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Episode 35: Why Your Brain Feels Different in Menopause · Joyful Menopause

• 0:00
  It's 3:00 in the morning and you're awake.
• 0:02
  Heart's going a little.
• 0:03
  Your mind is spinning about something that by tomorrow is going to seem really small.
• 0:08
  Or maybe it's 9:00 at night.
• 0:10
  You're standing at the pantry or in the fridge.
• 0:12
  Nothing dramatic happened.
• 0:13
  It was an ordinary day, and yet you feel wired and pulled towards something you probably would have walked past maybe five years ago without even a second thought.
• 0:22
  And underneath both of those moments is the same question: What is going on with me?
• 0:28
  I want to answer that today, and I want to start by telling you something before we go one step further.
• 0:32
  Something real is happening.
• 0:34
  It's physiological.
• 0:35
  It's well documented, and it is not a character flaw.
• 0:39
  So let's get started.
• 0:40
  Menopause doesn't have to feel like you are living in someone else's body.
• 0:44
  Your host, Lynda Enright, has spent the last 25 years helping women to thrive in midlife.
• 0:49
  Here, you'll find science-based practical advice that you can start using today to get real results for your health.
• 0:55
  Welcome to Joyful Menopause.
• 1:01
  As a registered dietitian nutritionist and a certified emotional brain training provider, I spend most of my days working with women in midlife.
• 1:09
  And the conversation I have most often starts with some version of what I just described.
• 1:13
  The 3:00 AM waking, the shorter fuse, the evening where you're just pulled toward food that you used to be able to ignore.
• 1:20
  Most women come to me assuming that they've lost something: discipline, motivation, willpower, the ability to stick with things.
• 1:27
  What I want to do today is to give you a different explanation, a physiological one, because I think it's the more accurate one, and honestly, it's a lot more useful.
• 1:37
  So let's start with that, what this transition actually is, because I think most of us were given a fairly thin version of the whole situation.
• 1:46
  So perimenopause is the hormonal transition leading up to menopause.
• 1:50
  For most women, it starts somewhere maybe in your mid-40s, though s- you know, it can be as early as your late 30s or it can be later than the mid-40s.
• 1:59
  The defining feature isn't that hormones just go down, it's that they fluctuate.
• 2:04
  Estrogen and progesterone swing.
• 2:06
  Like, they can go all over the place.
• 2:07
  They can be really unpredictable.
• 2:09
  Cycles can become irregular.
• 2:11
  Symptoms start showing up.
• 2:12
  Sleep disruption, mood changes, brain fog, weight change that just doesn't seem to respond to the same things it used to try.
• 2:19
  Menopause itself is, is a single point on the calendar.
• 2:23
  It's actually defined as 12 consecutive months without having a period.
• 2:27
  The average age for that is maybe 50, early 50s, though of course, that range is really wide.
• 2:32
  So then what follows is postmenopause, and that's a new hormonal baseline that your body has to adapt to.
• 2:39
  So here's what I want you to notice about all of that.
• 2:42
  This isn't an event.
• 2:43
  It's a transition that can span a decade or more, and for a lot of women, the most turbulent stretch of it isn't menopause at all, it's perimenopause, that long, unpredictable middle part which matters because a lot of women don't realize they're in it.
• 2:58
  They think,"Well, I still have periods, so this can't be a hormone thing." It can absolutely be a hormone thing.
• 3:05
  So now here's the misconception I w- I want you to challenge the most, is that most of us were taught that estrogen, progesterone, and testosterone are reproductive hormones.
• 3:14
  They run your cycle.
• 3:15
  They manage fertility.
• 3:17
  And when that chapter closes, they go quiet, and that's the end of the story.
• 3:21
  That's true, and it's a little bit of the story.
• 3:24
  These are actually whole body hormones.
• 3:26
  They have significant effects on nearly every major system you have.
