Not all in your head of course.

But it's there....

Surging hormones...dysregulation (or at least a "re-setting" of the system)...

And if you've experienced menopause and its hot flashes, you know you feel like your brain isn't functioning on all cylinders. (Many women say the same thing about being pregnant, but that's a little different story than this one.)

I find menopause fascinating from a neurofeedback perspective. Let me share with you an "inside" view of the brain during hot flashes and you'll see what I mean about menopause being firmly in your head!

The first time I worked with a woman that in the midst of menopause, I didn't really expect to be able to note anything about her brain activity that was any different than what I ordinarily see.

She was a 40-something professional woman that was interested in neurofeedback as a tool for helping her to regain some of the cognitive sharpness she felt was starting to fade on her.

We used the EEG neurofeedback system I use (NCP). This system is  interesting in that while being able to observe her brain wave frequencies, I can also observe bursts of activity in the moment-to-moment emergent variability of her brain's activity. (These bursts of activity are actually what we use in the training process...but that's yet another story.)

Here's where it gets interesting...

Ordinarily, bursts of brain variability are quick and relatively limited. They may last for a second, usually less, and I can see them on the screen. For some people with particularly large bursts,  I may have to adjust the screen a bit -- kind of "zoom out" so I can see how large they actually are.

We were moving along in this woman's training session with the kind of occasional bursts of activity I was used to seeing. All of a sudden her brain showed a HUGE burst, on both sides of her brain, at 2 hz (a very slow frequency - in the range where most people's symptoms tend to "sit"). This burst was so big that I had to zoom out to the maximum to find out just how large it was. And it lasted. And lasted. And lasted.

After a couple of seconds, I mentioned that I thought perhaps something had happened with the equipment or the connection.

"I'm having a hot flash", she shared. "Would that make a difference?"

We waited out the hot flash while I adjusted the computer's feedback to try to give her brain added information about what was happening.

Sure enough, as her hot flash subsided, so did the burst.

Later on, another huge 2hz burst on both sides of her brain...

"Hot flash?"

"Yes -- can you see it again?"

Same pattern as the last time, but the burst and the hot flash were shorter.

Each time it happened during our training sessions, there was the same trademark two-sided 2 hz bursts, although they started becoming shorter and smaller as we went. More importantly for her, the hot flashes got shorter as well and she stopped being awoken at night by hot flashes.

I was fascinated and inquired of other neurofeedback trainers whether they had seen anything like this before. I did hear back from someone else who had worked with a woman who had hot flashes during sessions and, sure enough, she also had the 2 hz bursts.

Hmmm....

I didn't think too much more about it until I saw another woman who was having hot flashes. This woman was working with a different system -- pirHEG -- that measures blood flow to the frontal lobes. You may remember from other articles that the task for the trainee in using pirHEG is to raise the temperature reading, which is an indirect reading of the level of blood flow in the frontal lobes.

Again, her main focus was not hot flashes, but she did sometimes have a hot flash during a training session.

And when she did have a hot flash, it was a striking effect.

She would be merrily raising the temperature level, letting it drop by a few hundredths of a degree, then raising it again to the same level or even higher. Then - WHAM - all of a sudden her temperature reading would drop by 1.5 degrees or more. Once the hot flash was over, the levels would start to recover, although she did still have to work a bit to get back to where she had been.

So, I see a clear pattern of involvement of the brain in menopausal hot flashes:
EEG: bilateral 2 hz bursts in emergent variability that are huge and last as long as the hot flash
HEG: sudden dramatic drop in blood flow to the frontal lobes that lasts as long as the hot flash

Even as a woman myself, before all this, I hadn't thought too much about the impact of these hormonal variations on the brain. But once I saw it, I realized it makes good sense. Dr. Candace Pert, in her book, Molecules of Emotion, talks about the brain as a "bag of hormones". Of course, given the role of the brain in regulating hormones and itself being affected by hormones -- how could sudden large hormonal surges NOT have an impact?

And given that the hormonal balance of the brain is disrupted, the rest of the brain's functioning would be impacted as well. And....

ta-da....

cognitive performance must be impacted to some degree. Hence, menopausal women's complaints about feeling "brain fog" - less able to attend, think clearly, remember what they were doing...

And it's not just cognition. Some women find that their migraines are worsened during menopause, which makes sense in terms of the hormonal shifts creating at least a temporary imbalance in the brain, and the imbalance leading to migraines being triggered more easily.

I have found that both EEG and HEG training can help some of the symptoms of menopause. And I find that women are reassured by seeing the changes in brain activity and feel validated that their impressions of cognitive change are "real".

Read more about the "brain fog" associated with menopause