The Wisdom of Menopause

by Christiane Northrup

  As the years passed I was introduced to new theories about the mind-body connection and information about the benefits of physically releasing emotional distress, past as well as present, through crying, yawning, sweating, shaking, and so on. These things remained a concept for a long time. I knew the information in my head, but I had not assimilated it into my being for use. I was still fighting the monthly disability of PMS and internally asking why—why did I, who was creative, intelligent, and loving, have this condition that was ruining my life?

  Insight came one day as I was getting a migraine and knew what would follow. I consciously asked myself what would happen if, instead of fighting the feeling and judging myself as a defective person, I instead allowed myself to fully feel what was happening in my body. I surrendered my control and focused on just being present with my body for the first time ever.

  I felt vulnerable. The shift in my hormones left me feeling vulnerable. That was not a state of being I could tolerate. I was a warrior, not a maiden. I cried, acknowledging my defenselessness. I experienced my feminine side for the first time. In fear, I had raged against it in the past. No wonder I felt like a victim. I was battering my own feminine side—my internal goddess.

  I stayed with the feeling. I didn’t die. I needed her softness and wisdom. The migraine faded. I eased up on my self-judgment and embraced that part of myself long hidden—even from my own view.

  The physical symptoms that had accompanied my PMS lessened. I now use the increased energy to do some other things for myself. I have a holistic nutritionist and slowly am improving my diet. I use a good massage therapist. I continue to feel and release my past and present feelings. I have fun at whatever I am doing because I see it as important, as my own creative expression. I talk before crisis occurs.

  I have continued to be challenged by my body’s response to my poor choices. I am grateful for its ability to do so, and now when I wonder, it is more a question of what than of why: what am I doing that denies my feminine inner wisdom and goes against my true spiritual identity?

  As I sit present with that question, the answer bubbles up from within. We do come with an instruction kit, if we will just quiet ourselves to receive the information and learn some new skills.

  Moving from an Alternating to a

  Direct Current of Wisdom

  At midlife, the hormonal milieu that was present for only a few days each month during most of your reproductive years, the milieu that was designed to spur you on to reexamine and redirect your life just a little at a time, now gets stuck in the on position for weeks or months at a time. We go from an alternating current of inner wisdom to a direct current that remains on all the time after menopause is complete. During perimenopause, our brains gradually make the change from one way of being to the other.

  Biologically, at this stage of life you are programmed to withdraw from the outside world for a period of time and revisit your past. You need to be free of the distractions that come when you are focusing your mothering efforts solely on others. Perimenopause is a time when you are meant to mother yourself.

  It may be no accident that the word menopause invites the association “pause from men.” We don’t really need to withdraw from men per se. We need, rather, to put our focus on ourselves instead of spending so much time and effort pleasing them! In truth, you are being urged, biologically, to pause from everyone—from mankind in general—in order to do important work on yourself. As a result of this, one of the most common threads running through women’s descriptions of how they feel during the menopausal transition is the longing for time alone, for a refuge that provides peace, quiet, and freedom from distractions and demands.

  It’s a wistful dream, seemingly out of reach in this busy age of multidirectional tugs-of-war. But those who have the yearning know deep within that their uncomfortable menopausal symptoms would simply dissolve if only they had the luxury of shutting out the world so they could tune in to the growth process occurring within themselves. This wistful dream is real. It comes from your soul. You can trust it and believe in it—and to remain healthy, you must do its bidding.

  Even if this dream seems out of reach, the simple truth is that every woman can find refuge within her existing environment. Even if you can’t charter a plane to a deserted island, odds are that if you acknowledge and validate your need for solitude, then you can clear some time and find a private corner to retreat to daily. You can in-sulate yourself from noise, telephones, the Internet, and interaction with others. I encourage every woman to find a way to do this on whatever level is possible, even just for fifteen minutes a day. When we commit to taking this first step, we have the chance to develop a newfound sense of ourselves and our life’s purpose, which gives us an exhilarating sense of what is possible for us during the second half of our lives.

  FIGURE 2: CURRENTS OF WISDOM

  FSH and LH stimulate ovulation and are released cyclically each month up until the years before menopause. They then undergo a change during which ovulation gradually ceases and FSH and LH levels gradually increase. I believe that these high levels have to do with moving from “AC current” to “DC current.” The intuitive wisdom that was once available most clearly during only certain parts of the menstrual cycle is now potentially available all the time.

  THE MULTIPLE ROLES OF YOUR

  “REPRODUCTIVE” HORMONES

  It has long been known that our female hormones are not involved solely with reproduction. They are connected with our moods and with the way our brains work. Boys and girls have the same rate of depression up until puberty. After that, when ovarian hormones surge and cycling begins, depression increases in females, with the highest incidence reached between ages twenty-two and forty-five. The lifetime incidence of depression in males is only one in ten, while in females it is one in four. After menopause, the rates of depression in men and women reach gender parity once again. Cross-cultural studies have shown that women have a higher lifetime incidence of depression in other societies as well.