• 3:31
  They help regulate your brain and your mood through serotonin, dopamine, and GABA, which are your calming, reward, and pleasure chemicals.
• 3:40
  They influence your metabolism, insulin sensitivity, where your body stores fat, how you use energy, bone density, muscle mass, both of which decline as these hormones fall.
• 3:50
  They protect, protect your cardiovascular system, your heart.
• 3:54
  They shape your sleep, which is a big part of why hot flashes and insomnia tend to arrive together.
• 4:00
  And this last one is the one almost nobody hears about, and it's the thread that connects everything else we're going to talk about today.
• 4:07
  They act as a buffer on your stress response.
• 4:10
  So let me explain what that means because this is the heart of what I want to talk about today.
• 4:14
  Your body has a primary stress response system.
• 4:17
  It's called the HPA axis.
• 4:19
  That stands for hypothalamic pituitary adrenal.
• 4:22
  You don't need to remember that.
• 4:23
  What you need to know is that it's a three-way conversation between your brain, your endocrine glands, and the rest of your body, and it governs how much cortisol your body releases.
• 4:33
  Cortisol touches almost everything, mood, digestion, immune function, energy, and appetite.
• 4:38
  And estrogen acts as a brake on that system.
• 4:41
  It dampens how much cortisol you put out when life comes at you.
• 4:44
  So picture this.
• 4:46
  Something stressful happens, a hard conversation, a deadline, a kid who needs something at the worst possible moment.
• 4:53
  With adequate estrogen on board, your alarm goes off.
• 4:56
  It does its job, then it settles back down.
• 4:59
  Now take the brake away.
• 5:01
  The alarm goes off more easily.
• 5:03
  It rings louder, and it takes considerably longer to settle.
• 5:07
  Same life, same stressors, different body response And it isn't only the break.
• 5:13
  These three separate calming systems are losing capacity at the same time.
• 5:18
  So serotonin drops.
• 5:20
  Estrogen supports serotonin, both how much is available and how long it stays available.
• 5:25
  Serotonin is your mood stability, your emotional resilience.
• 5:29
  So that baseline sense is that things are basically okay.
• 5:34
  Then dopamine dulls.
• 5:35
  Estrogen stimulates dopamine activity in the parts of your brain that are responsible for things like motivation, focus, reward.
• 5:42
  So when now dopamine declines, things that used to feel rewarding don't feel quite the same, feel a little bit flat, and you need more stimulation to get the same signal.
• 5:52
  And then there's progesterone.
• 5:53
  Progesterone converts into a compo- compound called allopregnanolone.
• 5:58
  It's calming.
• 6:00
  Some researchers describe it as your own brain's built-in anti-anx- anxiety compound.
• 6:05
  So as progesterone declines, so does that compound allopregnanolone.
• 6:11
  So three buffering systems losing capacity at the same time in the same brain in the same season of life This is why anxiety and mood changes so often show up in perimenopause in women who have never struggled with either one.
• 6:26
  Women with no history at all.
• 6:28
  That's not psychological weakness, that's a predictable consequence of hormonal change.
• 6:33
  Your brain isn't breaking, it's responding to a real, significant physiological shift.
• 6:39
  So now I want to give you a framework for this because I find it makes the whole thing really concrete.
• 6:44
  In emotional brain training, EB- EBT, we talk about five brain states.
• 6:49
  So you think of it as it's a simple scale, one to five.
• 6:52
  And at one, you're in very low stress.
• 6:55
  You feel great, you feel connected, maybe even joyful.
• 6:58
  Your thinking brain, your neocortex, is clearly in charge.
• 7:02
  At brain state two, a little bit...
• 7:05
  not feeling quite as great.
• 7:07
  Maybe a little bit of stress, but still feeling really pretty good.
• 7:09
  Still feeling connected, maybe not joyful, but feeling steady.
• 7:12
  So those are two balanced states.
• 7:14
  They're called homeostasis.
