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Hormonal Changes

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Estrogen and Progesterone Levels:

As discussed previously, estrogen, in particular, has a profound impact on brain function. It helps regulate neurotransmitters like serotonin, dopamine, and norepinephrine, which are crucial for mood regulation. The drop in estrogen levels can lead to imbalances in these neurotransmitters, contributing to mood swings, anxiety, and depression.

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Cortisol:

Stress hormone levels may also fluctuate during menopause. Increased cortisol levels can aggravate anxiety and depression and may also affect cognitive functions like memory.

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Neurotransmitter Imbalances

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Serotonin:

Estrogen positively influences serotonin production and its receptors in the brain. A decrease in estrogen can reduce serotonin levels, leading to symptoms of depression and mood swings. This is why it's so important to recognise the other symptoms of menopause and keep pushing for the doctor to take the possibility of menopause seriously. A misdiagnosis of depression and anxiety will result in medication that is only working on a small part of the bigger problem. With the other symptoms playing a significant role, anti-depressants aren't going to achieve much.

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Dopamine:

This neurotransmitter is associated with pleasure, motivation, and reward. Lower estrogen levels can affect dopamine pathways, potentially leading to a decrease in motivation, increased irritability, and anhedonia (loss of pleasure in normally enjoyable activities). My ex had barely any motivation to do anything, and a lot of my attempts to encourage and advise her fell on deaf ears until the HRT started to work. Then she started to take an interest in ways she could improve her quality of life. Ironically, my efforts to get her to do some exercise have finally sunk in now that we've broken up for good.

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So just remember that you can try and help her but she may be incapable of helping herself, and may get frustrated with your efforts to nudge her in the right direction.

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Norepinephrine:

Involved in the body's "fight or flight" response, norepinephrine levels can be affected by estrogen, contributing to feelings of anxiety and stress during menopause. My ex told me that she felt extremely guilty about pretending to still love me, and that the stress of it was overwhelming.

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Changes in Brain Structure and Function

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Hippocampus:

This region of the brain is involved in memory and learning. Estrogen helps protect the hippocampus and supports its function. Reduced estrogen levels during menopause may affect the hippocampus, contributing to memory problems and cognitive changes.

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Amygdala:

The amygdala plays a role in emotion regulation. Hormonal changes during menopause can affect its activity, potentially increasing susceptibility to anxiety and mood disorders.

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Past Traumas Resurfacing

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Emotional Vulnerability:

The hormonal fluctuations and neurotransmitter imbalances during menopause can make women more emotionally vulnerable, reducing their ability to suppress or manage past traumatic memories. The brain's heightened emotional sensitivity, combined with all of the other stressors she's dealing with, can trigger the resurfacing of unresolved traumas.

 

Additionally, as women reflect on their life during this transitional period, previously buried emotional experiences may come to the surface, leading to a re-experiencing of past traumas and the emotions associated with them. My ex did this A LOT:

 

She was once having a bath and asked me to make her a cup of tea. I brought it into the bathroom and she freaked out, explaining she had a creepy ex who would walk into the bathroom unannounced. 

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She would add extra layers of clothing over herself as apparently another ex would get very handsy and she would wear extra layers to put him off. This was her way of keeping me from instigating sex even though I'd already given up on that idea long ago.

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She told me a lot about her exes, and there were numerous things that I normally did that would suddenly remind her of some bad experience she had dealt with in her past. Where I was previously her perfect partner, she suddenly seemed to be turning me into every bad man she had known in her past. And all I was doing was trying to help and be considerate.

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Again, I need to remind you that your mental health is just as important as hers during this period of time. Imagine how it felt to me, to be suddenly thought of in the same light as these people, and often treated the same. It was extremely distressing and unfair of her to do so. Over time these little things really started to chip away at my self-esteem and image. I started to seriously question myself. By the end of it I was a broken shell of a man. Miserable, traumatised, paranoid, and utterly co-dependant.

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Sleep Disturbances

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We know by now that women experience major sleep disturbances during menopause. Chronic sleep disruption can exacerbate psychological symptoms, including anxiety, depression, and cognitive difficulties. I know this first-hand as I served for 25 years in the military. Lack of sleep can have a serious effect on your mind, the way you behave, and your ability to function.

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Psychosocial Factors

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Life Stressors:

Menopause often coincides with other midlife stressors, such as aging, changes in family dynamics, and career transitions, which can contribute to psychological symptoms. 

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Cultural Attitudes:

Societal and cultural attitudes toward aging and menopause can also influence how women experience and cope with this life stage, potentially impacting their mental health.

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Genetic and Biological Factors

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Some women may be genetically predisposed to mood disorders, and menopause can act as a trigger for these conditions. Additionally, individual differences in brain chemistry and hormonal sensitivity can influence how women experience menopause.

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My ex had a difficult childhood and had previously suffered with mental health. I knew about her post-natal depression, and previous drug abuse, but things she had kept hidden from me started to flood out during conversations. I would mention something that upset me about her behaviour and she would explain it. Or she would just throw out a random comment about certain meds she had been on, or loss of sexual function she had suffered in her past. I got all the gritty details of every relationship and was shocked to hear how cold and matter of act she was about some of these men that she had just dropped.

 

I found out after the HRT took effect that she had very serious commitment issues and had been keeping it secret from me. Often going along with me to keep the peace whilst secretly resenting me, or finding excuses for us not to go ahead with plans that would bring us closer.

 

By now, everything combined had had a MASSIVE effect on my mental health, and I started to really fall apart. I was crying randomly to music or kids cartoons. Even in public I would well up suddenly. A few weeks later was when our big argument happened and everything fell apart for good. More on that in the Men's Mental Health Section.

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Understanding the complex interplay of hormonal, neurological, and psychosocial factors is essential in addressing the psychological symptoms of menopause. Treatment options often include hormone replacement therapy (HRT), lifestyle changes, and psychological support to help manage these symptoms.

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