Women in Mid-Life and the Biology of Grief
Part 1: Why This Transition Was Never Just About Hot Flashes
I became an accidental expert in something I never wanted to study. Funny how that works.
In 2024, I buried both my parents. Well, not “buried” exactly – they were cremated. My mom died right before Christmas, but her funeral was at the beginning of January. I lost my dad 9 months later. He was disabled, so I spent those 9 months trying (and failing) to fill my mom’s shoes as best I could – arranging home care and meal delivery and doctor’s visits and insurance coverage issues, all from my life on the opposite end of the country. I logged a lot of miles in those months, flying home to be with my dad every month, sooner if there was an emergency. (There were always emergencies.)
Shoutout to Southwest Airlines (and also, screw you for taking away everything that was good about you, btw).
I’m adopted and, for all intents and purposes, an only child (that’s a whole ‘nother looooong and complicated story). All that to say, I was very close to my parents, especially my mom. After I lost my dad, I fell apart hard. Without him to take care of, I finally was forced to feel the immense grief of losing them both.
Professionally, I shut down, ignoring my inbox, social media, my newsletter … I turned inward and stopped connecting. My practice went quiet. And I – the person who advocates and encourages clients to prioritize colorful veggies and heal their nervous systems – was surviving primarily on hummus and numbness. (Look, I made a rhyme.) Also on coffee and Gilmore Girls. I wish I was kidding.
Here’s the thing about being a functional nutritionist with a research habit and too much time on your hands: when life (or in this case, death) breaks you, you hide in your safe space and start reading. After a while, I knew I needed to give this pain a focus, because it was suffocating me, all big and diffuse as it was. Why did food stop tasting like anything? Why did I feel so completely hollowed out and disconnected from everyone? Why did everything feel so wildly, biochemically wrong?
What I found – and eventually turned into a presentation, because apparently I process things by turning them into PowerPoints – was that grief and the menopause transition are not just two things that happen to collide in midlife. They are, at a biological level, deeply and uncomfortably intertwined.
Almost no one is talking about it. So let’s talk about it.
I want to give you the framework for what I just described. At the same time, I want to acknowledge that this information may land differently depending on where you are in the menopause transition, and your own personal lived experience.
Do you know the concept of Disenfranchised Grief? It’s a term coined by Dr. Kenneth Doka to describe grief that isn’t publicly acknowledged or socially supported – essentially, it’s mourning that happens in silence because society hasn’t given it a name, or status, or a casserole. Think of the early AIDS epidemic, whose losses were often shrouded in stigma. Think of miscarriage, family estrangements, or the end of a relationship that was never “officially” recognized.
I'm here to say that the menopause transition is a form of disenfranchised grief.
Because here’s what we’re losing (and grieving):
Fertility, maybe, for some – but also, the version of our bodies we knew. Youth: not just the physical privilege of youth (smooth skin and hair, a resilient metabolism, the taken-for-granted energy and ease), but the overall sense of possibility that lives there. The assumption that our sleep, our moods, and our temperatures were basically manageable. Our identities as mothers, as daughters, as partners – roles that quietly defined us, often until they didn’t.
(I suspect you could add a few of your own.)
Perimenopause doesn’t just change your hormones. It changes who you understand yourself to be. And that is a loss that deserves to be recognized and acknowledged.
So, there’s the grief of menopause – those losses that belong to the transition itself. And there’s grief in perimenopause – the losses that arrive from the outside: the social social structures that organize our professional lives, and the parents/partners/friends/roles that we lose precisely when our biology is least equipped to absorb them.
And – ready for more good news? – so often, both are happening at once. That’s not bad luck. That’s mid-life.
In upcoming Parts 2 and 3, we’re going to get into the actual biology:
The connections between your hormones and grief
Why the menopause transition makes you more vulnerable to getting stuck in grief (FYI, that diagnosis is Prolonged Grief Disorder (PGD) or Persistent Complex Bereavement Disorder (PCBD) – ask me how I know)
And most importantly, what you can actually do about it (yes, there are things – food, lifestyle, the works)
But I wanted to start here, with the naming of it, because in my experience, feeling seen is the first thing that helps.
If you’ve been wondering why you can’t “get over it” yet; if you’ve felt like grief hit you harder or differently than you ever expected; or if you’ve been white-knuckling it through a transition that nobody prepared you for – hormonally or emotionally or physically - I hope this makes you feel less alone.
You’re not too sensitive, and you’re not broken. You are supremely human, and you’re navigating loss. Your nervous system is doing exactly what it was designed to do – and sometimes, when the weight is this heavy, that means freeze. Or fold.
It’s not weakness; it’s biology.
Let’s start there (in Part 2).
About The Author
Stephanie Thompson is a New Orleans-based functional nutrition specialist who specializes in helping people alleviate frustrating (often mysterious) health symptoms with dietary guidance, targeted nutrients, and lifestyle modifications. She digs deep into the biochemical pathways and interconnected organ systems to find the root causes of her clients' issues for specific and sustainable relief!
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