What Really Happens to a Woman’s Brain During Menopause — And Why No One Talks About It
Menopause is often spoken about in hushed tones, reduced to jokes about hot flushes or brushed aside as something women are expected to “just get through.” But what if one of the most profound changes of menopause isn’t happening in the ovaries — but in the brain?
This question has been sitting with me deeply, both personally and professionally. It was brought into sharp focus when I began reading The Menopause Brain by neuroscientist Dr Lisa Mosconi. From the very first chapter, her words resonated — not because they were sensational, but because they reflected something I recognise in my own menopause journey and in the women I support every day: confusion, frustration, and a quiet sense of being dismissed.
Menopause: A Transition We’re Not Prepared For
Despite women making up half the population, menopause remains poorly understood and chronically under-discussed. Rather than being recognised as a natural life transition, it’s often framed as decline — the end of youth, vitality, productivity, and relevance.
Many women feel pressure to endure symptoms silently. Speaking openly about anxiety, memory lapses, sleep disruption, or emotional changes risks being labelled “hormonal,” unstable, or past one’s prime. For women without strong support networks, this can be deeply isolating.
What’s missing from most conversations is this: menopause is not just hormonal — it’s neurological.
The Brain on Menopause
Conventional medical discussions tend to focus on the physical markers of menopause — irregular cycles, hot flushes, breast changes. Yet the brain is one of the most hormonally sensitive organs in the body.
Oestrogen plays a critical role in brain energy production, temperature regulation, mood, sleep, and cognitive function. As hormone levels fluctuate during perimenopause, the brain must rapidly adapt.
Dr Mosconi’s research shows that during this transition, brain energy metabolism can decline by up to 30%. This helps explain why so many women experience:
Brain fog and memory lapses
Anxiety or low mood
Sleep disturbances
Increased sensitivity to stress
Difficulty concentrating or finding words
These experiences are real, measurable, and biological. As Dr Mosconi aptly states: this isn’t in our heads — it is our heads.
A “Second Puberty” of the Brain
In 2017, Dr Mosconi launched the Women’s Brain Health Initiative, the first research program to image the female brain across the menopause transition. What emerged was groundbreaking.
Brain structure, chemistry, and connectivity all shift during perimenopause. Neural networks reorganise. The brain is not failing — it is rewiring itself.
This is why menopause is increasingly being described as a second puberty. It is a period of intense neurological change, requiring support, nourishment, and understanding — not minimisation.
How History Shaped Menopause Shame
To understand why menopause is so misunderstood today, we need to look backwards.
For centuries, women’s biology has been viewed through a lens of inferiority. Charles Darwin famously claimed men reached higher intellectual achievement than women. In the 19th century, flawed skull measurements were used to “prove” women were less intelligent.
Menopause was labelled “women’s hell” and treated with alarming interventions — from vibrating devices and water therapies to morphine, opium, and even toxic metals. When symptoms persisted, women were often institutionalised.
The discovery of oestrogen in the 1930s didn’t entirely help. Instead of being framed as a hormone essential for long-term brain and metabolic health, it became associated with preserving youth and desirability. By the mid-20th century, menopause was positioned as a disease of deficiency rather than a natural transition.
Some of these outdated ideas still echo today, influencing how symptoms are dismissed and how women are treated within the healthcare system.
Why So Many Women Feel Unsupported
Many general practitioners receive minimal training in menopause care. As a result, women presenting with sleep issues, anxiety, mood changes, or cognitive symptoms are often offered antidepressants without any discussion of hormonal or neurological drivers.
This is not about blame — it’s about gaps in education and research that have left women underserved.
Rewriting the Menopause Narrative
The good news is that the story is changing.
Research in women’s brain health is expanding rapidly, and menopause is finally being recognised as a period of recalibration rather than decline. With the right support, this transition can become a powerful time to reassess health, priorities, and self-care.
Most women will spend up to 40% of their lives post-menopause. That is far too long to live with unanswered questions or unnecessary suffering.
This stage of life deserves clarity, compassion, and evidence-based care.
Supporting Your Brain Through Menopause
Supporting the menopausal brain involves far more than symptom management. It includes:
Targeted nutrition for brain energy and metabolic health
Nervous system regulation and sleep support
Reducing inflammatory and metabolic stressors
Supporting hormone–brain communication
Individualised care that acknowledges each woman’s experience
This is where naturopathic medicine can play a meaningful role.
Let’s Make Menopause Mainstream
We need to talk about menopause — openly and honestly. We need to research it, teach it, and share our experiences with the next generation of women.
Menopause is not the end of anything. It is a transition — one that deserves respect, understanding, and proper care.
If you’d like to explore how menopause affects the brain and what you can do to support cognitive, emotional, and metabolic health, I highly recommend The Menopause Brain by Dr Lisa Mosconi.
And if you’re seeking personalised support through perimenopause or menopause, y book an appointment via the link below.
