Stephanie Yang, ND
Discover how a personalized, root-cause approach helped one woman finally get deep sleep, mental clarity, and emotional balance during menopause.
When Sophia walked into my office, she looked like someone running on empty.
She was 48, healthy on paper, and determined to do everything “right”—daily walks, whole foods, stress management, the works. But for over a year, she hadn’t slept through the night. Her mind felt foggy, her emotions were unpredictable, and even simple tasks felt overwhelming.
“I don’t feel like myself anymore,” she said. “I’m wired and tired. I can’t focus. I cry for no reason.”
Sophia had entered menopause, a natural transition, but one that deeply impacts the brain as well as the body. And while her routine lab work looked fine, something was clearly off. That’s when we took a different approach, one that looked beneath the surface.
What Happens to the Brain During Menopause?
Menopause isn’t just a hormonal shift, it’s a neurological one. As estrogen, progesterone, and testosterone decline, they affect brain function directly. These hormones help regulate sleep, mood, focus, and energy. When they dip, so can our ability to feel balanced and alert.
For Sophia, the symptoms showed up as:
- Trouble falling and staying asleep
- Forgetfulness and difficulty focusing
- Mood swings and low motivation
- Constant fatigue, despite “doing everything right”
She wasn’t alone. Many women experience these changes during the transition into menopause (often starting in their 40s), but few get the support they need to connect the dots.
Looking Beneath the Surface
Sophia’s standard labs didn’t show anything “abnormal.” But deeper testing revealed:
- Low progesterone, estrogen, and testosterone: Linked to sleep disturbances, low motivation, and cognitive fog.
- Elevated evening cortisol: Suggesting a disrupted stress response that keeps the brain in overdrive at night.
- Low-normal vitamin B12 and vitamin D: Essential for mood regulation and brain energy.
These imbalances were quietly draining her brain’s ability to rest and reset.
A Stepwise Approach: Calming the Brain First
Rather than jump straight to hormone therapy, we started by helping Sophia’s nervous system find its footing.
Weeks 0–2: Regulate Stress and Circadian Rhythm
- Morning light exposure to reset her sleep-wake cycle
- High-protein breakfast to stabilize blood sugar and cortisol levels
- Magnesium at night for deeper sleep
- B-complex and vitamin D to restore brain nutrient levels
- Adaptogenic herbs (like Rhodiola and ashwagandha) to support stress resilience
Within two weeks, she started sleeping longer and waking up with less anxiety.
Gentle Hormonal Support
Once her foundation was stronger, we introduced bioidentical hormones, carefully, and only what her body needed.
Weeks 4–6: Hormone Rebalancing
- Micronized oral progesterone helped quiet her mind at night.
- Low-dose transdermal estrogen lifted her mood and supported memory.
- Topical testosterone cream helped restore focus, drive, and confidence.
She began sleeping through the night. Her thinking became sharper. Her mood stabilized. “I feel like I finally exhaled,” she told me.
Returning to Herself
By the end of 12 weeks, Sophia described feeling steady, clear-headed, and emotionally resilient. She reconnected with her family and her work—and with herself.
“I experienced healing sleep for the first time in years,” she said. “It gave me my life back.”
Key Takeaways for Navigating Menopause
- Menopause is a brain transition: Shifting hormones affect neurotransmitters like GABA, serotonin, and dopamine, so it’s normal to feel foggy, moody, or restless.
- Insomnia isn’t just in your head: It can be a red flag for hormone and stress imbalances.
- Start with the nervous system: Before introducing hormone therapy, support your body’s ability to rest, restore, and regulate stress.
- Micronutrients matter: Even “low-normal” B12 and vitamin D can affect mental clarity and mood.
- You deserve to feel like yourself: And with the right support, you can.
Final Thoughts
Menopause doesn’t have to feel like a slow unraveling. With the right approach—one that honors the connection between your hormones, brain, and stress response—it can become a powerful time of renewal.
If you’ve been told your labs are fine but you still don’t feel right, you’re not imagining things. Trust your body’s signals. There is a path back to clarity, rest, and vitality.
Stephanie Yang, ND, is a licensed primary care naturopathic physician specializing in cognitive health for busy professionals. Having experienced brain fog firsthand, Dr. Yang understands the profound impact it has on both work and personal life. She helps individuals overcome cognitive symptoms by addressing root causes such as chronic stress, perimenopausal shifts, digestive inflammation, metabolic imbalances, and nutritional deficiencies. Using a holistic approach that integrates mind, body, and spirit, Dr. Yang combines Eastern, Western, and naturopathic medicine to create personalized, science-backed solutions that restore focus, resilience, and well-being. Dr. Yang offers online consultations through her telemedicine practice and in-person consultations at Puget Sound Family Health in Tacoma, Washington. Socials: Instagram: @dr.stephanieyang Website: drstephanieyang.com
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