Brain health · Sanctum

The hormonal tide

Some weeks you are fine. Other weeks your brain simply stops. The focus goes, the words go, the patience goes, and then it lifts again and you tell yourself you imagined it. You have probably noticed it tracks your cycle, and been told it is just hormones, or just stress, or just you.

It is not just hormones, and it is not separate from everything else. Oestrogen is closely tied to the brain chemistry behind attention and mood, so when oestrogen falls, in the days before a period, in the months after a baby, and through perimenopause, the same difficulties you have always managed get suddenly, and predictably, worse. The pattern is real. It runs on a tide.

This is one of the most missed parts of the whole picture, because it falls in the gap between services. Mental health treats the low mood, the GP treats the periods, and no one joins either to the brain underneath. So women spend years on the wrong treatment, or are told their worst weeks are a flaw in their character, when they are a fall in their oestrogen.

We read the hormonal pattern as part of the brain picture, not a side issue, because for many women it is the single biggest thing shaping how everything else shows up. None of this is a diagnosis. It is what we explore with you.

Written by Dr Asad RaffiConsultant Psychiatrist · Founder & Medical Director