Midlife & Menopause Moments

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The Bank of Brain Chemicals

by on July 15, 2013 5 Comments

I think about brain neuro-transmitters (or brain chemicals) like money in the bank. We all make brain chemicals when we sleep, and we spend them throughout the day to accomplish everything we do. Some chores and events “cost” more brain chemicals than others — the more stressful the event, the more chemicals that are used and the higher the “cost.” We all experience periods of stress throughout our lives, and stressful events we feel the least control over cost us the most brain chemicals.

For genetic reasons, some of us make more brain chemicals than others. Unfortunately, when our estrogen level is low, we go through brain chemicals faster. Read on to learn about three separate women who are all dealing with brain chemical issues, and find out how one treatment can work for all three.

Sally’s Battle with Postpartum Depression
Sally* was 35, and she had recently given birth to her first child (Sam). Sally had a difficult time getting pregnant, and she used a tremendous amount of her energy preparing for his arrival. She attended childbirth classes, read numerous books, and joined online chat rooms to learn everything she could to become the best mom possible. Sally took a leave from her job, and her husband was just as excited about becoming a new parent as she was. Fortunately, the delivery went well, and she fell instantly in love with Sam when she saw him for the first time.

The first three weeks as a new mom were difficult, but the bright moments made the long nights worthwhile. Then “it” hit and things changed very suddenly. Sally and Sam were enjoying a day at a park; Sally was chatting with other moms, and a wave of sadness quickly moved over her. The sky went from blue to grey, and she felt her happiness fade. So, what changed?

Sally was a new mom, breastfeeding (a naturally-low estrogen state), and she wasn’t sleeping. She was placing high expectations on herself and spending large amounts of brain chemicals on trying to be the perfect parent. Therefore, she was not making her usual amount of brain chemicals, and she was spending more than she made. Sally was experiencing what experts call Postpartum Depression.

Linda’s PMS-on-Steroids Experience
Linda* was 43 and was known for being outgoing and happy — seamlessly juggling a busy household with four kids, several dogs and a husband who traveled for work. Linda exercised religiously, had numerous friends, and worked at home while her kids were young. At first,Linda began to lose her motivation to clean and decorate her house. Then, she stopped making her kids’ favorite cookies or muffins. Eventually, everything she enjoyed — exercising, sex, preparing healthy meals, going out with friends — simply became too much work and not worth the effort. Other changes started occurring as well: hot flashes and night sweats starting three days before her period, jeans feeling tighter, and losing her temper quickly over insignificant events. Linda felt completely overwhelmed! What happened to her “perfect” life?

Linda was having regular periods but not sleeping well for several nights before they started, and she ran a lifestyle that required a significant amount of brain chemicals. Doctors call her situation Late Reproductive Phase or Perimenopause with PMDD (PMS on steroids).

Susan’s Hormone Nightmare
Susan‘s* mom was 53 when she went through menopause, so Susan wasn’t surprised when her periods became irregular and then completely stopped when she turned 53. She also began having hot flashes and night sweats, but they didn’t interfere with her life enough to cause great concern. Susan wasn’t sleeping well, but she thought she was just going through a phase and it would pass. Then, little things began to irritate her — her husband’s snoring, his loud chewing, and preparing her classroom for her fourth graders. In addition, Susan began dreading the weekly scheduled cocktail hour in the summer with her husband and other couples. She used to look forward to catching up on the details of her friends’ lives, but it all seemed irritating to her. Even worse, her usual one drink soon became two drinks or more, and she became short-tempered over small things. And to top it off, Susan completely lost her sex drive and would get angry if her husband even suggested sex to her. What was wrong with her?

Susan lost her estrogen levels overnight, and she had unknowingly relied on them to keep her sleep patterns and brain chemicals in good balance. This is called New-onset Hormone-related Depressive Disorder.

Many of us can relate to at least one of these three stories in one way or another. So, what is the treatment and how can these women (and all of us) regain control of their lives? The answer begins with figuring out which body changes are intersecting with which lifestyle changes and starting to care for “you” again. It begins with the basics:

  • Get at least 7-8 hours of sleep each night
  • Drink 80 oz. of water per day
  • Take vitamins daily — especially B Complex and Vitamin D
  • Exercise regularly (at least 10,000 steps per day)
  • Minimize simple carbohydrates, including alcohol (instead eat sweet potatoes, brown rice, fruits, and vegetables).

