Dr. Brizendine on the post-menopausal brain

Louann Brizendine

It’s often the dreaded early signs of perimenopause that have us turning to Google, and what we’re typically greeted with is far from celebratory. All that information about the chronic pain, vaginal dryness, weight gain, hair loss, and hot flashes that come with menopause only reinforces the ineffable fear of losing one’s beauty, one’s youth, one’s appeal – one’s worth, even. One woman, however, has shifted the overarching narrative, painting a picture of this transformational process that’s downright liberating. Meet Dr Louann Brizendine, author of The Upgrade.

A neuropsychiatrist by profession, she set out to write this revolutionary book to not only explain how a woman’s brain gets “upgraded” in midlife and beyond, but also inspire and guide women to unlock their full potential. Exploring the power of this phase to shape-shift, she delves into how menopause is not a curse nor a punishment, but a chance to open and evolve. Life after ‘the change of life’ is no longer an afterthought. “What has surprised me most is the response of women in their thirties, who are so excited and relieved about the message in the book,” she observes. “They’re just glad to know their life isn’t over at 40 or 45.”

If anything, Brizendine says that hormonal changes help reshape women’s brains for the better in a way that creates a bracing clarity and laser-like sense of purpose – with the right approach, that is. But with change comes challenges, and the book doesn’t turn a blind eye to the assault of undesirable symptoms, so expect guidance on how to navigate the storm (while it lasts). In fact, unlike most titles of its kind – which seem to fixate on hot flashes – it also addresses the likes of sleep disturbances and concentration difficulties. The incredible possibilities of a new brain state, however, is its raison d’etre.

Interestingly, Brizendine steers clear of the words ‘perimenopause’ or ‘menopause’, stating that they’re medical establishment terms anchored in fertility, and therefore suggest a sense of obsolescence. Instead, she refers to menopause as the ‘Upgrade’, and the hormonal changes that take place leading up to it as the ‘Transition’. And from her spunky and optimistic perspective, the Upgraded female brain is more direct and authentic, courtesy of newfound neurological stability. “Without the monthly cycles of fertility hormones pushing and pulling like tides through our brain, our creativity and vision can take hold powerfully,” she explains.

There’s also a drop in anxiety that allows the female brain to flip its attentional style from multitasking to focusing on one thing at a time. “This isn’t a deficit,” she insists. “It means you will become more engaged, more thorough.” Brizendine’s research has also revealed that a woman’s inclination to cater to others’ needs relaxes in midlife, thereby allowing her to become more centred. The change in ratio of oestrogen to testosterone, meanwhile, changes the way her brain handles anger and disappointment, and makes her able to speak out.

“The female brain is no longer stressed by its wiring being hormonally altered by 25 percent every month, and so the freedom to solidify its circuitry allows easier access to feelings of firmness and conviction unlike at any other time in a woman’s life.” Long story short, brain 2.0 is focused and fearless.

While the Transition can last between two and 14 years, the Upgrade can continue to unfold over the course of 40 or 50 years, according to Brizendine. The freedom is extraordinary, she says, redefining what it means to be female. “Who do you want to be in your Transition and beyond? You have decades ahead of you following the reproductive phase of life.

Who do you want to be as you enter the fullness of your age? Is it a leader, an artist, a visionary, a mentor and sponsor? Is it a life filled with freedom, purpose, and focus unencumbered by the responsibilities of an earlier time?” asks an excerpt in The Upgrade. “Just as the female brain is wired for connection and communication at birth, the Upgrade allows those circuits to choose new synaptic partners that have nothing to do with the hormonal drives that dominate decision-making during the reproductive phase.”

Incidentally, Brizendine was among the first to explore why women feel, think, and communicate differently than men through her game-changing 2006 book, The Female Brain. Her latest roadmap and radically positive understanding of ageing came about from her own experiences and those of the thousands of women at her clinic – she founded the Women’s Mood and Hormone Clinic at UCSF in San Francisco back in 1994.

It is here that she has listened to countless stories of joy and loss, discovery and fear, freedom and disorientation from women in Transition. And it’s such intimate anecdotes that come together with actionable, science-backed steps for preserving brain health for the rest of your life – some of which may come as a surprise.

“Doing 100 butt-squeezes per day helps your brain!” she enthuses. “In a large study of women at age 80, those with the greatest leg strength also had the best cognition.” This is because stronger muscles can lead to a strong brain, and the gluteus maximus happens to be the body’s biggest muscle. Another tip she shares is to wiggle your toes and smile upon waking up every morning.

Doing the former activates the sciatic, the longest nerve in the body, and stimulates all the way up into the brain. As for why you should smile at yourself? A study published in Experimental Psychology reports that practising smiling stimulates the amygdala, the emotional centre of the brain, which releases neurotransmitters to encourage an emotionally positive state.

Forced smiles aside, a conversation with Brizendine reveals that we genuinely get happier with age, too. “It’s called the ‘positivity effect’,” she states. “Research at Stanford and other places shows that we get happier and happier with each decade of life. There’s no real known reason for why this is, but it’s something to look forward to. And it’s important to know because it’s almost counterintuitive, as we tend to say and think the opposite.”

Interviewer and journalist Samia Qaiyum

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We understand there’s a lot of information out there on the menopause. You can read through the NICE guidance on menopause management, as well as the NHS overview on the menopause.