Emotional Stability in Bendy Menopause: Why Your Nervous System Comes First

If you live in a sensitive, hypermobile, or neurodivergent body, emotional changes during menopause can feel sudden and unsettling.

You may notice:

• quicker emotional swings

• less tolerance for stress

• stronger reactions to things that once felt manageable

• difficulty settling, even when life is objectively “okay”

It’s common to wonder whether this means something is wrong with you—or whether you’re somehow failing to cope.

But for many people in what I clinically think of as Bendy Menopause, emotional volatility is not a personal or psychological failure.

It’s a physiologic stress response happening in a body with reduced buffering capacity.

Emotional Volatility During Menopause Is Often Physiologic

The menopausal transition affects far more than reproduction.

Fluctuating estrogen levels influence:

• neurotransmitter systems involved in mood and stress

• autonomic nervous system balance

• sleep quality

• stress responsiveness

Research shows that estradiol variability, not just low estrogen, is associated with increased depressive and anxiety symptoms during perimenopause. In practical terms, this means the nervous system has less margin to absorb stress.

When that buffering drops, emotions can feel:

• louder

• faster

• harder to regulate

This doesn’t mean emotions are “all hormonal,” and it doesn’t mean nothing else matters.
It means the nervous system is working harder to stay regulated.

When Hypermobility and Dysautonomia Are Part of the Picture

For many people, menopause doesn’t happen in isolation.

Hypermobility spectrum disorders and hypermobile Ehlers-Danlos syndrome frequently overlap with autonomic nervous system dysfunction, including conditions like postural orthostatic tachycardia syndrome (POTS). These conditions are associated with:

• altered heart rate and blood pressure regulation

• increased fatigue

• heightened stress reactivity

• greater symptom burden overall

When autonomic instability is already present, menopausal hormonal shifts can further strain regulation. Add in chronic pain, inflammation, or ADHD—and emotional tolerance may narrow even more.

This isn’t because someone is fragile.
It’s because multiple systems are asking the nervous system to adapt at once.

Why Stability Can Improve Before Symptoms Fully Resolve

Here’s an important reframe:

Emotional stability does not require symptom elimination.

Many people expect they’ll feel emotionally steady only after pain improves, sleep normalizes, or hormones are perfectly dialed in. But in practice, stability often improves earlier—before symptoms fully resolve.

Why?

Because stability is supported by:

• predictability

• pacing

• reduced background stress

• a sense of safety and coherence

When these are present, symptoms may still exist—but they feel less destabilizing. Emotional reactions recover faster. Days feel more predictable. Fear around symptoms softens.

This doesn’t replace medical treatment.
It simply creates better conditions for living—and for treatment to work.

Stability Is Not the Same as Symptom Elimination

In Bendy Menopause, emotional stability often looks like:

• fewer extreme swings

• quicker recovery after stress

• less fear of your own reactions

• more trust in your ability to handle hard days

It does not mean:

• never feeling anxious

• never getting overwhelmed

• being symptom-free

Emotional stability is the foundation—not the reward.

Where Treatment Fits (and Why It Still Matters)

It’s important to say this clearly.

Evidence-based treatments for menopausal mood symptoms include:

• cognitive-behavioral therapy (CBT)

• antidepressant medications when indicated

• hormone therapy in selected, time-sensitive contexts

• clinical hypnosis and mindfulness-based interventions for specific symptom profiles

These treatments are supported by research and clinical guidelines and should be considered when symptoms are persistent, impairing, or severe.

Nervous-system-supportive strategies—like sleep regularity, pacing, and gentle regulation practices—are not replacements for treatment. They are supports that can make emotional symptoms easier to live with and care easier to tolerate.

Why the Nervous System Comes First for Many People

Trying to “think your way” into emotional regulation often fails during this phase—not because you’re doing it wrong, but because regulation is not purely cognitive.

The nervous system responds to:

• consistency

• repetition

• predictability

• reduced threat

When those signals are present, emotional reactivity often softens—even if symptoms remain.

That’s why nervous system support is often a starting point, not an endpoint.

A Gentle Support: The Vagal Nerve Reboot

For a limited time, I’m sharing something I usually reserve for Phases Clinic patients:

The Vagal Nerve Reboot

This is not a medical treatment. It’s a free, 7-day email series designed to offer gentle, optional ways to calm the nervous system.

Each day includes:

• one short explanation of nervous system concepts

• one simple, body-friendly practice

• an emphasis on safety, pacing, and non-forcing

This is not about fixing yourself.
It’s not about starting over.

It’s about offering your nervous system small, steady signals of safety—especially during a season when everything can feel louder.

Because it’s a new year—
but you’re still you.

👉 Join the Vagal Nerve Reboot (free through Valentine’s Day)

Medical Disclaimer

This content is for educational purposes only and does not constitute medical advice. It is not intended to diagnose, treat, cure, or prevent any medical condition. If you have concerning, severe, or worsening emotional or physical symptoms, please consult a qualified healthcare professional.