If you truly can’t bring yourself to take these simple steps, see your doctor! It could be time to boost your brain chemical levels (especially serotonin) with a short course of medicine. These medicines — so-called antidepressants — can be safe and very helpful for many women. Other options for some women include a prescription for estrogen (in the form of birth control pills, topical gels, or patches) and/or progesterone. The most important thing to keep in mind is that help is available for many different situations — just ask!

*not her real name.

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About the Author ()

Diana Bitner, MD, is board certified in obstetrics and gynecology. She received her medical degree from Wayne State University School of Medicine in Detroit and completed her residency in obstetrics and gynecology at Butterworth Hospital in Grand Rapids, Michigan. Dr. Bitner has special interests in women’s wellness and prevention of heart disease, menopause, perimenopause, laparoscopic and robotic pelvic surgery, and pelvic pain. She is also fluent in Portuguese.

Comments (5)

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  1. Kashina Lee says:

    Thank you for this information. I have been feeling like I’m slowly going crazy these last 2 weeks. I am a 38 year old wife and mother. I feel as though I have lost my estrogen overnight. My periods have been regular but, with one due in the next day or so I have felt like I’ve been thrown into menopause hell! I cry, I have hit flashes, I have panic attacks, I woke up with my heart racing for no reason. I went to my doctor and got blood work done and I’m waiting for the results. My biggest anxiety is that she will tell me my blood work is normal and it still won’t know what’s wrong. I’m so depressed and I feel like I’m losing myself.

    • Diana Bitner, MD says:

      Kashina, I’m very glad you wrote to me, and I’m so sorry you are feeling like this! I hope the blog entry helped a bit to explain the relationship between hormone levels and brain chemicals. Read on for more information that can help you sort out what is happening to your body.

      Just before your period, your estrogen and progesterone blood levels fall, which signals a period to start. After the age of 35, it is normal for your levels to fall faster and to a lower level only during certain months. A result of this drop in blood levels can be a period that starts earlier than expected or is heavier than normal. The symptoms you are experiencing can also occur and may feel like menopause; fortunately, these symptoms are usually limited to three to five days and may not occur for another three to 12 months.

      When your estrogen levels fall lower and more quickly than normal, you may experience symptoms such as hot flashes, night sweats, interrupted sleep, crying jags and panic attacks. All of these can be related to your hormone changes, and we call this premenstrual dysphoric disorder (PMDD), or “PMS on steroids.” Before I would conclude that you have PMDD, I would first check your blood levels for thyroid, and I would perform some basic tests like a blood count (CBC), electrolytes and kidney/liver function. Hormone blood tests are not usually helpful and do not give helpful information unless you are in full-blown menopause, which I doubt you are. Therefore, do not be surprised if your tests are normal.

      The symptoms you are having are not in your head—they are real and have a real cause. They are caused by several things, including your body thermostat and your sleep quality. Your symptoms will also be much worse if you are dehydrated, overweight, eating too much sugar, and/or stressed about your long to-do list. Reduce your symptoms by doing the following:

      • Drink plenty of water
      • Keep your caffeine and alcohol intake to no more than one serving per day
      • Eat healthy and don’t eat too much sugar
      • Sleep as much as you can
      • Take “timeouts” for yourself by closing your mouth, breathing through your nose and focusing on a spot on the wall for five minutes
      • Write in a journal about what you are thankful for (a good tool to stop your panic attacks)

      If you try all of these suggestions and your symptoms continue, it might be time to consider medications. You should talk to your doctor about options, such as the birth control pill, if you are a candidate, or other hormone options for just the week before your period. Also, if you continue to experience these same symptoms every month, your doctor can also prescribe a medicine from the class SSRI (Selective Serotonin Re-uptake Inhibitors) for just the week before your period to stop your brain chemicals from falling so quickly as you become sleep deprived and stressed out.

      I wish you the best—you are not crazy, and you will not feel like this for the rest of your life!

  2. Lisa Basset says:


    Wonderful post and I was following all your post recently.


  3. Healanyone says:

    I have hit flashes, I have panic attacks, I woke up with my heart racing for no reason.

  4. Amy says:

    Thank you Dr. Bitner.

    I have a friend (age 40) who recently had experienced what she thought was an aura followed by a migraine. Her symptoms became worse a day later when she found it difficult to speak. She was checked into the hospital and had a battery of tests done. They ruled out stroke, tumor, aneurism however after the EEG results came in neurologist said she had signs of seizure activity. She has never had a seizure prior and it does not run in the family.

    Do you think there may be a relationship b/t her perhaps being peri-menopausal and that coupled with stressors that could be a factor in her EEG showing abnormal results (similar to seizing)?

    Appreciate your thoughts on this. I find this area of medicine fascinating.

    Thank you in advance.

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