  I believe that this gender-wide susceptibility to depression is in part related to the subservient roles that most women in most cultures have been forced to play for millennia. That said, it is also true that the menstrual cycle, pregnancy, the postpartum period, and the perimenopausal period are all associated with depression in many women. And those who are susceptible to PMS are also the most susceptible to postpartum depression and perimenopausal mood problems. Part of the reason for this has to do with the complex interaction between the hypothalamus, the pituitary gland, the ovaries, and the multiple hormones that are produced in and interact within these key areas. These key hormones are:

  ~ GnRH (gonadotropin-releasing hormone), which is produced in the hypothalamus

  ~ FSH (follicle-stimulating hormone) and LH (luteinizing hormone), which are produced in the pituitary and stimulate, in turn, the rise of estrogen and progesterone during the monthly menstrual cycle

  ~ Estrogen, produced in the ovaries, body fat, and other areas

  ~ Progesterone, which is produced primarily in the ovaries and together with estrogen, prepares the lining of the uterus for implantation and growth of an embryo

  The hypothalamus regulates the production of all of these hormones and is in turn regulated by them—and by many others. It has receptors on it not only for progesterone, estrogen, and androgens (e.g., DHEA, testosterone), but also for norepinephrine, dopamine, and serotonin, neurotransmitters that regulate mood and that are affected in turn by our thoughts, beliefs, diet, and environment.

  If estrogen, progesterone, and androgens had no other role in the body besides driving reproduction, your levels of these hormones would drop to zero after menopause. But they don’t. Similarly, if GnRH, FSH, and LH suddenly were without purpose after menopause, one might expect that there would cease to be any of these hormones circulating in your system after that time. In fact, quite the contrary is true.

  During perimenopause, GnRH levels begin to rise in th
e brain, causing FSH and LH to surge to their highest levels ever. A popular explanation is that this is the body’s attempt to “kick-start” the ovaries into resuming their original function, which might make sense if it weren’t for one eloquent fact: those elevated FSH and LH levels stay elevated, permanently, well after it is physiologically obvious that the ovaries (which are, essentially, out of eggs) have no intention of jumping back onto the reproductive bandwagon. It would seem that your body, in its wisdom, has ulterior motives for continuing to produce the so-called reproductive hormones, and reproduction no longer is the point. In fact, evidence is mounting that at least one of the roles for this off-the-charts production of FSH and LH, and of the GnRH that precipitates this rise, is to drive the changes taking place in the midlife woman’s brain.

  For biological reasons, females of the human species are often easier to control—intellectually, psychologically, and socially—during their childbearing years than they are before puberty (from birth to age eleven) or after menopause. Interestingly, hormone levels after menopause are identical to those in girls before puberty. When we are creating a home and building a family, our primary concern is to maintain balance and peace. We seem to know instinctively that when we’re raising a family, it’s better for all if we compromise and maintain whatever support we have, even if it’s less than ideal, rather than risk going it alone. Though this may mean we lose sight of our individual goals, our ability to “go with the program” is in fact protective. A recent medical study done in Sweden, for example, demonstrated that single mothers had an almost 70 percent higher risk of premature death than did mothers with partners. And, surprisingly, this increase in the rate of premature death was the same regardless of socioeconomic or health factors. In other words, even single mothers with adequate economic resources who were physically and psychologically healthy were at greater risk.8

  FIGURE 3: THE HYPOTHALAMUS-PITUITARY-OVARY CONNECTION

  The brain and the reproductive organs are intimately connected by a complex series of feedback loops.

  This process of sublimating our truest selves begins early, in adolescence. The “activist” mindset of the prepubescent girl, her childlike forthrightness and honesty, and her tendency to jump in when there is conflict all become hormonally sublimated. Though an adolescent girl may be concerned with social injustice, she is likely to be even more preoccupied with her body image and attractiveness to potential mates. Put another way, while a woman is being biologically primed for childbearing, child rearing, and nurturing of others—all vital and species-enhancing roles—the conflicts in the world at large become somewhat blurred to her. Her concern with personal injustices and childhood traumas may also fade or be suppressed. She is likely to give minor offenses no more than cursory attention, for to lick her own wounds, analyze old hurts, or confront long-standing abuses would demand precious energy. She needs to fulfill her primary role, which, biologically speaking, is to reproduce and nurture.

  She is rewarded handsomely for complying with this biological agenda. Reproductive hormones are directly responsible for stimulating opioid centers in the brain. These areas actually produce narcotic-like chemicals that swirl into the bloodstream and provide a feel-good sensation, a natural high. Estrogen, for example, is richly provided during the high-fertility phase of the menstrual cycle, when a woman is most “electric” to men and most receptive to their advances. Hormones such as prolactin and oxytocin also flood the system while she is in mothering mode, breast-feeding her baby or nurturing her loved ones. Those strong feelings of attraction, that deep sense of satisfaction, that mantle of loving warmth and purpose that a woman feels when nurturing—all are due in part to natural, narcotic-like chemicals produced by the brain in response to reproductive hormones. Since it feels wonderful, she is encouraged to continue. This is one of the reasons why women are extraordinary caretakers.

