Perimenopause and the Brain
Mood changes, brain fog, and insomnia anyone?
We have been told that it’s coming - the night sweats, the mood swings, the erratic periods.
But perimenopause is much more than just a transition out of our reproductive years, it is increasingly being understood as a complete rewiring of the brain and neurological system.
And for many of us, these neurological changes can start much earlier than the internet and our GP tells us.
Most women are told that perimenopause usually starts in our mid-40s, and goes until our periods stop completely, 7-10 years later.
But for many women, the neurological and mood changes begin much earlier.
Do any of the following feel familiar?
Insomnia
Spinning thoughts more than before, or waking up and not able to fall back asleep? Insomnia can be related to or triggered by changes in body temperature or stress and anxiety, which can both be caused by hormonal changes.
Brain fog
Suddenly losing your words or forgetting the name of your kid’s best friend’s mum? You’re not alone.
Anxiety or Depression
Intrusive thoughts, worrying way more than normal, suddenly feeling exhausted and unmotivated or outright depressed. This can be related to early changes to hormonal levels that may not be evident in blood tests, and many women are put on anti-depressants or other medication which may not address the underlying cause of erratic hormonal fluctuations.
Night sweats or hot flashes
Possibly the most commonly known symptom of perimenopause, for some women the occurrence of these can be reassuring that all the cognitive and mood symptoms are not a sign that you are losing the plot, but a sign that you are starting the transition into perimenopause.
But on their own, hot flashes and night sweats can be uncomfortable, can lead to sleep disruptions, and can be embarrassing - particularly as they can be exacerbated or triggered by a stressful situation - like giving a presentation at work.
Pre-menstrual headache or migraine
Headaches or migraines that come on right before or during your period can be a sign of hormone fluctuations (headaches are also common in pregnancy for the same reason).
So what can we do about all of this?
While it is of course important to get any concerning symptoms - physical or mental - checked out by your primary healthcare provider, it is worth approaching perimenopause from a variety of angles.
Perimenopause is a biopsychosocial transition - meaning that it is not “just” about hormonal changes (the bio part of biopsychosocial), but also about the context in which this transition takes place.
Perimenopause does not happen in a vacuum.
Many women in their late 30s and early-to-mid 40s are parenting children aged anywhere from newborns to teenagers. You may have ageing parents. Your career may be particularly busy or in a growth phase.
And statistically, women still carry the majority of the mental and emotional load when it comes to managing a household - think making the grocery lists, knowing all the kids schedules and when the next birthday party is (plus organising the buying of the gift), and sorting out childcare. No kids? There is still meal planning and laundry and social calendars and the massive cognitive load that goes with it all.
And because of these cognitive and mood changes, we may find that our capacity to carry it all is reduced - even if we seemed to be able to “do it all” before.
And the point of all this is that because perimenopause is not “just” about the hormones, we cannot focus only on the hormones and expect a full resolution of symptoms.
Here are our best suggestions for a holistic approach:
Share the load
This is a great time to have a frank discussion with your partner if you have one, with your friends, with your neighbours, with your parents - with anyone in your community that you think may be able to help. We have been doing too much for too long, and it is time to share the cognitive load.
Not sure where to start? Check out Fair Play for resources, information, and a book all about the unequal mental and domestic load that women generally carry.
(Be prepared to get a bit angry before you come to the solutions part)
Offload any tasks that you can - and not just the physical doing, but also the mental thinking and planning part.
This can be challenging and may lead to uncomfortable feelings and discussions but long-term this is possibly the most important suggestion on this list.
Food and Movement
Like most things in life, eating well and moving your body enough can make a big difference.
We have all been inundated with messages of “eat more protein” but it bears repeating - 1-1.2gm/kg of body weight for sedentary women, and up to 2.3gm/kg of body weight for active or athletic women.
So if you are 65kg - this is anywhere from 65-150gm of protein per day depending on your activity levels.
Check out this handy pdf for info on how much protein is in certain foods https://wellsouth.nz/assets/NEW-Your-Health/Services-we-offer-the-community/Protein.pdf
Getting enough fibre is also crucial in this time of life.
Fibre is important for ensuring your body can process and eliminate excess hormones; supports a healthy microbiome, which is key for regulating hormones; and helps to support stable blood sugars. Blood sugar dips and swings can influence hormones such as insulin, cortisol, and your sex hormones.
But getting enough fibre doesn’t have to be complicated or require supplementation. Eating plenty of fruit and veg as well as whole grains, beans and legumes at each meal and snack should help you to meet your daily needs.
Our exercise needs change at this time of life, too. You may find you need more recovery time than previously - and you would be wise to heed your body’s call for rest. Pushing through can lead to increased cortisol levels which 1) are a stress hormone, and we don’t need anymore of that, and 2) cortisol can exacerbate other hormonal symptoms, which we also don’t want.
Finding an exercise or movement routine that supports and honours both your need to move, keep your flexibility, amp up your bone density - and your need to rest - is key.
Acupuncture for Hormone Balance, Mood, and Energy
Multiple studies support the use of acupuncture to regulate the menstrual cycle and support a smoother perimenopausal transition.
Here's how acupuncture works to regulate hormones:
a.) Stimulating Key Points: Points are carefully selected to target the endocrine system, which governs hormone production and regulation. By stimulating these points, acupuncture can help regulate hormone levels and promote balance.
b.) Enhancing Blood Flow: Acupuncture improves blood circulation throughout the body, ensuring that hormones are effectively transported to where they are needed. This enhanced circulation can also support the function of the ovaries and other hormone-producing glands, helping to alleviate symptoms of hormonal imbalances.
c.) Reducing Stress: Chronic stress can disrupt hormone levels and contribute to imbalances. Acupuncture has been shown to reduce stress and promote relaxation by stimulating the release of endorphins, the body's natural feel-good chemicals.
d.) Addressing Specific Symptoms: Whether you're experiencing menstrual irregularities, menopause symptoms, or want to boost your fertility, acupuncture can be tailored to address your specific concerns. We’ll work together to develop a personalized treatment plan that targets your individual needs and goals.
e.) Holistic Approach: Instead of focusing solely on symptom management, acupuncture aims to address the underlying imbalances that are contributing to your symptoms, promoting long-term healing and wellness.
How many treatments are recommended?
One treatment per week for three months is the standard recommendation for regulating the menstrual cycle and reducing symptoms, although it is common for patients to see positive changes before this.
Why three months?
Because ovarian follicles typically take three months to mature. Follicles produce hormones that influence the menstrual cycle and eventually release an egg during ovulation. Acupuncture helps create optimal conditions for follicles to ripen, and the timeframe for this process happens to be three months.
Perimenopause is a huge transitional time that half of the world’s population will go through if we are lucky enough to live to that age. It is time that we honour this change and its challenges with the seriousness and care it deserves.
At Lifecycles, our goal is to support your wellbeing through every age and stage with holistic care that centres you and your needs. Contact us or book today.