• 7:16
  Once we get to brain state three, now we're into moderate stress.
• 7:19
  Your limbic brain, or your emotional brain, starts to take over.
• 7:23
  Once we get to four, we have high stress.
• 7:26
  The limbic brain is running things, and you're starting to slide toward your reptilian brain, your pure survival.
• 7:33
  And at five, that's now we have very high stress.
• 7:36
  Fully reptilian brain.
• 7:38
  So everybody moves up and down this scale during a normal day.
• 7:41
  That's expected.
• 7:42
  That's normal.
• 7:43
  We all do that.
• 7:44
  But what the research shows about this stage of life is that most women in perimenopause are spending considerably more time in the threes, fours, and fives.
• 7:54
  Not because they're weaker, not because they're more emotional.
• 7:56
  Because the neurological buffer that used to hold the stress response in check is no longer doing its job.
• 8:03
  And this matters enormously because if you're in state three, four, or five, you lose access to your neocortex, your thinking brain, your wisdom, your planning, your ability to step back and think it through.
• 8:16
  Which is exactly where stress eating stops feeling like a choice and starts feeling automatic.
• 8:21
  The chips at 9:00 PM aren't really about hungry, they're hunger, they're about just your brain state.
• 8:27
  And then there's sleep, which makes all of it worse, as we all know.
• 8:31
  So let me walk you through this cycle.
• 8:33
  Hot flash wakes you up.
• 8:35
  Night sweats wake you again.
• 8:37
  Every one of those wakings keeps your stress system firing all night, so the HPA axis never fully powers down.
• 8:45
  Morning comes, your cortisol is already elevated, which means you're starting the day at a three before you've had breakfast, and it tends to go down from there.
• 8:54
  In a lower brain state, the pull toward external solutions grows: food, wine, scrolling, whatever takes the edge off.
• 9:03
  And then it's nighttime again.
• 9:04
  Hot flashes, poor sleep, elevated cortisol, lower brain state, stress eating.
• 9:08
  Repeat night after night, week after week.
• 9:12
  Honestly, for some women, year after year before they get these answers.
• 9:16
  It's not a personal failing, it's a physiological loop.
• 9:19
  And here's what I want most for you to hold onto: loops can be interrupted.
• 9:25
  So I want to leave you with a picture.
• 9:27
  Imagine a woman waking twice a night for six months, exhausted by noon, noticing that her mood is less steady than it used to be.
• 9:34
  Her anxiety's a little higher, her cravings are harder to manage.
• 9:38
  And now add in what midlife actually looks like.
• 9:41
  She might have kids at home.
• 9:42
  She might also have aging parents.
• 9:44
  She's likely at peak career demand.
• 9:46
  She's probably running the household and managing the social calendar for the entire family.
• 9:51
  That's what I see every single day in the women I work with.
• 9:54
  It is a lot to navigate.
• 9:57
  Her baseline brain state has shifted, so circumstances that used to feel manageable now feel completely overwhelming, and food she used to walk past is now calling to her at nine o'clock at night.
• 10:09
  Nothing is wrong with her.
• 10:11
  Her hormones have changed, her brain state has changed, and that changes everything.
• 10:17
  Understanding this is not an excuse, it's an explanation, and an explanation is something you can actually work with.
• 10:23
  In the next episode, I'm going to show you exactly what happens to the chemicals that drive hunger, cravings, and fat storage when stress and hormone declines arrive at the same time.
• 10:34
  It's the clearest answer I know to the question, why doesn't anything work anymore?
• 10:39
  In the meantime, if you'd like to see all of this laid t- laid out, including the charts that I couldn't show you on audio, I've recorded a free video called Stress, Your Brain, and Menopause.
• 10:49
  You'll find it at bewellconsulting.com, and I'll link it in the show notes.
• 10:54
  Thank you so much for being here today and for your commitment to understanding your health at a deeper level.
• 11:00
  Be well, and I'll see you next time.