A Holistic Approach to Mental Health during Menopause
When menopause comes up in conversation, we often picture hot flashes, night sweats, or shifting metabolism. These physical changes get a lot of airtime, and for good reason, but there is another layer we don’t talk about enough.
Menopause is also a time when deep psychological and emotional health shifts occur. For many, it can feel like a reckoning: a time when the brain feels different, when old coping patterns no longer work, and when questions about identity and purpose rise to the surface.
The Mental Health Shifts during Menopause that No One Warned Us About
Alongside physical changes, shifts in how our mental health can also occur. These are often hormone-related and could include:
Short-term memory lapses
Sensory overwhelm, becoming more easily overwhelmed by noise, screens, or busy environments
Difficulty multitasking
Mental fogginess: a sense of static in the brain that makes thinking less sharp
Reduced focus and distractibility: Hello, reading the same paragraph three times and still not absorbing it
Slower information processing
Word-finding difficulties: those lovely “tip-of-the-tongue” moments
Low energy: or that famous tired but wired feeling- my personal non-favorite
Insomnia: need I say more?
Increased anxiety: that fun sense of impending doom.
*These symptoms can mimic many other conditions. That is why a careful assessment from a certified professional is so important.
What’s Happening in the Brain During Perimenopause and Menopause
The most important point of this blog post is that the brain is not immune to the impact of hormonal changes.
Estrogen plays a vital role in supporting memory, attention, and learning by influencing regions like the hippocampus and prefrontal cortex.
As estrogen levels decline during perimenopause and menopause, neurotransmitters like acetylcholine, dopamine, and serotonin are disrupted, which affects mood, motivation, and focus.
This is real, folks! These shifts are even visible on imaging.
Progesterone is usually the first hormone to drop. This hormone has calming and sedative effects through its action on GABA receptors in the brain. That is why lower progesterone levels can contribute to mental health symptoms like mood swings, sleep issues, and anxiety.
The way I view it, these hormonal shifts reduce our tolerance to stressors and thus turn the dial up on any mental health issues we might have already been experiencing.
This is also why some individuals notice that they have neurodivergent traits for the first time during perimenopause and menopause.
Ten Ways to Support Mental Health Through Menopause
1. Connecting with Self-Compassion
Some of the most compassionate words you can tell yourself are:
“What you’re going through is common for this stage. You are not alone in finding this hard. Please be kind to yourself ”.
2. Naming to Tame it
Naming what is happening helps to step out of shame and into understanding. This can help you see that you don’t have a character flaw or a personal failing, but rather are simply going through biological changes!
3. Remembering that This too Shall Pass
It can be helpful to keep in mind that, for many, these changes stabilize post-menopause.
Reminding yourself of this helps your nervous system recognize that it won’t have to sustain the discomfort and intensity of this transition forever.
4. Supporting Executive Function Support
Menopause related changes can affect our executive function. Instead of pushing harder, it often helps to work differently. Strategies can include:
To-do lists
Phone alerts
Visual schedules
Body doubling (having someone present while you organize or complete tasks)
Breaking tasks into smaller chunks
Embracing monotasking instead of multitasking
Beginning with the most unpleasant task
5. Exploring Gains and Losses
For some, the changes brought by menopause elicit grief, and even shame. If your identity was tied to being a workout queen or quick thinker, this period can bring a sense of loss.
It is important to recognize and grieve the losses while also remembering that there can be some real gains that arise during menopause.
Both can be true…
Perimenopause and menopause are often times when individuals find the courage to live more authentically, without worrying as much about what others might think of them. (The expression “no more ---- to give” comes to mind here!)
This makes it a rich time to re-evaluate our values, establish new goals, and embrace what feels important to our beings right here, right now.
Maybe our inner wise women shows up more often. Maybe she offers us reframes along the way (it is scientifically proven that wisdom does increase with age after all)!
6. Prioritizing Sleep
Poor sleep is one of the biggest culprits behind “brain fog” and fatigue in menopause. Because of this, prioritizing sleep is non-negotiable!
Doing all the things that help with this goal is important. Some of my favorites are: yoga nidra, a slick night routine, pink noise, lavender oil, moving outside during the morning, and optimizing my hormonal levels with the help of my doctor. Your solutions might be completely different, and that is more than ok!
7. Managing Stress and Sensory Load
Maybe you have heard about the “spoon theory”, which is the idea that we have a limited number of spoons throughout the day to do the things we want to do. Menopause and perimenopause might reduce these spoons and make us more prone to becoming overwhelmed.
That is why finding ways to rest and regulate when you feel overwhelmed is important. This will look very different for everyone and will take some trial and error to figure out. Some things that might help are:
- Embracing your inner hermit and turning a space in your home into a sensory-friendly cocoon filled with the sounds, colors, smells, and textures that ground you. Oh, and if you want me to speak your ear off for hours at some point, just ask me about binaural beats. Quick version of the story: I find them so grounding.
- Breath work, particularly focusing on lengthening your exhale.
- Restorative yoga (for example, the legs up the wall posture).
- Intentional short breaks throughout the day, even if it just means sipping some tea while looking out the window for five minutes.
Most importantly, I would say, find what works for you, then rinse and repeat!
8. Finding your Movement Medicine
Finding what movement nourishes you and making room for it in your life is essential. It’s all about protecting your vitality!
For some, lifting weights connects them to their internal superwoman strength. Others might like to go full dancing queen or mermaid mode while swimming in the pool. Whatever your thing is. Make space in your life for it. Pro tip: you don’t need to pick just one!
9. Up Leveling your Interdisciplinary Support
We are multilayered beings. That is why optimizing the physical layer with the right medical team can be a game-changer. Connecting with your family doctor, obgyn, naturopath, physiotherapist, or osteopath for extra support can make a big difference.
Psychotherapy can also help with the emotional, cognitive, and even spiritual layers.
My general rule is: the greater the challenge, the more we need to up our resources.
Menopause doesn’t require a “just power through” mindset. The right team can make all the difference.
10. Reframing your Menopause Story
When we see menopause as a recalibration rather than an ending, we open ourselves to the wisdom, clarity, and grounded self-knowledge that often emerge on the other side.
Menopause can be an opportunity to get to know our current body/minds, and to find ways to meet them with compassion.
Reflection Prompts While Navigating Menopause
If you’re navigating menopause right now, you might explore these questions in a journal or with a therapist:
What are you loosing and gaining?
What additional resources would help you?
Who are you becoming?
Closing Thoughts
Menopause can be messy, surprising, and disorienting. It can also be an invitation. When the fog clears, many find themselves more anchored in who they are, less willing to carry what no longer serves them, and more attuned to what matters.
If you are in this season, you are not broken, and you are certainly not alone.
You are in the midst of a recalibration.
One that, with support and self-compassion, can lead to a rich and grounded chapter of life.
If any of this speaks to you, you don’t have to walk this path alone. I offer online therapy across Ontario. Please reach out for a free consultation. I would love to connect!
You can find out more about how psychotherapy can help you manage menopause and perimenopause here.