It is wonderful that there are now so many excellent resources and ongoing research on the impact of hormonal changes that women experience during the menopausal transition.  

Having treated women for over 35 years and continuing to research and educate women during this time, I am happy that these resources are now readily available. In addition, because more women scientists and physicians are researching and writing about perimenopause and menopause, there is an evolution of good data to investigate numerous aspects of hormonal changes on health and function.  

I have some concerns about the over-medicalization of this phase of life and want to stress that the presentation of symptoms is as varied as women’s menstrual cycles. Some women have minimal hot flashes, sleep disturbance or emotional changes. The spectrum is vast and it is helpful for women to understand the possibilities and to work with a qualified & experienced health care practitioner who will investigateindividual risk factors and address preventive measures. The more a woman knows about her body, the less vulnerable she will be to the fear that may accompany this transition. Health care practitioners should not use a “one size fits all” approach and ensure that their patients feel fully heard. 

Certainly, hormones have a pronounced impact on emotional function which, again, varies vastly from woman to woman.  Concern for mental health during this period needs to be evaluated and addressed individually. Hormones offer wonderful support and relief for many of the challenging symptoms of this transition, including and particularly problems with sleep and anxiety. These two factors affect a woman’s desire to be social. Lack of sleep especially affects cognition and concentration.  

Knowing that a woman’s hormones have changed, and more specifically how, can be reassuring in navigating this period. It can also be helpful to their partners to see that the changes they are witnessing have a clear association with a very real biological phenomenon, and perhaps help them to exert more patience, support and understanding. This is an excellent reason to utilize the DUTCH hormone tests.  

The combination of the emotional and physical impacts of perimenopausal/menopausal hormone changes provides an additional challenge and may contribute to an increase in social isolation and a higher risk for these illnesses. 

Several recent studies have investigated the impact of social isolation vs prosociality in general. Prosocial behaviors include those intended to help or benefit others, such as sharing, volunteering, or making a charitable donation. These behaviors may influence flourishing, such as happiness, spirituality and financial well-being through social connectedness. Research has found that being socially disconnected is associated with a higher risk of illness, including heart disease, stroke, anxiety, depression, and dementia. (1) 

Initial evidence suggests that increases in prosocial behavior reliably lead to downstream improvements in physical health. Some studies have shown that meditation-based interventions that cultivate compassion and kindness, and other methods of modifying prosocial behaviors, have positive effects on major health outcomes, including cardiovascular disease and brain health. (2, 3) 

One trial to gauge the impact of social interactions on individuals is the Baltimore Experience Corps Trial. (4) This large study evaluating the health benefits of volunteering for older adults found that seniors who spent about 15 hours a week tutoring and mentoring young children in public schools experienced improvements in both their cognitive and physical health, including better memory, increased mobility and strength.  

Another is the Human Flourishing Program, founded in 2016 at Harvard's Institute for Quantitative Social Science. It aims “to study and promote human flourishing, and to develop systematic approaches to the synthesis of knowledge across disciplines.”

The study follows more than 200,000 participants in 22 countries around the world, looking at different factors that may influence their flourishing, such as happiness, spirituality, financial well-being, and social connectedness. Preliminary results seem to suggest that, across the religious traditions examined, people who participate in spiritual practices go on to report better health. (5)  

What about ‘brain fog’? Should women worry that this is permanent and a sign of early dementia? Know that at least 60% of women experience this symptom and it can be significant! This includes problems with short-term memory, i.e. forgetting names and dates specifically. Difficulty with concentration and feeling mentally slower, along with challenges with the usual multitasking, are typical examples of this symptom. It does feel scary, and while research is clear that this symptom generally resolves within 2-3 years after actual menopause, it is not often reassuring when there are so many other changes that feel overwhelming. (6) 

Social engagement should be a priority for women in perimenopause and menopause. This may feel difficult to accomplish when everything else is feeling altered and foreign. Simply knowing that these symptoms and feelings are absolutely normal may bring some relief and engender motivation to find ways to engage in at least a few nurturing activities and connections that will sustain you during the transition. Perhaps knowing that, while this is a difficult period, it is a ubiquitous experience for women between 40 and 55, and you are not alone. Hopefully this knowledge will provide a more hopeful outlook and engender optimism.  

Although it can be hard to face the physical and emotional changes with this phase of life, keeping a hopeful attitude towards the future is important to encourage. A study on optimism and health indices noted that women who had a positive outlook could live longer than those with a more negative outlook. (8) 

Women can be assured that the changes they experience are a part of personal growth and there are many supportive resources available to help navigate this transition. Opening up to nourishing relationships and exploring new and exciting activities can offer true healing benefits.  

References: 

1. Kubzansky LD, Epel ES, Davidson RJ. Prosociality should be a public health priority. Nat Hum Behav. 2023 Dec;7(12):2051-2053. doi: 10.1038/s41562-023-01717-3. Erratum in: Nat Hum Behav. 2023 Dec;7(12):2228.   

2. Krittanawong C, et al. Meditation and Cardiovascular Health in the US. Am J Cardiol. 2020;131:23-26. 

3. Calderone A, et al. Neurobiological Changes Induced by Mindfulness and Meditation: A Systematic Review. Biomedicines. 2024;12(11). 

4. Varma VR, et al. Experience Corps Baltimore: Exploring the Stressors and Rewards of High-intensity Civic Engagement. Gerontologist. 2015;55(6):1038-1049.  

5. Vanderweele TJ, et al. The Global Flourishing Study: Study Profile and Initial Results on Flourishing. Nature Mental Health. 2025;3(6):636-653. 

6. Mosconi L. The menopause brain: new science empowers women to navigate the pivotal transition with knowledge and confidence. New York: Avery; 2024.  

7. Cambieri G. Strong social connections could boost healthy aging, experts say. Harvard T.H. Chan School of Public Health. 2025 Oct 9. Available from: hsph.harvard.edu/news/strong-social-connections-could-boost-healthy-aging/ 

8. Koga HK, Trudel-Fitzgerald C, Lee LO, James P, Kroenke C, Garcia L, Shadyab AH, Salmoirago-Blotcher E, Manson JE, Grodstein F, Kubzansky LD. Optimism, lifestyle, and longevity in a racially diverse cohort of women. J Am Geriatr Soc. 2022 Oct;70(10):2793-2804. doi: 10.1111/jgs.17897. Epub 2022 Jun 8. PMID: 35674052; PMCID: PMC9588526.