Menopause is a natural biological transition, yet for many women it arrives with symptoms that feel anything but natural. Hot flushes, night sweats, brain fog, mood swings, sleep disruption, weight changes, and a sense that the body has fundamentally shifted — these experiences are real, and they are rooted in significant hormonal change.
Understanding what is happening hormonally during menopause can help women make more informed decisions about their health and wellbeing.
What Is Menopause?
Menopause is defined as the point at which a woman has not had a menstrual period for 12 consecutive months. In the UK, the average age of menopause is 51, though it can occur earlier or later.
The transition leading up to menopause — known as perimenopause — can begin years earlier and is often the period during which symptoms are most disruptive. Hormone levels during perimenopause fluctuate unpredictably before eventually declining.
The Key Hormonal Changes
Oestrogen
Oestrogen is the dominant female sex hormone and influences almost every system in the body. During menopause, oestrogen production by the ovaries declines significantly. This decline is responsible for many of the most common menopause symptoms, including hot flushes, vaginal dryness, bone density loss, cardiovascular changes, and cognitive effects such as brain fog and memory difficulties.
Progesterone
Progesterone has calming, sleep-supporting, and mood-stabilising effects. As ovulation becomes irregular during perimenopause, progesterone production declines — often before oestrogen does. This can contribute to anxiety, poor sleep, and emotional sensitivity in the early stages of the transition.
Testosterone
Women produce testosterone in smaller amounts than men, but it plays an important role in libido, energy, muscle tone, and mood. Testosterone also declines during menopause and is increasingly recognised as an important part of the hormonal picture.
DHEA and Cortisol
Adrenal hormones including DHEA and cortisol become more significant during menopause, as the adrenal glands take on a greater role in hormone production. Chronic stress during this period can further disrupt the hormonal balance.
The Comprehensive Female Saliva Hormone Profile (LCMS) measures oestrogen, progesterone, testosterone, DHEA, and cortisol using highly accurate LCMS technology — providing a detailed picture of where hormones stand during perimenopause and menopause.
Common Menopause Symptoms and Their Hormonal Roots
- Hot flushes and night sweats — driven by declining oestrogen affecting the brain’s temperature regulation centre
- Sleep disturbances — linked to low progesterone and night sweats disrupting sleep architecture
- Brain fog and memory difficulties — associated with declining oestrogen and its effects on dopamine and serotonin signalling
- Mood changes and anxiety — related to progesterone decline and disrupted neurotransmitter balance
- Weight gain — influenced by oestrogen decline, cortisol, and changes in insulin sensitivity
- Low libido — associated with declining testosterone and oestrogen
- Fatigue — linked to poor sleep, adrenal stress, and thyroid changes
The Neurotransmitter Connection
Oestrogen influences serotonin, dopamine, and noradrenaline — neurotransmitters that regulate mood, motivation, and cognitive function. As oestrogen declines, these neurochemical systems can be disrupted, contributing to the emotional and cognitive symptoms many women experience during menopause.
The Women All-In-One Test – Hormones, Neurotransmitters & Heavy Metals combines female hormone assessment with neurotransmitter measurement — providing a comprehensive view of both the hormonal and neurochemical changes occurring during menopause.
Frequently Asked Questions
How do I know if I am in perimenopause?
Perimenopause is characterised by irregular periods, changing cycle length, and the onset of symptoms such as hot flushes, sleep disruption, and mood changes. Hormone testing can provide additional clarity about where you are in the transition.
Can menopause cause anxiety and depression?
Yes. Hormonal changes during menopause can disrupt neurotransmitter systems involved in mood regulation, contributing to anxiety, low mood, and emotional sensitivity.
Does menopause affect brain function?
Declining oestrogen can affect dopamine and serotonin signalling, contributing to brain fog, memory difficulties, and reduced cognitive sharpness — symptoms that many women find particularly distressing.
Final Thoughts
Menopause is not a disease — it is a transition. But it is one that deserves to be understood and supported. Knowing what is happening hormonally in your body can help you have more informed conversations with your healthcare provider and make choices that support your wellbeing through this significant life stage.
This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional for diagnosis and treatment.