Mood swings. Night sweats. Brain fog. Menopause comes with a host of symptoms that can make you feel awful emotionally and physically. Due primarily to declining levels of the hormone, estrogen, the unfamiliar and erratic symptoms that lead to and through “the change,” can wreak havoc on your overall sense of well-being.
During the years of fertility, estrogen naturally fluctuates throughout the month, commensurate with a woman’s menstrual cycle. Then after 3 decades or so of having a monthly period, women enter perimenopause, which is a years-long process that reflects changing levels of estrogen related to decreasing fertility. During this time, instead of having rolling fluctuations of estrogen each month, this hormone will start to spike and dip, with the highs being higher, and the lows lower than what one would have experienced during PMS. Since there are estrogen receptors in every organ of the female body, when this hormone begins declining, it can have a significant impact on overall functioning.
Mood swings. Night sweats. Brain fog. Menopause comes with a host of symptoms that can make you feel awful emotionally and physically. Click To TweetSymptoms of Perimenopause
Although symptoms usually start out as mild, they begin to worsen as a woman gets closer to the beginning of menopause. At the same time that estrogen levels are decreasing, progesterone—nature’s feel-good hormone that helps you feel calm—also begins to decline. The combination of changes in these and other hormones can lead to numerous symptoms, including episodes of:
- Feeling depressed or anxious
- Aggressive behavior
- Irritability
- Weight gain
- Headaches
- Fatigue
- Brain fog
Hot Flashes and Other Menopause Symptoms
In addition to experiencing the emotional and cognitive symptoms of menopause, the majority of women will start having hot flashes, one of the most prominent issues during “the change.” Episodes of being suddenly overheated can be embarrassing too as a woman becomes drenched in perspiration, dreaming of a walk-in freezer to help her cool off. Being in warm temperatures, taking a hot shower or bath, and working out can contribute to hot flashes. Other triggers include:
Basically, anything that causes blood vessels to dilate can set the stage for a hot flash to occur. Nonetheless, they feel miserable while they last, which can be anywhere from a few seconds to 10 minutes or more. There is also a lot of variability in the duration of this bothersome symptom. Some women may have a few hot flashes a week, while others may have them multiple times a day. And this may go on for a matter of months or many years, although the average length of time is about 4 years.
Other symptoms that women commonly develop during menopause include:
- Night sweats
- Vaginal dryness
- Urinary tract infections or urinary incontinence
- Decreased libido
- Low mood
- Sleep difficulties
- Memory problems
No one ever said it was easy to be female!
7 Ways to Manage Menopausal Symptoms
There are a number of ways to help reduce or manage the symptoms of menopause and the deleterious effects they seem to have at times. Here are 7 ways to feel better:
1. Hormone Therapy.
While there are some concerns regarding traditional hormone replacement treatments, such as an increased risk for heart disease and breast cancer, the short-term use of low doses of bio-identical estrogen and progesterone can give some much-needed relief for symptoms like hot flashes. Vaginal estrogen creams are also helpful in reducing dryness, urinary symptoms, and increasing comfort during sexual intercourse. Working with a functional medicine doctor who will do a full hormone evaluation and treatment may be very helpful in getting your symptoms under control.
2. Medications.
Not all women can or want to use hormone therapy, so fortunately certain medications can be helpful. Research published in the medical journal, Menopause, found that the use of the anticonvulsant medication, gabapentin, was effective for reducing hot flashes and night sweats. Similarly, low doses of some antidepressants may help with hot flashes too, and in addition, can help with mood problems.
3. Eat a well-balanced diet.
Be sure to include plenty of fresh produce, clean protein, and healthy fats like those found in avocados and nuts. And because the lack of estrogen can deteriorate bone health leading to osteoporosis, be sure you’re getting adequate calcium and vitamin D. Talk to your doctor about any need for supplements in this regard.
4. Regular exercise.
While the overall benefits of being physically active are amazing, getting regular exercise can help you manage anxiety while boosting your mood and supporting your heart health (your heart can also be adversely affected by the lack of estrogen). And be sure to include a couple of days of weight training each week to help keep your bones strong.
5. Sleep hygiene.
Being exhausted due to lack of sleep as a result of hormonal changes is certainly one of the biggest challenges. Therefore, improving your habits around bedtime can be very helpful. Try these:
- Keep your bedroom temperature low and have a fan near you to help you cool down during night sweats.
- Minimize extraneous noise. Use a white noise device, if needed.
- Use dark curtains to block exterior light.
- Turn off electronic devices for at least an hour before bedtime. The blue light they emit can disrupt your circadian rhythm.
6. Stress management.
Unpredictable hormonal changes and the accompanying symptoms—which may differ from one day to the next—can be unsettling and stressful. Incorporating relaxation techniques into your life, such as gentle yoga, meditation, and acupuncture, can help offset this.
7. Avoid alcohol.
As mentioned above, it can exacerbate the frequency of hot flashes, but in addition, hormonal imbalances can cause emotional issues, such as feeling more sad, irritable, or anxious. Since alcohol makes you less inhibited, it can worsen these symptoms and cause you to say or do things you might regret.
