Mood, Motivation and Menopause
The physical symptoms of menopause can be a tough time for women – hot flushes (flashes), night sweats, insomnia, poor sleep, weight gain and aching joints to name a few! When you add on serotonin depletion and the resulting mood swings, life just gets a bit tougher as well.
Within the realm of psychiatry, the term ‘Mood’ refers to an emotional mental state that can fluctuate both acutely and over time. And as many of us know, individual experiences of mood are dependent on both exogenous ‘situational’ factors and intrinsic ‘dispositional’ factors, which are assumed to involve internal physiological processes such as fluctuations in hormones, neurotransmitters, and nutrients.
Understanding mood changes during menopause is important for Practitioners and Coaches, especially when it comes to helping women with their lifestyle solutions specific to their fluctuating moods and motivation levels – whether they have chosen to go on menopause HRT or not.
When I went to my GP because I was concerned about feeling emotional, tearful and anxious in my early 50’s, which was so unlike ‘highly- motivated-and happy-me’, my doctor never once spoke about tryptophan, gut health, sunlight, my circadian rhythm and calming aerobic exercise. Nor my stress levels.
Instead he only spoke about anti-depressant medications. I told him I would think about it.
That day was a turning point for me. Because as I scanned the women’s health and ageing research whilst doing my doctoral studies, I began to look for scientific articles about the relationship between our changing hormones in menopause, mood and depression.
My curiosity about why our mood and motivation changes so suddenly as we get into our mid-life years, led me on a journey of self-discovery about how our changing reproductive hormones in menopause also change the powerful mood and motivation hormone, serotonin.
I also learnt about the powerful role of the gut microbiome in the production of serotonin, but most importantly, my journey took me towards the lifestyle research on depression and moods and the research about restoring serotonin levels naturally.
Knowledge is always power, so understanding this crucial connection menopause hormone changes, gut health and serotonin production, led me to ask myself a very simple question –
“If menopause is the time of life when millions of women start taking anti-depressant medication for their mood swings and anxiety, then how can I better plan my day, prepare my food and do the right exercise, so that my body is making serotonin naturally?’
Serotonin Production and Oestrogen Levels
The surge in studies on menopause and depression over the past decade, elicits the knowledge that oestrogen may produce its effects on cognition and mood through the modulation of serotonergic function.
Oestrogen has pronounced effects on numerous neurotransmitter systems and within mitochondrial organelles, whereby it helps with membrane integrity. [Arnold et al., 2012].
Menopause, specifically the hormonal fluctuations during perimenopause and the subsequent, often rapid, decline in oestrogen levels in some women, may have a profound impact on the body’s serotonin production. In turn, this can impact on mood, sleep, and cognitive function.
Oestrogen plays a critical role in supporting the serotonin system.
This means that the decline in oestrogen levels during menopause, can triggers a decrease in serotonin production. This is linked to increased anxiety, depression, and irritability during the menopausal transition.
This is why many women are prescribed Hormone Replacement Therapy (HRT) in their menopause transition. Oestrogen plays a significant role in managing mood and mental well-being by directly influencing the production, availability, and sensitivity of serotonin in the brain and body.
Because oestrogen also acts as a precursor that supports the production of neurotransmitters, it enhances the activity of tryptophan hydroxylase, the key enzyme needed to synthesize (produce) serotonin.
But there is more to this connection between serotonin production and menopause hormonal changes too.
Serotonin also causes changes to melatonin production and this has an effect on the circadian rhythm.
Furthermore, serotonin production (synthesis) is impacted by tryptophan levels. This means that gut health is also important.
When women experience changing gut health during menopause and they aren’t sleeping well, (as many nurses and shift-workers find), and stress levels are higher than normal, then these factors may accummulate to affect serotonin production too.
Serotonin Production Starts in the Gut and the Skin
Knowing that serotonin is reduced with our natural ageing as women move through menopause, is powerful knowledge.
It’s one of the things I talk about in my 12 week programmes and in the Certified Practitioner Course.
As such, women have the ability to help the body to make serotonin naturally. This requires a protein called Tryptophan.
90% of serotonin is found in the intestine and the remainder in the central nervous system. As a major nerve-transmitter, this powerful hormone, helps to regulate mood, anxiety, control the reproductive cycle, the cardiovascular system, the circadian rhythm, libido and helps to manage stress. We need serotonin in our lives.
Serotonin is also found in the skin.
Human skin acts as an independent neuroendocrine organ capable of producing serotonin and its derivative, melatonin. [Sansone, 2013].
This is why seasonal variations in psychiatric symptoms have been described for a number of psychopathologies, including mood and anxiety disorders in midlife and older women. Sun exposure on the skin helps sleep.
Boost Mood with Sunlight and Food
Getting light in the eyes in the morning, helps women to regulate their circadian rhythm – the 24 hour biological clock. When women have a well-functioning Circadian Rhythm, the brain produces more serotonin.
Early-morning light in the eyes is important and it’s why, I tell women to try and walk outside in the mornings. Which may mean, as I found, a mind-set reset in their morning routine.
