The Female Brain (23 page)

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IFE?

Soon Sylvia and Robert came to see me together for another couple’s session. Unresolved issues for both of them had finally come to a head. Robert couldn’t believe what he was hearing. For instance, “Make your own damn dinner or go out by yourself. For the last time, I’m not hungry. I’m happy painting right now and I don’t feel like stopping.” He said she had snapped at him at a party two nights before when she offered a suggestion about investing in a group of stocks and he told her to stay out of the discussion because she didn’t know what she was talking about. He was the one who read
Barron’s
, after all. “Yeah, you keep reading it, and you keep losing money. Have you seen my portfolio lately? I’ve made three times the amount you’ve made, so stop belittling me,” she’d replied. Everything he said seemed to annoy her. She announced she was moving out.

When Sylvia was younger, she would do everything she could to avoid fights with her husband, even if she was really mad. Remember the tape that gets rolling during the teen years, when estrogen dials up the emotions and communication circuits—the one that makes a woman panic about any conflict as a threat to a relationship? That tape doesn’t stop rolling until a woman either consciously overrides it, or the supply of hormones that fuels it is cut off, or both. A time like now. All her life Sylvia had prided herself on being coy, accommodating, and willing to let her husband win—especially when he came home exhausted and on edge from the office. Her empathy for him was real. She kept the peace, as her Stone Age brain was compelling her to do, to keep the family together. Having a husband is good. We’re better protected this way. These were the messages keeping her from engaging in conflict. If Robert forgot their anniversary, she would bite her tongue. If he was verbally abusive after a long day at work, she stared straight into the stew she was stirring and didn’t respond.

But as Sylvia hit menopause, the filters came off, her irritability increased, and her anger wasn’t headed for that extra “stomach” anymore, to be chewed over before it came out. Her ratio of testosterone to estrogen was shifting, and her anger pathways were becoming more like a man’s. The calming effects of progesterone and oxytocin weren’t there to cool off the anger either. The couple had never learned to process and resolve their disagreements. Now Sylvia confronted Robert with regularity, venting decades of pent-up rage.

At their next session, it became clear that it was not all Robert’s fault. He was going through his own, more modest, life changes. But Sylvia still wanted to move out. Neither of them was yet aware of the changing reality in her brain, which was rewriting the rules not just for arguing but for every interaction of their relationship. Studies show that women who are unhappy with their marriages report more negative moods and illnesses during the menopause years. So when the hormonal haze lifts and the children leave home, women often find themselves more unhappy than they could allow themselves to realize before. Often all the unhappiness gets blamed on the husband. Obviously, Sylvia had her legitimate complaints about Robert. But the root cause of her unhappiness was still unclear.

The next week she reported that her daughter had said, “Mom, you’re acting weird, and Dad is getting scared. He says you’re just not the woman he’s been married to for nearly thirty years, and he’s afraid you’ll do something crazy—like take all the money and run away.” Sylvia wasn’t crazy, and she wasn’t going to abscond with their savings, but it was true, she wasn’t the same woman. She told me that her husband once screamed at her, “What have you done with my wife?” A huge number of her brain circuits had been abruptly shut down, and just as abruptly, Sylvia had changed the rules of their relationship. As often happens in these situations, nobody told Robert.

It is commonly believed that men leave their aging, chubby, postmenopausal wives for fertile, younger, thin women. This couldn’t be further from the truth. Statistics show that more than 65 percent of divorces after the age of fifty are initiated by women. My suspicion is that much of this female-initiated divorce is rooted in the drastically altered reality of postmenopausal women. (But as I have seen in my practice, it could also be because they are tired of putting up with difficult or cheating husbands and have just been waiting for the day when the children leave home.) What had been important to women—connection, approval, children, and making sure the family stayed together—is no longer the first thing on their minds. And the changing chemistry of women’s brains is responsible for the shifting reality of their lives.

During any time when hormones are shifting and hijacking your reality, it’s important to examine impulses and make sure they’re real, as opposed to hormone-induced. Just as the drops in estrogen and progesterone before a period can make you believe you’re fat, ugly, and worthless, the absence of reproductive hormones can make you believe your husband is the cause of all your misery. Maybe he is. And maybe he isn’t. As Sylvia learned through our discussion, if you understand some of the biological reasons for your changing feelings and reality, you might just learn to talk about it with him—and he might just change. It’s a long process of education, one that best begins before the “change” takes place.

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INNER?

During our session after my August vacation, Sylvia told me that she had decided she wanted a divorce after all. As a matter of fact, she had moved out the month I was away. Her friends had even started setting her up with new men. It didn’t take long before she was as annoyed with them as she was with Robert. Sylvia quickly discovered that older men were looking for a “nurse with a purse”—someone who had her own money and would take care of them for the rest of their lives. This was a bit shocking to her. It was just what she had been looking for in a man when she was young. Back then she wanted someone who would take care of her and bring the money with him. Back then she was willing to take care of him along with the children. Now it was the last thing on her mind.

Sylvia still felt hopeful that she would find the “perfect man” to grow old with, an equal partner, a soul mate, someone she could talk to and share life’s joys with, but not do the physical caretaking, shopping, cooking, laundry, and cleaning that many of the men she was dating had come to expect of their ex-wives. As she put it, she had no intention of being a nurse, and she didn’t want someone to steal her purse. “Otherwise,” she said, “I’d rather have no one right now.” After all, she had lots of dear friends who made her happy. She was looking forward to a much less psychologically stressful existence than what she had been experiencing lately in arguing with Robert.

