Menopause and Mental Wellness: Grasping the Science of the Menopausal Mind
Evaluated by Brian St. Pierre, MS, RD and Helen Kollias, PhD
My Thoughts Were Lost in Disarray.
On a typical Friday evening, my husband and I would deliberate on dinner choices like this:
Me: What about that eatery?
Him: Which one?
Me: The one with peanut shells scattered on the floor? It’s close to… You know, the street where we took the dog to the vet. Does that ring a bell?
Details seemed to disappear into the recesses of my mind, only to pop up hours later when I’d suddenly shout…
“Texas Roadhouse!”
Memory Gaps Are Typical in Midlife.
However, what I faced in my late 40s and early 50s felt anything but typical.
I not only struggled to remember names of restaurants, individuals, books, or films, but my work efficiency was plummeting.
I would sit at my desk, gazing blankly at a document, battling to gather the motivation to type. Everything felt hazy, akin to those sluggish moments in the morning when you’re alert enough to silence the alarm but too drowsy to proceed.
My sharper moments usually occurred in the mornings, when I aimed to pack eight hours of writing into just two or three hours of mental sharpness.
On my darkest days, I awoke shrouded in a fog that never dissipated. Work became unfeasible, and I had no stamina to read or achieve much of anything.
I Sought Guidance from Health Experts.
Three physicians recommended antidepressant medications. I trialed one, but it made me feel worse. I tried another, and then another at a greater dose, yet I felt like a walking corpse. One doctor prescribed a sleep aid, which left me feeling even more lethargic.
My thyroid levels were checked—normal. I wasn’t anemic either. I experimented with dietary supplements, mushroom coffee, and any product labeled as “brain-boosting.”
After nearly two years of consultations with various doctors, I finally met with a gynecologist for my annual evaluation. I mentioned vaginal dryness, which prompted her to inquire about my sleep, mood, energy, hot flashes, and cognitive fog.
“It’s amusing you bring up cognitive fog,” I replied in my typical monotone. “I feel as though I’m hardly functioning.”
By the end of the appointment, I realized I most likely hadn’t been experiencing depression.
What I Was Dealing With Was Menopause.
My gynecologist prescribed estradiol and progesterone.
Within a few days, it felt as if a light switch had been turned on.
I could think clearly again. I could type logically. I could participate in discussions. I could work past lunch.
For the first time in years, I managed to sleep more than two hours straight without waking up.
Menopause Is Not a Health Disorder.
It’s not a sickness.
Rather, akin to puberty, it’s a life phase—a transitional stage.
Once you have gone 12 continuous months without a menstrual period, you enter menopause, and from that moment, you are regarded as “postmenopausal.”
As women approach this transition, hormone levels fluctuate and decline, resulting in various symptoms. Weight gain and a lowered libido frequently receive significant focus.
However, about 40 percent of women report heightened irritability, mood fluctuations, anxiety, fatigue, and challenges with focus during and following menopause, according to the American College of Obstetricians and Gynecologists.1 2
It’s also a period when women are particularly susceptible to developing depression,3 especially if they have a personal history of it.
Before initiating hormone therapy, I often found myself weeping with no clear reason. Everyday sounds—like passing traffic or conversations in a shopping center—felt overwhelming.
I was jumpy, irritable, and anxious about situations that had
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