells take up glucose (aka: fuel).
- Helps preserve insulin signaling so the neurons can utilize glucose efficiently.
Estrogen decline doesn’t kill brain cells. But the reduced insulin sensitivity and glucose (fuel) make the brain work harder to accomplish the normal tasks.
And that is where you see:
- What is that word?
- I have to read this paragraph several times to remember.
- I can’t multitask like I used to.
- Why am I in this room?
-
Mitochondrial ATP Production:
- Mitochondria convert glucose into ATP (fuel/energy) to power the brain
-
Estrogen helps support healthy mitochondria, ATP production, and reduces oxidative stress
Your brain still works on lower estrogen levels. But now there is a smaller energy budget in menopause. Meaning that tasks that once felt effortless require more mental effort. -
This is where you see: Decision Fatigue
- At the end of the day, I don’t even want to decide what to watch on Netflix
- You can still do math, organize the schedule, write emails, and decide what to make for dinner. But you might need more concentration, more time, and fewer distractions while doing your tasks.
- After several errands, you might feel exhausted and want to rest
-
Cerebral Blood Flow:
- We all know we need proper, healthy food and clean oxygen to survive. It is no different for your brain.
- Estrogen supports healthy blood flow (rich in glucose/fuel and oxygen) to the brain, enabling it to function properly.
When estrogen declines in menopause, the brain isn’t deprived of glucose/food and oxygen.
The brain can still do its job; it just has to work harder.
- For example, it’s like your Wi-Fi. We all love lightning-fast Wi-Fi. But when we have a weak wifi connection/signal, your computer still works, and the router is still working.
- Instead, websites load slowly, video freezes, buffering takes forever, and uploading and downloading can take an eternity.
That is why multitasking, concentrating, and decision-making feel more mentally draining and can take longer during menopause. It can also contribute to mental sluggishness, slower processing speed, and reduced cognitive performance. Your brain isn’t offline; it just has a weaker signal.
-
Synaptic Communication:
- Helps brain cells ‘talk’ to each other.
-
Supporting neurotransmitter release and receptor function.
Estrogen helps these conversations run smoothly by supporting neurotransmitter release, receptor function, and efficient communication between brain cells.
- This is where you find yourself forgetting words
- Using the word ‘thing(s)’ all the time.
- Longer pauses in answering questions (especially when flustered)
-
Neuroplasticity:
- Neuroplasticity is your brain's ability to learn, adapt, and remember.
-
Neuroplasticity is so cool because it helps you:
- Develop new skills
- Form memories
- Like learning a new language or skill, or becoming more proficient in a task with practice
- Learning how to work your iPhone (def not there yet)
-
Neuroplasticity literally changes your brain (physically). Neuroplasticity is making new synapses or enlarging existing ones, growing more dendritic spines, and strengthening frequently used neural pathways.
Estrogen supports neuroplasticity by helping the brain build, strengthen, and maintain connections between brain cells, making learning, memory, and adaptation more efficient.
When estrogen drops in menopause, this is where you see:
- More repetition to learn something new.
- More practice to master a skill (repeating the refresher course on my Duolingo app, Spanish is hard!).
- Longer to retrieve a memory (it’s on the tip of my tongue).
-
Dopamine Signaling:
-
Dopamine gets the party started and keeps it going.
- Motivation, reward, focus, attention, and getting your projects started and finished.
Estrogen helps regulate dopamine production, release, and receptor sensitivity, particularly in the prefrontal cortex.
When estrogen drops in menopause, women can frequently notice:
-
Low motivation
- The laundry isn't hard...you just can't seem to start it
-
Difficulty initiating tasks
- You have a to-do list, but instead of tackling it, you find yourself scrolling your phone.
-
Lower focus
- You walk into a room, notice something else that needs to be done, and completely lose track of your original task.
-
Things (lol), activities that once felt exciting or rewarding may not bring the same level of enjoyment or enthusiasm.
- Hobbies you used to look forward to now feel more like obligations
-
Acetylcholine Function:
- Acetylcholine is a neurotransmitter that plays a key role in attention, learning, and memory
- Helps your brain pay attention, learn, and store information
-
Helps you focus on what's important while filtering out distractions.
- Listening to someone in a noisy restaurant
- Reading a book without your mind wandering
- Staying focused in a meeting or class and remembering what was discussed
-
It is important for ‘working memory’, which holds information in your mind.
- This is why I work with two computer screens. Often, I find myself flipping back and forth between tabs because I can't remember the information long enough to use it.
Estrogen helps brain cells make and use acetylcholine.
In menopause, when estrogen drops, it can affect attention, learning, and memory.
This is where you experience:
- I just lost my train of thought
- I walk into a room and forget why
- I have to write everything down now
- If someone or something interrupts me, I forget what I was doing
Notice that none of these changes, by themselves, explain overwhelm. But together, they create a brain that has to work much harder to accomplish everyday tasks. That's why a sink full of dishes, an email notification, a barking dog, someone asking a question, and dinner cooking on the stove can suddenly feel like "too much." It's not because you've become weaker. It's because your brain has less reserve than it used to.
Now that we know the WHY, what about the HOW? How can I improve my brain function so I can better plan, focus, get started, stay more zen, and remember what I went to the grocery store for without my list?
There is no magic bullet for working with brain function in menopause. There are lifestyle aspects, nutrient/food-as-medicine, and even HRT, if appropriate.
So let’s get into:
- What foods to eat for brain health and function
- What lifestyle aspects for my brain
- What supplements can support my brain function
- What HRT will be helpful for me, and what dose?
- NAD injections, cycling, and dosing for brain energy
- Peptides for focus, cognition, and memory
I love learning and compartmentalized systems, so let’s break this down one by one:
In this next section, you will learn:
-
Glucose Metabolism: Food
- Lifestyle
- Foods/nutreints
- Supplements
-
Mitochondria ATP: Brain energy
- Lifestyle
- Foods/nutreints
- Supplements
-
Cerebral Blood Flow: Food and oxygen to your brain cells
- Lifestyle
- Foods/nutreints
- Supplements
-
Synaptic Communication: Cells talking to each other
- Lifestyle
- Foods/nutreints
- Supplements
-
Neuroplasticity: Learning and adapting
- Lifestyle
- Foods/nutreints
- Supplements
-
Dopamine: Getting started and liking it
- Lifestyle
- Foods/nutreints
- Supplements
-
Acetylcholine: Learning and memory
- Lifestyle
- Foods/nutreints
- Supplements
-
HRT:
-
Peptides: Memory, focus, and motivation (neuroplasticity and dopamine)
- Combination of semax and selank
- Dosing
- Cycling
- Reputable sourcing
-
NAD injections and NAD oral precursors
- Mental and physical energy
- Mitochondrial fuel,
- Balance dopamine and serotonin for motivation
- Neuroplasticity for learning and memory
- Dosing
- Cycling
- Repuable sourcing
The free edition explains why your brain feels different. The paid edition shows you what you can do about it.
Let's take this one step further. In the paid edition, we'll dive into the foods, lifestyle habits, supplements, and hormone therapy options that may help support each of these brain systems.
