hormone balance after 50 – Balance & Bloom 50+

Keto for Your Brain? How the Medical Keto Diet May Support Mental Health in Menopause

By Lori Wesmiller, Mental Health Therapist & Founder of Balance & Bloom 50+

Let’s start with a surprising question…

What if your anxiety, brain fog, and emotional ups and downs in menopause weren’t just about hormones… but also about how your brain is being fueled?

The medical ketogenic diet—a therapeutic, doctor-supervised version of the popular keto trend—is gaining attention not just for weight loss, but for its powerful effects on brain health and mental well-being. Especially in midlife women.

In this post, we’ll explore what the medical keto diet actually is, how it works, and why it may help stabilize mood, reduce inflammation, and support cognitive health during menopause.

What If You’ve Been Fueling Your Brain the Wrong Way?

When I first heard that some doctors were prescribing fat as medicine for the brain, I did a double take.

As a therapist and a midlife woman going through the rollercoaster of menopause, I’ve spent years learning about how food affects mood. But what I discovered about the medical ketogenic diet went far beyond the usual clean eating advice. This isn’t about weight loss or counting macros—this is about how your brain gets its fuel.

And if you’re dealing with brain fog, mood swings, anxiety, or mental exhaustion in midlife, it’s a conversation worth having.

midlife woman discussing menopause options with her doctor

What Is the Medical Ketogenic Diet?

Let’s separate fact from fad.

The medical ketogenic diet is a therapeutic, high-fat, very low-carb diet originally developed in the 1920s to treat epilepsy. Unlike trendy versions of keto focused on weight loss, the medical approach is often clinically supervised, especially when used for neurological or psychiatric conditions.

Here’s how it works:

When you cut carbohydrates significantly, your body switches from burning glucose to burning fat. This metabolic shift produces ketones, an alternate fuel source—especially powerful for the brain.

Researchers are now exploring how ketones can impact serious conditions like:

Bipolar disorder Major depressive disorder PTSD Alzheimer’s disease Perimenopausal mood instability

And the results are promising.

The Brain on Ketones: Why It Matters

Your brain typically runs on glucose, but it can thrive on ketones—especially when its regular fuel system becomes less efficient (like in aging or menopause). Here’s what ketones may do:

🧠 Reduce neuroinflammation

🧠 Balance neurotransmitters like GABA and glutamate

🧠 Enhance mitochondrial function (energy production at the cellular level)

🧠 Protect neurons from oxidative stress and degeneration

🧠 Stabilize mood by smoothing out energy crashes

In a 2025 Stanford study, individuals with severe, treatment-resistant mental illness saw significant symptom improvement on a medically supervised keto protocol. Other research supports benefits in reducing symptoms of anxiety and depression—especially when blood sugar, insulin resistance, and inflammation are involved.

Midlife, Menopause & Mental Health: The Connection

So where does menopause come in?

During perimenopause and menopause, estrogen levels decline, and with that drop comes a ripple effect across your brain. Estrogen helps regulate neurotransmitters, blood sugar, inflammation, and even how your brain metabolizes energy. That’s why many women report symptoms like:

Brain fog Forgetfulness Anxiety or panic Mood swings Depression Motivation loss

Add in poor sleep, cortisol spikes, and hormone chaos, and it’s no wonder your mental health takes a hit.

Medical keto may provide a steady, efficient energy source for the brain when estrogen is no longer buffering the system. It’s not a cure-all—but it’s a tool worth understanding.

But Is It Safe? And Is It for You?

This isn’t about going full bacon-and-butter overnight.

The medical ketogenic diet should be explored with a provider—especially if you have thyroid issues, adrenal concerns, or take medications for mood or blood pressure. Nutrient deficiencies, electrolyte imbalances, and fatigue can happen without guidance.

Questions to explore with your provider:

Do I have signs of insulin resistance or metabolic dysfunction? Have I experienced mood instability or anxiety since entering perimenopause? Do I respond poorly to blood sugar fluctuations or caffeine crashes? Am I already on a high-carb diet and noticing energy crashes or mental fog?

A skilled dietitian or integrative provider can help personalize the approach—because keto is not about extremes. It’s about fueling your brain in a way that supports mental resilience.

The Takeaway: It’s About Options

If you’re in midlife and feel like your brain is stuck in molasses… or like your mood isn’t matching your mindset, keto might be worth exploring—not as a diet, but as a metabolic therapy.

Want More Support?

If you’re in midlife and feeling overwhelmed by mental changes, hormonal chaos, or just off, you’re not alone. I’ve been there too.

🎥 Watch my YouTube video:

▶️ Keto Isn’t Just for Weight Loss—It’s for Your Mental Health Too!

Learn how the Ketogenic diet can alleviate mental health symptoms from anxiety, depression, schizophrenia and more!

