The underlying cause of severe menopausal symptoms can be four-fold.
Early on (early forties) in the perimenopausal era, your symptoms are most likely due to a decrease in progesterone. Worsening PMS is the first sign to declining hormone levels. Estrogen declines as your periods stop and this decline is accompanied by the foggy brain, night sweats and hot flashes. The other two factors involve the thyroid and cortisol levels.
As women enter their 40’s and 50’s, thyroid function naturally declines and cortisol levels naturally increase. Both changes can make menopausal symptoms worse and you need to be aware of the fact that hypothyroidism can mimic menopause, and increased cortisol can affect memory, concentration, weight gain and sleep.