References:

1. Brown L, Hunter MS, Chen R, et al.
   Promoting Good Mental Health Over the Menopause Transition.
   The Lancet. 2024;403(10430):969–983.
   doi:10.1016/S0140-6736(23)02801-5

2. Fidecicchi T, Giannini A, Chedraui P, et al.
   Neuroendocrine Mechanisms of Mood Disorders During the Menopause Transition: A Narrative Review and Future Perspectives.
   Maturitas. 2024;188:108087.
   doi:10.1016/j.maturitas.2024.108087

3. Joffe H, de Wit A, Coborn J, et al.
   Impact of Estradiol Variability and Progesterone on Mood in Perimenopausal Women With Depressive Symptoms.
   Journal of Clinical Endocrinology & Metabolism. 2020;105(3):dgz181.
   doi:10.1210/clinem/dgz181

4. Ycaza Herrera A, Mather M.
   Actions and Interactions of Estradiol and Glucocorticoids in Cognition and the Brain: Implications for Aging Women.
   Neuroscience & Biobehavioral Reviews. 2015;55:36–52.
   doi:10.1016/j.neubiorev.2015.04.005

5. Gordon JL, Peltier A, Grummisch JA, et al.
   Estradiol Fluctuation, Sensitivity to Stress, and Depressive Symptoms in the Menopause Transition.
   Frontiers in Psychology. 2019;10:1319.
   doi:10.3389/fpsyg.2019.01319

6. Csecs JLL, Dowell NG, Savage GK, et al.
   Variant Connective Tissue (Joint Hypermobility) and Dysautonomia Are Associated With Multimorbidity at the Intersection Between Physical and Psychological Health.
   American Journal of Medical Genetics Part C: Seminars in Medical Genetics. 2021;187(4):500–509.
   doi:10.1002/ajmg.c.31957

7. Mathias CJ, Owens A, Iodice V, Hakim A.
   Dysautonomia in the Ehlers-Danlos Syndromes and Hypermobility Spectrum Disorders—with a Focus on the Postural Tachycardia Syndrome.
   American Journal of Medical Genetics Part C. 2021;187(4):510–519.
   doi:10.1002/ajmg.c.31951

8. Collins Hutchinson ML, Liang E, Fuster E, Blitshteyn S.
   Autonomic Symptom Burden, Comorbidities, and Quality of Life in Women With Hypermobility Spectrum Disorders and Hypermobile Ehlers-Danlos Syndrome.
   Autonomic Neuroscience: Basic & Clinical. 2025;262:103356.
   doi:10.1016/j.autneu.2025.103356

9. Spector A, Li Z, He L, et al.
   The Effectiveness of Psychosocial Interventions on Non-Physiological Symptoms of Menopause: A Systematic Review and Meta-Analysis.
   Journal of Affective Disorders. 2024;352:460–472.
   doi:10.1016/j.jad.2024.02.048

10. Ye M, Shou M, Zhang J, et al.
    Efficacy of Cognitive Therapy and Behavior Therapy for Menopausal Symptoms: A Systematic Review and Meta-Analysis.
    Psychological Medicine. 2022;52(3):433–445.
    doi:10.1017/S0033291721005407

11. Hunter MS.
    Cognitive Behavioral Therapy for Menopausal Symptoms.
    Climacteric. 2021;24(1):51–56.
    doi:10.1080/13697137.2020.1777965

12. Donegan E, Frey BN, McCabe RE, et al.
    Impact of the CBT-Meno Protocol on Menopause-Specific Beliefs, Dysfunctional Attitudes, and Coping Behaviors.
    Menopause. 2022;29(8):963–972.
    doi:10.1097/GME.0000000000002003

13. Green SM, Donegan E, Frey BN, et al.
    Cognitive Behavior Therapy for Menopausal Symptoms (CBT-Meno): A Randomized Controlled Trial.
    Menopause. 2019;26(9):972–980.
    doi:10.1097/GME.0000000000001363

14. Hickey M, LaCroix AZ, Doust J, et al.
    An Empowerment Model for Managing Menopause.
    The Lancet. 2024;403(10430):947–957.
    doi:10.1016/S0140-6736(23)02799-X

15. Otte JL, Carpenter JS, Roberts L, Elkins GR.
    Self-Hypnosis for Sleep Disturbances in Menopausal Women.
    Journal of Women’s Health. 2020;29(3):461–463.
    doi:10.1089/jwh.2020.8327

16. Gordon JL, Rubinow DR, Eisenlohr-Moul TA, et al.
    Efficacy of Transdermal Estradiol and Micronized Progesterone in the Prevention of Depressive Symptoms in the Menopause Transition.
    JAMA Psychiatry. 2018;75(2):149–157.
    doi:10.1001/jamapsychiatry.2017.3998

17. Langhe R, Kelly T, Ibrahim R, et al.
    The Role of Hormone Replacement Therapy in the Management of Perimenopausal Mental Health Symptoms.
    International Journal of Gynecology & Obstetrics. 2025.
    doi:10.1002/ijgo.70728

18. Glynne S, Kamal A, McColl L, et al.
    Transdermal Oestradiol and Testosterone Therapy for Menopausal Depression and Mood Symptoms: A Retrospective Cohort Study.
    British Journal of Psychiatry. 2025.
    doi:10.1192/bjp.2025.101

19. Toffol E, Heikinheimo O, Partonen T.
    Hormone Therapy and Mood in Perimenopausal and Postmenopausal Women.
    Menopause. 2015;22(5):564–578.
    doi:10.1097/GME.0000000000000323

20. Genazzani AR, Monteleone P, Giannini A, Simoncini T.
    Hormone Therapy in the Postmenopausal Years: Considering Benefits and Risks in Clinical Practice.
    Human Reproduction Update. 2021;27(6):1115–1150.
    doi:10.1093/humupd/dmab026

21. Wium-Andersen MK, Jørgensen TSH, Halvorsen AH, et al.
    Association of Hormone Therapy With Depression During Menopause in a Cohort of Danish Women.
    JAMA Network Open. 2022;5(11):e2239491.
    doi:10.1001/jamanetworkopen.2022.39491

22. Crandall CJ, Mehta JM, Manson JE.
    Management of Menopausal Symptoms: A Review.
    JAMA. 2023;329(5):405–420.
    doi:10.1001/jama.2022.24140