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Mid-life and menopause mark the beginning of the second half of life. Menopause represents a major life passage for women and there is no way out - except to go through it.

The choices we make in this second half of life are extremely significant.

Choices about health, nutrition, lifestyle, wellness, and performance require knowledge and a commitment to make these choices work. Menopause and mid-life offer endless possibilities and opportunities for you. Women today can individualize their choices and design their second life to their liking so that it is in line with their particular requirements, needs, dreams and desires.

We are entering a time in the history of the world where there will be more menopausal women then ever before. An estimated forty million American women are now in or past menopause. And another twenty million - the baby boomer - generation, will reach that stage of life in the next decade. That is one every seven and one-half seconds for the next ten years!

Mid-life and menopause are wonderfully rich times of life.

The more we know about menopause and how we need to change and how to take care of ourselves the greater the promise menopause holds for us.

Menopause and peri-menopause

Menopause is defined as the period in life when you have had no menstrual periods for one year. Peri-menopause is the years that lead to menopause when the reproductive hormones begin to fluctuate more widely. During this time the dialogue between your brain and your ovaries slows down, develops gaps, and changes it’s conversational pattern. Peri-menopause may last 7-10 years or longer or last only a year or two. Women in peri-menopause rank insomnia, irritability, and depressed mood among the most common complaints. Mental health is the most prevalent difficulty and not hot flashes.

During peri-menopause, there are wide fluctuations in estrogen, testosterone, FSH, LH, and progesterone. Peri-menopause is not simply a time when estrogen diminishes. It is a time when you don’t have enough estrogen and then you have too much estrogen. Peri-menopause is a time of wide fluctuations in hormone levels. These fluctuations result in the mood disturbances associated with peri-menopause.

Blood tests may be used to measure hormone levels during peri-menopause. But due to the many fluctuations in the ovary-brain dialogue during this time, blood tests can be unreliable in indicating exactly where you stand with your hormone levels.

The more definitive way to know if you are close to menopause is to know how many months it has been since your last period. If it has been six months or more since your last period it is likely that you are close to the end of the peri-menopause process.

Eventually you will have no more eggs but the brain still attempts to make the ovaries respond by stimulating the secretion of FSH and LH. FSH and LH hormone levels increase at menopause and remain high thereafter. When there has been no response from the ovaries and your periods have ceased for one year, peri-menopause is over and menopause has arrived.

Your brain, your hormones and your mood

The relationship between your hormones and your brain is critical because the relationship is very vulnerable to the hormonal fluctuations of peri-menopause and menopause.

Estrogen is integral to your health and brain function. It influences the way your serotonin and other neurotransmitter pathways react to normal hormonal shifts. It is easy and common to experience mood variations related to these reproductive hormone fluctuations across your cycle and over the changing years.

Many women will develop mood and sleep difficulties during peri-menopause. Women who have had mood disturbances before in the form of anxiety or depression disturbances are especially vulnerable to the hormone brain dialogue changes during peri-menopause. The loss of estrogen can significantly worsen anxiety, depression, and other mood disorders. Some women are especially sensitive to the loss of estrogen and its effect on the brain.

You do not need to have hot flashes, night sweats, or significant changes in your menstrual periods to be in peri-menopause. Your brain may the first and the only manifestation of the changing hormonal levels in the form of mood or cognitive changes. Hormone fluctuations and mood changes

Estrogen fluctuations can alter neurotransmitter levels in the brain that may result in mood disturbances. The hormonal fluctuations in peri-menopause and its effects on the brain result in fatigue, loss of the feeling of subjective well being, difficulty sleeping, mood alterations, anxiety, poor concentration, depression, changes in thinking patterns and abilities, and problems with memory. Hormone replacement therapy will relieve night sweats and the loss of well being associated with peri-menopause but often it will not alleviate the symptoms that arise from depression.

It is not unusual for women with a history of mood disturbances to find that their moods become harder to manage as they enter peri-menopause. They may find it difficult to find a regime – medication or otherwise - that stabilizes their moods and restores coping abilities. Women who have been taking antidepressants may find that when they enter peri-menopause these medications may not work as well and their symptoms may worsen. Those with mood disorders may destabilize despite adequate medication.

A woman’s mild or severe life long or occasional depression may worsen significantly under the influence of peri-menopausal hormonal fluctuations. A history of mood disturbances and depression indicates that a woman’s brain already requires precise management in self-regulation. Due to hormonal fluctuations, peri-menopause may further compromise the brain’s ability to self-regulate.

