Oestrogen and progesterone are the primary sex hormones in females, playing powerful roles throughout life - from puberty and periods to pregnancy and eventually menopause.
Author
- Jessica Piasecki
Associate Professor in Exercise Physiology, Sport Science Department, Nottingham Trent University
During adolescence, these hormones surge, kick-starting the menstrual cycle. In adulthood, they fluctuate month to month, driving ovulation and menstruation. But between the ages of 45 and 55, their levels start to decline.
This signals the beginning of perimenopause - the transitional phase leading to menopause, which is officially marked when a woman has gone 12 consecutive months without a period. After that, hormone levels settle at a lower, steady baseline, ushering in the postmenopausal stage.
However, this hormonal journey is far from one-size-fits-all . Each woman's hormonal profile is as individual as her fingerprint : pregnancy, breastfeeding, contraceptive use and lifestyle choices can all influence hormone levels in unique ways.
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Oestrogen and progesterone don't just affect the reproductive system, they also act directly on the brain . Both hormones can cross the blood-brain barrier and influence neural function. Oestrogen tends to excite brain activity, enhancing alertness and mood , while progesterone is more calming and balancing .
When these hormone levels begin to fluctuate during perimenopause, they can disrupt many of the systems they regulate, especially in the brain. Common symptoms like hot flushes, night sweats, memory problems, mood swings, poor sleep and even depression are not just nuisances. They're signs that the central nervous system is being affected.
These neurological symptoms can have a domino effect on physical and mental health. In fact, research shows that women are more likely than men to experience frailty and cognitive decline in later life - a trend that may be linked to the hormonal shifts around menopause.
That's why it's so important to approach menopause as a whole-body, whole-brain experience and not just a reproductive event.
Experiences of menopause
Along with colleagues from Nottingham Trent and Northumbria universities, I conducted research that explored how women describe their personal experiences of menopause. The findings were eye opening.
When asked to sum up menopause in one word, participants offered responses like: "Anxiety." "Horrific." "Bizarre." "Depression." Many expressed frustration at the lack of clear, trustworthy information and a feeling of isolation. One woman said: "I don't know what my body is capable of doing from one minute to the next … the pain, it's just horrible."
Another described overwhelming fatigue: "I haven't got the energy I had when I was young." While others reported profound mental health struggles: "I had this thing where I hated myself", "I would have a rage within me, which wasn't me normally", "I had depressive episodes and was very poorly." One participant reported that she was "feeling overwhelmed and panicked about doing anything, even leaving the house".
These stories reveal the reality behind the statistics - menopause can be deeply destabilising, and for some women, life altering.
The more symptoms women experience, the more their quality of life can be affected. But there is hope. Research shows that higher levels of physical activity are linked to fewer and less severe menopausal symptoms.
That's why our research team has taken our findings beyond the lab. Through public events and workshops, we're helping women learn about how nutrition, brain health, and exercise can support them through the menopausal transition. And the impact goes beyond biology: gaining knowledge has been shown to boost self-confidence and help women feel more in control and less alone.
There's still much to learn about the full impact of menopause on the brain and body, but one thing is clear: supporting women through this major life stage is not optional - it's essential.
By continuing to share knowledge, break taboos and support one another, we can change the story of menopause from one of confusion and isolation to one of empowerment, understanding and resilience.
Jessica Piasecki receives funding from The Royal Society and MyAge. She is affiliated with Power Group -- National Institute of Women's Health and Performance and Relative Energy .Deficiency-Sport (RED-S) interest group
