Great news for you ladies out there in perimenopause and menopause: The female brain actually gets rewired during the second half of life, creating space for new perspective and purpose, so your next decades may be your best yet! On the most recent episode of my podcast I talk with Dr. Louann Brizendine (I call her Dr. Brain), a brain specialist – neuropsychiatrist - and author of three New York Times bestselling books, The Female Brain, The Male Brain, and most recently, The Upgrade, which is all about how the female brain just keeps getting better in midlife.  Believe me, you’ll want to hear this! Check out this episode of Sex, Body, and Soul to hear our conversation about hormones, anxiety, and other things that crop up in middle age.

I may be dating myself, but remember the book Men are From Mars, Women are From Venus back in the 1990s? It talked about the difference between men and women in their needs, desires and behaviors? Well, it turns out that there are real differences between male and female brains. This is unsurprising, says Dr. Brizendine, as babies’ brains are essentially marinading in hormones in utero. 

In fact, hormones influence the brain and behavior throughout life as they ebb and flow. In women, this largely begins with the onset of puberty and menstruation, fluctuates monthly throughout the menstrual cycle, then changes again in perimenopause and menopause when menstruation ends. While I had heard some of this before, Dr. Brizendine broke it down for me in a way that really made sense – and connected the dots as to why, at 54, I am living with brain fog.

Here's the deal: Day 1 of your cycle is the day the period bleeding starts. Ovulation happens around day 14, which is when your estrogen is at its peak. Estrogen (the miracle hormone), gives you some of your best days when you are most verbal and flirtatious - this is Mother Nature encouraging you to have sex to fertilize your egg during this key fertility window) Then estrogen drops and progesterone rises (pro-gestation, get it?) to give any fertilized egg a nice cushy home in your uterus.  When there’s no fertilized egg to house, progesterone drops and you get your period. 

Here’s the interesting part: in the brain, progesterone turns into a compound called ALLO, which hits the same receptors in your the brain as Valium, so it has a powerful calming effect. When progesterone crashes at the end of your cycle, your brain essentially experiences progesterone withdrawal, resulting in irritability, PMS, or brain fog. During perimenopause (the period of transition to menopause that Dr. Brizendine calls “The Upgrade”), your hormones can be all over the place all the time, meaning you could have these symptoms intermittently or at any time of the month. I can attest to that! Fortunately, Dr. Brizendine assured me that brain fog associated with menopause is temporary and the female brain in midlife and beyond is stronger than ever.

However, the transition itself can be challenging.  A drop in overall estrogen in perimenopause and menopause can also result in night sweats that contribute to poor sleep that many women struggle with. Unfortunately, I can also attest to this. Dr. Brizendine suggested adding a meditation practice to our sleep routine to help calm our multi-tasking brains, so I’m going to try that. I already try my best to keep caffeine and sugar to a minimum, and practice other good sleep hygiene practices like exercise, but my hormones are still calling the shots to some extent. I’ve started on estrogen, which Dr. Brizendine and other guests on the show have recommended, so watch this space for an update. I’m hopeful it will help me at last be able to fall asleep quickly and sleep through the night! (Note that since I still have a uterus, I need to take estrogen AND progesterone as part of my hormone therapy.  Be sure to talk to your health care provider about what is right for you.)

Female hormones can have both physical and mental effects.  There is something about female hormones makes us more sensitive and depression and mood disorders, so once menstruation starts, the female to male ratio of anxiety disorders is about four to one, meaning for every man affected by mood disorders, there are four women similarly affected. It’s important to know this – remember, you are not broken!  And there are solutions for hormone-related mood disorders, but they are not one-size-fits-all. Some women may be helped with consistent exercise and behavior modifications, some may need antidepressants, while others may benefit simply from hormone stabilization (like the birth control pill). The critical message here is that you don’t need to suffer. You may need to try a few to find one that works for you, but trust me, you will never regret starting that conversation with your health care provider. Self-care starts with you!

Speaking of self-care, those of you with teenage daughters (or tweenage daughters, like mine), will need lots of it. On the podcast, Dr. Brizendine talked about the enormous amount of brain growth during these years and how the female brain is pretty much completely rebuilt by the time girls are 19 to 20 (in contrast to boys, who often aren’t finished until 22 or 23).  This is the result of their hormones including testosterone (yes you read that right) that peaks in females around age 19. She reports, however, that this growth period is a very difficult time for parents when it’s very hard to have a normal conversation with them about anything. (Yep, I can attest to this too.)

I learned so much in our short conversation, I encourage you to listen and to buy Dr. Brizendine’s books, starting with The Upgrade. In this amazing book, you will learn how to sail through midlife and menopause with a healthy brain, and who doesn’t need that? I hope to have Dr. Brizendine back on the show again soon to focus just on the brain and its important role in sexual pleasure (hint: check out chapter 4 of her other book, The Female Brain). If this is of interest to you, stay tuned! In the meantime, you may want to check out The Body Agency’s sexual wellness kit that can help you kick off and maintain a sexual wellness routine.  

Be your best at every age, take care of yourselves!