This decreased urge to tend and nurture after menopause may not come as a relief to all women. Research has yet to examine the effects of low oxytocin, which ensues after estrogen declines, but it may lead to some real behavioral changes. Most women, however, are only vaguely aware of it—if at all. My patient Marcia, age sixty-one, admitted to me, for example, that she was feeling much less concerned about the problems and needs of her family, friends, and children, and less inclined to look after them. Nobody had complained to her about this decreased caretaking, though her husband wondered why he’d been fixing his own dinner a lot. Mainly, it was just something Marcia noticed in herself. She didn’t really mind her newfound emotional independence—she was spending more time on solo pleasures, such as the genealogical research she loved to do. She had not had a menstrual period in over four years. But her vaginal dryness, night sweats, and interrupted sleep had led her to start being treated with estrogen pills. Three months after she began estrogen therapy, however, Marcia’s nurturing instincts had returned. She hadn’t recognized how drastically they had changed over the past four years until they came flooding back. She told me she was shocked that one little pill could make her feel more like her old self—a self she only vaguely realized she had lost. Estrogen therapy may have stimulated her brain to produce higher levels of oxytocin again, triggering familiar, affiliative patterns of behavior, to her husband’s relief.

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HE LAST TIME
a woman had a nonfluctuating stress responsivity because of steady, low hormones was in the juvenile pause, or during the months of pregnancy, when the pulsing cells of the hypothalamus are shut down and the stress response is kept low. After ten years of no hormones, one of my postmenopausal patients reported to me that, although her sex drive was suffering, she and her husband had stopped fighting when they went on trips. It used to be that travel really stressed her out, but suddenly she was loving every minute of waking up early to catch a plane and going to unknown places. She even liked packing, and as the stress faded away, their travel fights had disappeared as well.

As for Sylvia, soon after she moved out, she noticed that her mood swings and irritability stopped. She told me that her work with preschool teachers and parents had allowed her to become the person she always knew she ought to be. She began to look forward to the nights she spent alone, watching old movies, taking long bubble baths, and working late in her new studio. If her kids called, she was always eager to talk to them, but she found that she would not become as engaged in helping to solve their problems, getting upset, or giving them endless advice. At first she thought the reason her moodiness and irritability had decreased was that she had gotten the biggest problem out of her life: her bad marriage. But she had also noticed that her hot flashes had almost disappeared and she was sleeping well again.

When she came to see me six months after leaving Robert, I gently queried whether it was only that her husband was out of the house, or whether it might also be that she had now settled into a new hormonal state, in which her mood was steadier. Sylvia also mentioned that she was less irritable, and during this session she even complained about being lonely and having nobody with whom to discuss the events in her children’s lives and her own. I suggested that she might be missing Robert’s company and that if they started spending time together but negotiated a new set of rules, she might notice that their relationship was more balanced.

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ETTING
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TARTED

At menopause, the female brain is nowhere near ready to retire. As a matter of fact, many women’s lives are just hitting their peak. This can be an exciting intellectual time now that the burden of rearing children has decreased and the preoccupation of the mommy brain is lessened. The contribution of work to a woman’s personality, identity, and fulfillment once again becomes as important as it may have been before the mommy brain took over. When Sylvia found out that she was accepted into a master’s program in social work, it was one of the happiest days of her life. She hadn’t had such a feeling of accomplishment since she graduated from college, got married, or had her children.

As a matter of fact, work and accomplishment can be critical to a woman’s sense of well-being during this life transition. Studies have shown that women with high career momentum at this stage of life viewed their work as more central to their identities than did women who were just maintaining or decreasing their career momentum. Also, women with high career momentum scored better on measures of self-acceptance, independence, and effective functioning in their fifties and sixties, and rated their physical health higher than did other women. There’s a lot of life left after menopause, and embracing work—whatever that may be—passionately clearly allows a woman to feel regenerated and fulfilled.

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Edith made an appointment with me as her husband, a psychiatrist, was winding down his practice in order to retire. Although they had a good relationship most of the time, all she could envision was that he would be constantly invading her space, demanding she serve him twenty-four hours a day. Her distress over the idea had given her insomnia. And she turned out to be right. The minute he was home, he started asking, “Where’s lunch? Did you buy my salami? Who moved my toolbox? Aren’t you going to clean up the dishes? They’ve been sitting in the sink for an hour.” When she hadn’t gone shopping because she was busy, he said, “Busy with what?” She had been helping her mother’s oldest friend with things around the house. She had been taking care of her grandchildren on Tuesdays. She had a regular bridge game and lunch dates, and she attended a book club. She was busy working at the things that mattered to her. She liked her freedom. Her husband was dumbfounded that she showed little interest in him and had so much of her own life to live.

This change in behavior is actually the most common one I see in women sixty-five and older. Like Edith, they come into my office depressed, anxious, and unable to sleep. I soon find out that their husbands have retired over the past year. They feel conflicted, angry, and pulled away from their own work and activities. They don’t want to live this way for the rest of their lives. This fear of losing freedom can happen even if the marriage relationship is basically good. Somehow many women feel that they cannot renegotiate the unwritten marriage contract. “Of course you can,” I tell them. “Your life depends on it.”