Menopause Is All in Our Heads

Menopause Is All in Our Heads and that’s not the insult you think it is! If you are experiencing brain fog, lack of concentration, forgetfulness, short-term memory loss, feel like you have ADHD or early onset dementia THEN this is for you.

In the last couple of years there has been a real growth in the understanding of how eostrogen affects all areas of our body as we navigate through menopause.

As I have said before, but it’s really important to repeat…… Menopause is a WHOLE BODY experience.

Menopause is much more than just a reproductive experience (periods stopping). We are discovering more and more how menopause impacts our whole body because our “reproductive hormones” do TONS of things in our body beyond just regulating our menstrual cycle.

A really big milestone moment has come from understanding how eostrogen affects our brains and more specifically our changing brain function.

Pioneering research by Dr. Lisa Mosconi and her work with monitoring and mapping women's brain function during menopause has shed much needed light on understanding that there really is something important going on here with changing women’s brains.

Much has been written about the statistics that seem to show that older women have much higher rates of Alzheimer’s (about double)and other cognitive degenerative diseases compared to their male counterparts. As a result, the thought process and conventional wisdom that is being promoted at the moment says this:

"Older women have much higher rates of dementia and Alzheimer's related diseases. Eostrogen is an essential hormone for brain function, neurotransmitter function, growth and stimulation and overall brain health.Women loose eostrogen in menopause and therefore if we support eostrogen levels as women age (HRT) we can stop all neuro-degenerative decline/ disease."

This approach is being promoted as one of the main reasons for supporting long term HRT use in menopause and post-menopause.

Kate Muir, a journalist and writer, is one of the pioneers of the menopause conversation in the UK. She was the producer of Davina McCall's Menopause Documentaries on Channel 4 (in the UK), has written books on menopause and hosts a podcast on the topic. She should definitely be credited with bringing the menopause conversation to the masses.

BUT, and this is a BIG BUT, her voice and position are now being used to promote the thinking that HRT is the ONLY solution to all our menopause and midlife problems. She is also promoting HRT for healthy aging including supporting your bones, brain and heart as we age and supporting the “HRT is the GOLD Standard for healthy aging” position held by Dr Louise Newson and others.

Read any of Kate’s social media posts (example here 1) and see how she lays out the problems of midlife in such a stereotypical, triggering and negative way that the obvious next step has to be HRT use and now long-term HRT use.

Now I will repeat here, as I have done numerous times in the past..... I am NOT anti-HRT. 

It has its role in supporting women on their menopause journey.What I am against however, is the assumption that HRT is the ONLY way to manage menopause. That it is a one-stop shop, one size fits all miracle solution.

I am also against biological facts (specifically about the role of hormones in our body) being applied and used to implement a "gold-standard" pharmaceutical solution approach without nuance, education and personalization for each woman.

I want to suggest you keep some perspective when you are reading the doom and gloom posts and risks to women's health as we age and the linear connection made specifically (but not exclusively) between the decline in our brain function and the use of HRT as a way to prevent this.

Four things to keep in mind when talking about HRT:

1. Many "menopause experts" will use biology and science to justify their claims of the range of symptoms and diseases that are caused by our declining hormones. It is REALLY difficult to peel back the layers here and differentiate between when science is being used to justify a position or when research and data is being used accurately and how the information is being used honestly to explain a situation.

But pay attention to the language used, to the research being brought and try and see where the thought process is ending up (for example, is HRT being offered up as the magic bullet).

2. So many menopause experts and specialists use empowering language at the beginning of their posts. Phrases like:

“Menopause is a normal, natural biological stage of life. It gives us the opportunity to look inwards and pay attention. It is a time for us to connect to our true selves and listen to what is going on.”

This is great and very true!

BUT then it is followed by such sentences as

“But you are struggling, you are suffering, you are not functioning, your body is betraying you. HRT is going to support your hormones so we don't suffer with symptoms and protect you as you age.”

We have heard this so many times we just assume it makes sense.BUT is it true?

Furthermore we just moved from empowering language to disempowering, fearmongering language in one fell swoop without even noticing.

3. I want to address the specific gender issue that is being propagated with respect to women’s higher risk of Alzheimer’s and cognitive decline.

A UK Alzheimer’s Society 2 article and a PubMed paper 3 both discuss the gender differences observed, but express the problems with making a direct link between menopause, declining hormones and the increased risk to women.

Other factors need to be investigated and researched including lifestyle differences, stress experienced by each gender, genetics and specific gene mutation, the role of Traumatic brain injury (TBI) as a dementia risk factor.

To quote the Alzheimer’s Society article “the relationships between sex, menopause and dementia risk are extremely complex and until recently researchers have not prioritised menopause as an opportunity to learn more about dementia. We need a lot more research before we can draw any firm conclusions.” 

4. The approach presented by Kate Muir and others in her posse is the linear medical approach in its most simplistic form.

But we know our bodies are more complex and complicated, disease is multi-layered and healthy aging, being symptom-free and feeling amazing in your body is not dependent on ONE action, treatment or solution.

This simplistic approach ignores that supporting our bodies, nourishing them, keeping them in optimal health with limited illness and healthy aging has to be an integrative multipronged approach. Being told that HRT (or any other treatment option) holds THE secret to curing you is a dangerous road to travel down.

The menopause movement, especially in the UK, seems to have been co-opted by the “HRT is the Gold Standard Treatment” approach as a response to the WHI 2002 Report which positioned HRT use as dangerous and increasing cancer risks.

But the messaging todays seems to be very jumbled and uses the most basic fearmongering tactics to justify their position.

Using the biology of hormones and the important role they play in our body as the rationale for promoting long-term HRT use is at best naïve and at worst intellectually dishonest.

As Dr. Lisa Mosconi says herself ““There’s a whole system {referring to the brain and our body} that needs to be better understood before we mess with it.” 4

We need more research, more data, more gender based education and information and more nuance in the menopause information and conversation. And we need to be very careful what assumptions we make when it comes to educating and supporting women to really understand what is happening to their changing bodies as they navigate through menopause and beyond.

Jacqueline Rose is a Menopause Educator and Coach, hormonal health specialist and founder of the Menopaus Informed Training Program for therapist, coaches and wellness practitioners. You can schedule a free Discover Call with Jacqueline