The challenges women face during this time in their lives can often feel overwhelming. However, using a variety of healthy strategies to help manage your symptoms can make a big difference in how you get through “the change.” The good news is that many of the more difficult symptoms resolve once menopause has passed!
Hormone problems can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.
My personal approach is to eat legumes such as red kidney beans, broad beans, Le Puy lentils, and so on, regularly, and to drink plain water throughout the day , starting with a cup or glass first thing in the morning and then some more later on – about 3 or 4 cups/glasses a day as needed. The legumes and water both help me with menopausal (actually, post-menopausal) hot flashes , which can be severe especially at night, reducing sleep quality. If I’m hungry before bedtime, I also eat a small snack such as a high fibre cracker, to keep my blood sugar comfortable, which also aids sleep.
I don’t know if my regime does anything for my bone and heart health, so I’d suggest speaking with a primary care physician for more information, and perhaps treatment for menopausal symptoms which can be extremely debilitating and seriously unpleasant.
Comment by Alice Mander — September 17, 2021 @ 8:33 AM
Thanks Dr Amen for another great article. I never expected menopause to be so difficult and life changing. Although I never had too bad a time with hot flashes, I began to get migraine headaches for the first time which would last for days.. then the low mood, low libido and difficulty sleeping.. textbook really. What’s so frustrating is I have been to multiple doctors who just want to write prescriptions for medications with other side effects.. I’m still searching 8 years later but Dr Amen is one of my most valuable resources, so thank you again.
Comment by Barbara Vest — September 18, 2021 @ 4:49 AM
Hormones declining is not the only thing that is happening in a woman’s body. This is reductionist approach. We need to see the body as a whole. Proper nutrition and lifestyle practices is all is needed to recover and maintain health. Taking hormones is unnatural . There is sufficient scientific and medical evidence showing they promote cancer, heart disease, strokes as demonstrated in the largest studies like the WHI (The Woman’s Health Initiative) in 2002 that was terminated three years before completion because “the harm was greater than the benefits”.
Kalyani Fad
Comment by Kalyani Fad — September 20, 2021 @ 5:13 AM
My aunt invited me over for dinner where she told me about how she has been having mood swings recently that she thinks may be due to the menopause. Ever since, she has been looking to visit a menopause treatment clinic and that’s where I decided to help her with some research. I did some looking around online and there, I found your wonderful post here. I really liked where you mentioned that getting regular exercise can help you manage anxiety while boosting your mood. This is a good point you made here, one I’m sure anyone like my aunt here will be glad to have learnt of. I’ll make sure to share this with her soon, thank you!
Comment by Dean Phillips — September 20, 2021 @ 5:49 AM
I,m 88 and getting night sweats??
Comment by Joan — September 20, 2021 @ 5:58 AM
Sincerely, I was extremely excited to receive this mail about menopause especially from team dr Amen. Reading about hormone replacement therapy kind of disappointed me. As a functional medicine practitioner, I work with women going through menopause since quite a few years and my holistic approach never included HRT. I was really hoping to find out something new and innovative as I am used from dr Amen . Is there any research on how the brain changes during menopause and how one can deal better with the emotional roller coaster women experience during this time?
Comment by Laura Peischl — September 20, 2021 @ 6:16 AM
Gabapentin really does help alleviate hot flashes. Since I have family history of breast cancer, no one will prescribe me hormones.
I would be interested in ANY suggestions to help w/all other physical menopause issues (dry skin, dry everything) that fall under “hormonal”.
Comment by Patty Vollen-Tigo — September 20, 2021 @ 7:09 AM
FYI,
Hardly no one is talking about more rare primenopause symptoms which can make your life hell on earth:
Itchy legs
If you had migraines you will probably get it stronger and more often
If you had tendency for Vertigo, you will likely get it stronger more often
The different “flavors “ of hot flashes:
Hot and red and Sweaty
Red, hot but no sweat
Hot but dry and not red
Hot, dry and red
Red, not hot, no sweat
Wonderful, isn’t it?
I was sure I am going crazy when I got all regular symptoms and in addition I had itchy legs which I scratched like a nut, and on top of it the vertigo which I used to get mildly every few years came back (BPPV) with a vengeance.
Only a female OBGYN was kind enough to tell me it all had to do with Primenopause.
Just putting it here in the open. It might help someone to feel less out of control.
Comment by Ori Dinur — September 20, 2021 @ 7:24 AM
Hello Ori, what you describe sounds like my allergy to nickel. I had to go on a nickel free diet (which sadly included cutting out dark chocolate, beans, oats, brown rice & kale). My skin was inflamed from all of these foods and it was miserable. I was tested at my allergist (wore the 48 hour patches on my back). Food allergies develop as we age and I encourage every person to be tested! My shrimp allergy developed at 28; then nickel at 35.