The addition of TRYPTOPHAN-RICH FOODS during menopause is an important lifestyle intervention.
Tryptophan boosts serotonin.
Tryptophan is an essential amino acid. This means it cannot be produced by the body and must be consumed via the diet. It is critical for protein synthesis, repairing tissue, and producing vital neurotransmitters.
It is a precursor to serotonin (regulating mood and sleep) and melatonin (regulating sleep-wake cycles), and also contributes to niacin (vitamin B3) production.
The more I began to understand the connection between menopause, gut health, tryptophan and serotonin production, the more I focused on this important nutrient.
Because it’s absorbed in the small intestine and primarily absorbed overnight, it’s an important addition to the daily diet of midlife women.
Tryptophan rich foods not only help to make serotonin, but they also help to make melatonin. It’s why, turning around sleep, what women eat and the timing of it matters.
Foods that are high in TRYPTOPHAN include:
– Almonds, cashew nuts
– Salmon.
– Organic Chicken.
– Oats, Brown rice
– Organic free-range eggs
– Chickpeas (e.g. hummus)
– Green Peas
– Grass-fed beef
– Banana (slightly green banana’s are also high in potassium).
Gut Feelings!
It’s only been in recent years that technological advancements have unveiled significant alterations in gut microbiota and their metabolites in various neurological disorders. (Akbar et al, 2024).
This has meant that scientists now better understand the profound bidirectional communication between the gastrointestinal tract and the brain.
A majority of the serotonin in the human body is produced within the gut, and SSRIs affect enteric (gut) neurons. Selective Serotonin Reuptake Inhibitors (SSRIs) are a widely used type of antidepressant. They can disrupt the gut microbiome. (Sjöstedt et al, 2019; Xu et al., 2023).
oestrogen has a role to play in both the bacteria levels in our gut and also on the maintenance of the integrity of the intestinal wall. When oestrogen levels decline, women become susceptible to leaky gut and other inflammatory conditions in the bowel. In turn, these changes may also impact mood and anxiety levels during menopause.
Many of the women I come across in my programs who are on anti-depressants, have no idea about this connection. I wonder if this is the same for your clients too?
Without a healthy gut, the body can’t absorb essential B-vitamins and without these being absorbed, women feel run-down, depressed and anxious.
“Without a healthy intestinal flora, the body cannot absorb essential B-vitamins.” [Dr A. Junger, Author of Clean Gut]
Joining the dots on these important relationships between menopause moods, melancholy, serotonin and sunshine, trytophan absorption and gut health was life-changing, not only for me, but for thousands of women who join me on the MyMT™ programs and who are, or have been, on anti-depressants.
The menopause transition is a time when women have to consider the connection between sleep, circadian rhythm, food, exercise, liver, gut and joint health renewal and stress management techniques.
When there is a focus on taking an integral approach to symptom management, including mental health, symptoms can resolve, alongisde, or instead of, hormone therapies.
Women have so much of life still to enjoy, which is why my passion is helping women from all over the world get back to feeling like their old selves again and educating Practitioners and Coaches as to how to support women in midlife.
Wendy Sweet, PhD/ Women’s Healthy Ageing Researcher & MyMT™ Creator & Coach.
References
Environews (2008). Benefits of Sunlight: A bright spot for human health. Environmental Health Perspectives, 116(4), 1-8.
Osaali, A. et.al. (2016). The Effect of Twelve-Week Aerobic Exercise on IL-6 level and depression in 50-65 Years Old Women with Syndrome Metabolic. Med J Tabriz Uni Med Sciences Health Services.
Saurabh S., Berman, A. et.al. (2019). Circadian rhythm of vascular function in mid-life adults. American Heart Association, DOI: 10.1161/ATVBAHA.119.312682.)
Sansone, R .& Sansone L. (2013). Sunshine, Serotonin, and Skin: A Partial Explanation for Seasonal Patterns in Psychopathology? Innov Clin Neurosci. 10(7–8):20–24.
Yang JL, Hodara E, Sriprasert I, Shoupe D, Stanczyk FZ. Estrogen deficiency in the menopause and the role of hormone therapy: integrating the findings of basic science research with clinical trials. Menopause. 2024 Oct 1;31(10):926-939. doi: 10.1097/GME.0000000000002407. Epub 2024 Jul 30.
Young LM, Pipingas A, White DJ, Gauci S, Scholey A. A Systematic Review and Meta-Analysis of B Vitamin Supplementation on Depressive Symptoms, Anxiety, and Stress: Effects on Healthy and ‘At-Risk’ Individuals. Nutrients. 2019 Sep 16;11(9):2232. doi: 10.3390/nu11092232.
Xu F, Xie Q, Kuang W, Dong Z. Interactions Between Antidepressants and Intestinal Microbiota. Neurotherapeutics. 2023 Mar;20(2):359-371. doi: 10.1007/s13311-023-01362-8. Epub 2023 Mar 7.
