By Karen and Erica

Menopause. The ceasing of menstruation. Most woman lucky enough to live long enough go through it. Most women fear it, and most people speak about it only in whispers. Just like we used to speak about menstruation. What a strange state of affairs for natural processes that are fundamental to the physical lives of all women.

Happily, a spotlights is being shined on both--though more the beginning than the end. (You can stare at illustrations of menstrual underwear as you ride the subway to work. Menopausal issues have not yet made the main stage, as far as we know.) 

Many of us have been through menopause. We didn’t love it while it was going on. But we think that for most people it is does not require the level of fear and loathing the media promotes—especially for people who have had periods for several decades. And once you are through it you may feel rather liberated. Even empowered. (Maybe that’s the media’s real concern. What will we do with our new power?)

But it certainly would not hurt to know more about menopause. What exactly happens to us, and why? What purpose do hot flashes serve? Why do we feel mental fuzziness? What can we do about sleep disruption?

At a recent Ted Women conference, we heard a fascinating talk about all of this from Linda Mosconi, a neuroscientist and neuro nutritionist, a brain researcher at Weill Cornell who also studies Alzheimer’s prevention. She did not answer all of our questions, but she gave us some intriguing information.

For one thing, Dr. Mosconi is emphatic that women’s brains are the same as men’s. Maybe better? Any differences come from the things that happen to those brains—like menopause.

Our brains and reproductive systems are linked elements of our neural systems. In menopause, our hormonal picture changes significantly. Those changes affect the brain by reducing brain energy. It is that change in hormones that can cause you to feel mentally fuzzy. Surprisingly, your performance is not affected--and the fuzziness will go away. (Since women perform mentally at a higher level than men, even the fuzziness of menopause leaves you performing at a higher level than your male colleagues. Cheery news!)

Your brain is affected, though. And maybe that’s why many more women than men get Alzheimer’s--men do not have the same drastic hormonal swings. They don’t get hot flashes, either. Can you imagine what world politics would look like if they did?

Hormones can help with hot flashes by replacing the hormones the brain is missing. Most of us did not take hormones, because we were entering menopause just when doctors worried about a link to breast cancer. That was discouraging, of course, and now that we know about Alzheimer’s risk, we wonder if taking hormones would have helped. Apparently not. The good and the bad news seems to be that hormones can reduce the effects of menopause, but they have no impact on the likelihood of getting dementia after, or as a consequence of, menopause.

But we are not without power to affect dementia risk. While there is no unanimity on these points, Dr. Mosconi suggests that three things are important: exercise, diet and sleep. 

• We already know that moving is critical to our well being, and there is a fundamental connection between movement and neural health.

• We also know we feel better when we sleep—though sometimes that is difficult, and we were offered no great ideas about what to do about that.

• We also know that the Mediterranean diet—plants, olive oil, dried fruits and nuts, grains, not much meat and no processed meat—is good for us, but what we did not know is that it is good for us in part because it is good for brain energy. And so is dark chocolate!

So the messages are:

• Menopause is a major brain event. It will make your brain do things a man’s brain will not do. Not too much to do about it except live through it--which is not that big a deal, billions of women have done it and for many of us it has its bad moments but it’s nothing to fear.

• You likely can influence your Alzheimer’s risk. That’s big. 

• Once menopause is over, you will become more regal than ever. Something to anticipate with joy. and maybe consider what kind of tiara you want.