Comment by Jenny Blum — September 20, 2021 @ 9:46 AM
Thank you Dr Amen for this important information! I thought I was getting crazy! This roller coaster of emotions sometimes all in one day…
Comment by Dianne — September 20, 2021 @ 12:24 PM
Thats all well, and everyone will try different approaches, but sometimes unfortunately you need to take HRT,
I have hated it during my post menopause and still after 6 years because of UTI, continually. How do you choose between UTI or breast problems.. I am trying to figure this out, Dr Amens products are wonderful, I have used them for years but they do not stop every problem you get from menopause.
Comment by Diane — September 20, 2021 @ 2:08 PM
I’m also a bit dissapointed, I didn’t think he would recommend HRT or medication as gabapentine or antidepressants. I was expecting a more natural integrativo treatment..
Comment by Caroline — September 20, 2021 @ 2:29 PM
Im a chiropractor and have worked on Native American herring fishermen in the San Frsncisco bay. I asked what does the Native American Indian women do for menopause. He said our women don’t experience menopause we don’t eat the meat you people eat. I take my son hunting for deer and rabbit with a bow and arrow. Our meat is loaded with synthetic harmonies plastics pesticides all estrogenic.
Comment by Dr Jay English — September 20, 2021 @ 6:56 PM
Please send more info on hormones and mental/emotional effects on mood/brain etc. . Throughout my life I’ve dealt with major mood swings. Dr Oz once explained it perfectly-ones Outlook on life in general is altered relative to hormonal levels. Please send solutions/explanations as to how each hormone affects the brain. Thank you!!!
Comment by Carol — September 20, 2021 @ 7:22 PM
70 years old and continuing to experience hot flashes, night sweats, pre-period-like cravings for salt and sweet.
The worst is sweating profusely after taking a shower, even a tepid one. I can’t wear face moisturizer or makeup because it melts or I can’t even get it on. After about 40 minutes I’m OK but it’s miserable while it’s happening; makes getting dressed difficult too. Drink 3-4 bottles of water a day and eat whole foods as much as possible. Lazy, though, gardening is my go-to exercise.
Comment by Deborah Freeze — September 21, 2021 @ 9:51 PM
I see plenty of comments against HRT. I went through early menopause 10 years ago and did try many alternatives but eventually adopted HRT after tons of research both on HRT and to find a gynecologist that had a lot of experience. Although I respect anyone who will just stick to more natural solutions, I think the decision must be made by each person. Personnally, after 1 year where I suffered from incredible fatigue, heart palpitations, debilitating lack of focus and depression, HRT in the span of 1 week gave me back my life and enabled me to return to the level of physical and intellectual activity I was accustomed to. 10 years later, I have phased out HRT and feel perfectly fine. I left the business qorls to study with IIN where Dr Amen was one of our brilliant advisers. your work on mental health and healthy brain aging is outstanding and I share many of your advice with my clients both in the US and France. I do listen to my clients concern so I would never push anyone towards HRT, what I always advice is education on various approaches so the person what best suited their symptoms and I always start with natural approaches. Thank you for your dedication.
Comment by Cassis Moussu — September 22, 2021 @ 5:52 AM
I would suggest to all women to read Dr John Lee’s books”What your Doctor May Not Tell You about Menopause” or Premenopause. Dr Lee was the pioneer in addressing our issues and brought to light the Bio-Identical hormones needed to enjoy this stage of life, without jeopardizing our lives using the big pharma drugs prescribed by many doctors. A friend in her 80s gave the book & I feel it saved my life.
Comment by Teddi Thompson — September 22, 2021 @ 9:42 AM
I don’t think my head sweats are from menopause. I’m 65 and the sweat just pours out of my head , and streams down my face and neck and down my back. It’s horrible and it happens whenever it wants .
Never at night in bed. Can’t get any answers .
Comment by Cynthia Kachadorian — September 22, 2021 @ 4:23 PM
Estrogen Matters is an excellent book by Avery Bluming MD and Carole Tavris PhD explaining the history of HRT and its safety for the overwhelming majority of women, and the health benefits to the brain, bones and heart, as well as relieving the common symptoms of hot flashes, brain fog, disrupted sleep, muscle and joint aches, moodiness, painful sex, fatigue, etc. Earthquakes are “natural” too, but no one wants to experience it 24/7 forever. Women only lived to around 50 in 1900 so we’re in perimenopause or menopause, and not having to deal with decades of difficult symptoms, Alzheimers, heart disease, osteoporosis. Women deserve to live a healthy, happy long life . One out of 5 women get Alzheimers vs. 1 out of 10 men. Scientists are studying the drastic drop of estrogen in women in regards to Alzheimers. I hope Dr. Amen and colleagues read this book.
Comment by Ellen Mulle — December 5, 2021 @ 1:13 PM
I hope you update this as the new research shows that HRT helps prevent women from serious cancers, cardiovascualr disease, etc. Thank you for including HRT as a part of the original posting. We know so much more now than we did even two years ago. Women do not need to suffer and treatment is available. Thank you.
Comment by KSC — November 3, 2023 @ 10:08 AM