  FIGURE 4: REWARD ACROSS THE LIFE CYCLE

  Women who are lesbians and/or who choose not to marry or bear children are not exempted from this built-in incentive system, because it is stamped into their circuits within the first few days of life as a female embryo. Whether the nurturing behavior is related to pregnancy and child rearing or to other forms of caregiving, the biological feedback is unavoidable, powerful, and very, very positive. Research has clearly shown that when women are under stress, we produce the bonding hormone oxytocin, which promotes supporting others. UCLA professor of psychology Shelley Taylor, Ph.D., author of The Tending Instinct, calls this the “tend-and-befriend” response to stress versus the more male “fight-or-flight” response.9

  How Menopausal Hormonal Changes

  Facilitate Your Brain Rewiring

  As a woman enters menopause, she steps out of the primarily childbearing, caretaking role that was hormonally scripted for her. This is not to say that the postmenopausal woman is no longer an effective nurturer. Rather, she becomes freer to choose where she will direct her creative energies, freer to “color outside the lines.” Many of the issues that had become blurry to her when the hormones of puberty kicked in may suddenly resurface with vivid clarity as those hormones recede. This is why so many midlife women recall and decide to confront and resolve past abuses. The concern with social injustices, the political interests, and the personal passions that were sublimated in the childbearing years now surface in sharp focus, ready to be examined and acted upon. Some women funnel this heightened energy into new businesses and new careers. Some discover and cultivate artistic talents they never knew they had. Some women note a surge in their sexual desire, to heights never before experienced in their lives. Some report changes in sexual preference. However they channel it, there’s a wonderful sense of living from the inside out!

  EMBRACING THE MESSAGE BEHIND OUR

  MENOPAUSAL ANGER

  The GnRH pulses associated with menopause prime the brain for new perceptions—and, subsequently, for new behavior. It is very common for women to become more irritable, even downright angry, about things that were more easily overlooked before. Long before we begin to feel hot flashes from changing hormonal levels, our brains undergo changes in the hypothalamus, the place where GnRH is produced. This same brain region is key for experiencing, and ultimately expressing, emotions such as anger.10 It is well known that hormones modulate both aggression and anger. Our midlife bodies and brains fully support our ability to experience and express anger with a clarity not possible prior to midlife.

  GnRH is just one of several hormones that support the changes occurring in the brain. Estrogen and progesterone molecules bind themselves to areas such as the amygdala and hippocampus, which are important for memory, hunger, sexual desire, and anger. Changing levels of these and other hormones may well help to bring up old memories, accompanied by strong emotions, especially anger. This is not to say that anger is caused by hormonal change. Rather, it means that the hormonal changes simply facilitate remembering and clearing up unfinished business.

  Many women are disturbed or frightened when they feel this anger arising. Maybe you don’t feel angry. Maybe you’re “just” irritable, grouchy, aggravated, envious, overwhelmed, or depressed, or you “just” have high cholesterol or high blood pressure. Believe me, all these emotions and physical conditions are associated with the same thing: anger. Anger in women has a bad rap in general unless that anger arises in the service of others. This probably accounts for the fact that although anger has been studied exhaustively in men, the gender in which it is acceptable, the only kind of female anger that has received a great deal of study is maternal anger, the function of which is to protect a child who is threatened. It is also culturally acceptable for women to express their personal anger by fighting for social justice, which too often becomes a platform for releasing personal anger. Though we’re socialized to believe that our anger arises from observing the injustice done to others, the political is always personal: our anger is ultimately about ourselves, and its energy is always urging us toward self-actualization.


  That doesn’t mean we should abandon social protest, reform, and a quest for justice if we feel passionately about these areas. It simply means that we must be mindful of our personal motivation for participating in these arenas, not allowing them to distract us from self-transformation and self-healing—processes that always render us even more effective as agents for social change.

  We need to claim our anger. Especially during midlife, it can play an important role in improving the quality of our lives and our health. It is a powerful signal from our inner wisdom—one we should learn to listen to and act on. Anger always arises from a genuine need that isn’t being met. In fact, in his groundbreaking work on nonviolent communication, Marshall Rosenberg, Ph.D., points out that all human behavior is an attempt to get a need met. (I recommend that you go to Dr. Rosenberg’s website—www.cnvc.org—for an extensive list of needs, which include food, safety, touch, and love. The site also contains a list of emotions that signal those unmet needs.)

  Here are some situations from which anger arises, and the messages behind the anger:

  ~ Being unable to count on promises or commitments made to us (need for reassurance, honesty, and integrity in relationships)

  ~ Losing power, status, or respect (need for respect or recognition)

  ~ Being insulted, undermined, or diminished (need for respect or recognition)