When a woman notices that "this feels hormonal," it is appropriate and advisable to look to management of the reproductive hormones to destabilize mood disturbances. Peri-menopausal hormonal fluctuations can greatly influence the brain and may cause something in the brain to shift thus overwhelming a woman’s normal coping mechanisms.

Hormone replacement and mood stabilization

The addition of estrogen replacement by itself during peri-menopause is not capable of resolving the mood symptoms in women with a history of depression and other mood disorders. Once the neuroreceptors and pathways in the brain have sustained the biochemical changes of depression, estrogen alone is ineffective in treating the symptoms of depression. Estrogen can, however, help antidepressants to work more effectively during peri-menopause and menopause.

Some women, when placed on hormone replacement therapy, may actually worsen in their depressive symptoms because progesterone tends to affect moods negatively.

Women with a history of mood problems often can not tolerate the use of progesterone during peri-menopause. Progesterone acts against estrogen in the brain and acts as a dysphoric hormone causing mood and anxiety changes. Various forms, dosages, and regimes, however, may be better tolerated than others. Women with bipolar disorder are particularly subject to the hormonal fluctuations of peri-menopause.

Normal hormonal fluctuations during this time can destabilize moods. Taking progesterone may worsen your depressive symptoms and adding estrogen may make you fluctuate rapidly between mood states.

Hormone fluctuations and cognitive changes

The hormonal fluctuations of peri-menopause may also affect your memory and learning. Estrogen is involved in maintaining specific cells in your hippocampus that are responsible for detailed communication between nerve cells. Estrogen is also related to supporting your acetylcholine levels. When estrogen levels fluctuate or decline, acetylcholine levels fluctuate or decline. Acetycholine is the neurotransmitter that is responsible for memory, creative pursuits, and retrieval of words.

Estrogen is involved in maintaining verbal memory (the recall of spoken material) and enhances the capacity for new learning in women. (Estrogen does not seem to affect what is learned visually.)

Estrogen changes in peri-menopause may also affect other cognitive functions such as recognition, interpretation, decision-making, and eye-hand coordination. Compensating for the changes in estrogen is important for maintaining peak cognitive functioning.

Steps you can take

You can take steps to move more smoothly through peri-menopause and into the new life patterns of menopause by following a program that focuses on:

• Proper nutrition for peri-menopause
• Adequate dietary supplementation
• Increasing your understanding of the hormonal changes occurring and how these affect your neurotransmitters, neurons and brain chemistry
• Paying attention to your sleep patterns and ensuring adequate rest and recovery during the day
• Taking time for yourself
• Increasing your self-awareness

Use the following checklist to find out if you might be peri-menopausal and need to take special care to manage your moods and retain your memory and learning skills.

Do you have these symptoms?

• Hot flashes, night sweats, perspiration and/ or chilly sensations
• Sensations of numbness and/ or tingling of skin
• Insomnia, sleeplessness, and/or restless, fragmented sleep
• Fatigue, feeling of weariness of mind and body with desire for rest; disinclination to make further effort
• Vaginal dryness
• Irregular menstrual bleeding
• Changes in frequency of menstrual cycle
• Irritability, feelings of anxiety or apprehension
• Feeling of depression, sadness, unhappiness and / or being miserable without any obvious reason
• Pain affecting joints and/or muscles
• Headaches of any kind
• Dry skin
• Urinary problems
• Digestive problems
• Sexual / desire changes
• Quickening or acceleration of heartbeat or a fluttering/pounding heartbeat in a sitting or resting position
• Sensation of "crawly skin"
• Forgetful, scattered and/or suddenly disorganized
• Clumsiness and /or incoordination
• Difficulty remembering past events and/or learning new material
• Slow to recall a name or to find the right word

The more symptoms that you have experienced the more likely it is that you are entering peri-menopause. It may be time for you to take some steps to shift your health and self-care focus to provide adequately for your new hormonal and well-being needs.

If you want help, schedule an appointment now. I have lots of experience and tools to guide you toward being the person you want to be in an exciting second half of your life. Call 434-263-4996 or mailto:maryann@evenstaronline.com

© Copyright 1997 - 2008 by Mary Ann Copson and Evenstar. All rights reserved.

About the Author:
Mary Ann Copson is the founder of the Evenstar Mood & Energy Wellness Center for Women. With Master's Degrees in Human Development and Psychology and Counseling, Mary Ann is a Certified Licensed Nutritionist; Certified Holistic Health Practitioner; Brain Chemistry Profile Clinician; and a Health, Wellness and Lifestyle Coach. Reconnect to your physical, emotional, mental, psychological and spiritual natural rhythms at
http://evenstaronline.com

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