From Puberty to Power: The Hormonal Hat Trick

Let’s take a moment to appreciate the hormonal hat trick that is womanhood: puberty, pregnancy, and perimenopause. Throughout women’s lives, these major hormonal shifts are changing us physically, mentally, and emotionally.

Turns out, these three milestones are like sisters from the same hormonal family. Each one kicks off a massive reorganization of the brain and rewires everything from memory and focus to how we process emotions. Being hormonal is more than a little moodiness; it’s a full brain renovation. We are nothing if not stunningly dynamic beings.

Our brains are always adapting to our needs. Our neural pathways are always evolving to strengthen the connections we use and weaken those we no longer need. However, the massive hormonal shifts across women’s lifespans are responsible for some seismic shifts that are rarely discussed.

If we look at the experiences of puberty, pregnancy, and postpartum, the similarities are striking because the mechanism is the same: massive hormone change. All three phases come with changes in mood, sleep, libido, memory, and our brain function.

It’s strange that the first two shifts are often met with a celebration of a new life stage (milestone birthday parties, bat mitzvah’s, quinceañeras, baby showers, and more) while we treat menopause like a death instead of rebirth.

Let’s not sugar-coat things. Like puberty and pregnancy, perimenopause can feel like you’re riding an emotional tilt-a-whirl. Anxiety, brain fog, low mood, irritability aren’t “just in your head” (well, they are, technically, but they’re also neurobiological).

Estrogen plays a starring role here, acting like an expert regulator of brain function. As it starts to fluctuate and decline, so does its calming, mood-lifting magic. That’s why a forgotten word or a sudden wave of overwhelm isn’t just “a bad day;” it’s a biochemical event.

For all three P-stages, there’s vulnerability here. While the brain is in a state of change, there’s increased risk for mental health challenges like anxiety/depression. It’s not by accident that we see increased mental health diagnoses during the teenage years, perinatal period, and perimenopause. This is a vulnerable time both hormonally and emotionally as we transition from one life phase to the next.

Here’s the part no one tells you: on the other side of this hormonal chaos is a brain with the potential for greater clarity, emotional resilience, and even sharper cognitive function.

Your brain is pruning old pathways and laying down new more efficient, optimized ones.

During puberty, we lose old neural pathways as we automate skills (like tying our shoes and riding a bike). We experience mood swings, and the potential for mental health challenges rise, but we also see the brain evolve for increased social maturity and judgement to help navigate adulthood. In pregnancy, the brain is shaped for caregiving, language skills, and hyper-awareness to an infant’s needs.

In perimenopause? It's preparing for something entirely new — a post-reproductive, wise-woman phase. It’s not a decline but a transformation. It was the American anthropologist Margaret Mead who coined  in the 1950s the phrase 'post-menopausal zest' with her popular quote “There is no greater power in the world than the zest of a postmenopausal woman.”

Yes, it’s a wild ride. But it's also a turning point, and one that’s full of power, if we know what’s happening and how to work with our brains, not against them.

Your brain isn’t breaking. It’s evolving.

We can downgrade some of those skills we no longer need to prioritize (including many of the ones our brain optimized during pregnancy) that are less relevant after the parenting phase. But it’s not all decline. Once again, the brain has the opportunity to replace lost pathways with new ones better equipped for our current reality.

There are significant upsides to postmenopausal life. Many women feel liberated from pregnancy prevention and the end of the burden of menstrual periods. They may also find that premenstrual symptoms such as bloating, migraine headaches, and premenstrual mood changes reduce significantly once they reach postmenopause.

Menopause affects happiness for the better. Of course, much like puberty and pregnancy, during the big hormonal shift, things are often chaotic, messy, and hard. But after menopause, most women experience a consistent increase in happiness and life satisfaction. By the time many people are in their sixties, if they still have their health, they’ve never been happier.

This is supported by brain changes that make us less reactive to negative emotional stimulation and better control over our own reactions. The result is a more even-keeled existence. It’s important to note that menopause itself is a highly personal experience, it is hardly one-size-fits-all. A woman’s experience of menopause is absolutely shaped by her personal mental set, constellation of life experiences, and working ideas about women and aging, as well as her individual biopsychosocial map.

There’s also a shift toward greater empathy. Perhaps, you’ve noticed a grandparent who has a very different relationship with their grandchild than they did with their children. This might be related to the brain shifts happening at that time.

Post-menopause, we’re wiser, softer people. How fitting that this life phase would be characterized by a brain that’s streamlined for more emotional than physical contributions to life.

The good news is that we’ve expanded our practice specialties to include (peri)menopause care because the work feels so connected to our current focus. People have tons of agency over large swaths of the menopausal experience, and we would love the opportunity to join them on the journey of discovery during this time. The identity shifts happening around puberty, pregnancy, and postpartum are all interconnected, and we keep evolving to be able to continue to serve women and families as they approach each milestone.