When going through the menopause it can literally feel like you are losing your mind: grappling with irritability, struggling to find the right word, or overpowered by anxiety. You can feel like you are losing your grip on the capable woman you once were.
Neurological symptoms in menopause
It therefore might not be a surprise that many of the common menopausal symptoms are thought to originate in the brain. 80% of women are thought to experience one or more of these so-called neurological symptoms including: hot flashes, insomnia, depression, anxiety and memory loss.
Prominent neuroscientist Lisa Mosconi has been at the forefront of investigating what is going on in women’s brains during the menopausal transition, beginning in perimenopause through to post-menopause once periods have stopped for good. The picture is far from complete, however, her research is providing a number of insights – which may help us to take care of our transitioning brains. There is also some hope that the post-menopausal horizon may not be as bleak as it may seem if you are currently mired in the perimenopause.
Before going into detail about the menopausal brain it is helpful to lay out a few facts about menopause and the brain.
Menopausal symptoms and the brain-fuel connection
The brain is a huge consumer of energy – it is estimated to consume around 40% of our body’s energy use per day. If the brain isn’t getting enough energy it won’t function effectively. For men and most women prior to the menopausal transition, glucose is the primary fuel for the brain. Generally our brains are thought to utilise glucose less effectively as we age but the decline is greater post-menopause and in people with a genetic risk of dementia. Less effective use of glucose is thought to underlie problems in the brain and nervous system at these times.
When glucose isn’t available the brain can also get it’s necessary energy from ketones – created by breaking down fat. Generally the brain should trip into ketone burning during fasting, for example, overnight and between meals. Our ability to swap between glucose and ketones is called our metabolic flexibility.
Poorer ability to use glucose during the menopausal transition should ideally push our brains towards greater use of ketones as a source of fuel. If, however, we don’t do this there is evidence that we instead break down neurons to provide fuel!
How might nutrition and lifestyle affect menopause?
All of the above suggests various factors that might influence our brain’s access to fuel during the menopausal transition.
- How well our body is generally managing it’s blood-glucose balance. For example, a high sugar diet can actually lead to patches of low glucose as the body’s blood-glucose regulation systems become dysfunctional.
- Do we encourage metabolic flexibility, for example, do we give our bodies time to drop into ketosis between meals and overnight or are we constantly grazing and therefore always carb burning?
- How much muscle mass do we have – a greater percentage of muscle may be protective in a number of ways as we age. The key relevance here is that higher muscle mass is associated with greater metabolic flexibility.
What does this mean for our future brain health
Current evidence suggests that there are significant changes in the brain during the perimenopause including a decline in energy production but that the brain may adapt and recover post-menopause. Interestingly, a number of changes are also seen during pregnancy, with the brain recovering postnatally.
Further information
If you would like find out more about how you can support your mind and body through the menopause contact me for a personalised assessment and tailored support program.
For those of you who have a genetic risk of Alzheimer’s Disease and are interested in how brain fuel and menopause fit into the Alzheimer’s picture I will be post a blog post relating to this specifically soon.
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