💛 Free Therapist-Created Guides to Help You Feel Like Yourself Again

🧠 Feeling more anxious than usual in your 40s or 50s?
You’re not alone. Midlife anxiety is real—and manageable.
Download the free guide:
Midlife Anxiety—Understanding, Calming & Reclaiming Peace
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You’re not too late. You’re just getting started.

Let’s rewrite the midlife story—one hormone, one habit, one healing moment at a time. 💚

💡RESOURCES & RESEARCH

Here are the studies and articles referenced in this blog post:

Stanford University (2025) – Keto diet therapy shows promise in serious mental illness https://news.stanford.edu/stories/2025/04/keto-diet-therapy-mental-illness-research Nature (2020) – Ketogenic diet effects on mood and brain function https://www.nature.com/articles/s41598-020-80727-x.pdf Medical News Today (2023) – Keto diet improves mental health and metabolic symptoms https://www.medicalnewstoday.com/articles/a-keto-diet-may-help-improve-severe-mental-health-metabolic-symptoms The Journal of Clinical Psychiatry – Keto diet for bipolar disorder https://www.psychiatrist.com/news/ketogenic-diet-shows-promise-for-bipolar-disorder/ The Journal of Clinical Psychiatry – Can keto help treat mental illness? https://www.psychiatrist.com/news/can-physical-changes-like-a-keto-diet-help-mental-illness/ NIH / PMC (2024) – Keto’s role in PTSD, anxiety, and neuroinflammation https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11182043/ Frontiers in Nutrition (2025) – Ketogenic diet as adjunctive therapy in psychiatry https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2025.1506304/full

Hormone Replacement Therapy (HRT) & Why I Chose to Start

After struggling with menopause symptoms, the author turned to hormone replacement therapy (HRT) for support. Working with a menopause specialist, she developed a personalized plan including progesterone and estrogen to address sleep, mood, and energy issues. She emphasizes that HRT can complement natural wellness and encourages others to consider it.

by Lori Wesmiller, MS – Balance & Bloom 50+

Organizing medication for hormone therapy management at home.

I’m all about tuning in to what your body needs in each season of life—and after trying so many natural strategies to manage my menopause symptoms, I reached a point where I felt like I needed more support.

I wasn’t sleeping well. My motivation had dipped. My joints were achy, and I had this nagging sense that I was pushing through each day, rather than living it.

Lori wrapped in a yellow blanket, holding a tissue to her eye, expressing emotion.

Thankfully, my OB-GYN is a menopause specialist, and she really listened. We reviewed my symptoms, medical history, and lab results together. From there, she created a customized HRT plan tailored to my body’s needs and sensitivities.

We decided to begin with one 200mg progesterone capsule taken in the evening. Even though I had a hysterectomy back in 2012 and technically don’t need progesterone to protect the uterus, my doctor included it for other benefits. Specifically, it supports better sleep, eases anxiety, and helps stabilize mood swings.

Micronised progesterone soft gelatin capsules (200 mg) used in hormone replacement therapy.

After two weeks on progesterone alone, I started using a 0.0375mg estrogen patch, which I’ll change twice a week. This low-dose patch helps support energy, cognitive clarity, temperature regulation, and joint comfort, among other things.

Estradiol Transdermal Patch — Estradiol 0.0375mg Estrogen Transdermal Patch for HRT

This wasn’t an overnight decision—it was thoughtful, researched, and guided by a specialist. And I want other women to know: exploring HRT doesn’t mean you’re “giving up” on natural wellness. For many of us, it’s part of the picture of balanced, thriving health.

Disclaimer: Always consult your healthcare provider before starting any hormone therapy regimen—whether medicinal or natural. HRT is not one-size-fits-all. A trained provider can help you make the most informed and safe choice based on your unique health history and symptoms.

I’ll be keeping you updated on how this HRT journey unfolds, both here and over on my socials. If you have any questions about my path so far or are just curious about what it’s really like to start HRT, I’m always happy to share more. You’re not alone in this season—we’re blooming through it together.

Are you taking HRT for perimenopause or menopause symptoms? If so, what has your experience been?

Happy blooming beauties!

Embracing Menopause: A Guide to Thriving Through Life’s Changes

By Lori Wesmiller, Balance & Bloom 50+

A diverse group of women celebrating the strength and beauty of aging together.

Let’s be honest—perimenopause, menopause, and post-menopause are not just phases to “get through.” These transitions are powerful seasons of life. How we care for our bodies during them matters more than ever. If you’ve felt like your body is shifting beneath your feet—emotionally, physically, even spiritually—you’re not alone. And more importantly, you’re not powerless.

In fact, this is the perfect time to reconnect with your body in a whole new way.

🌙 Why It Matters

Hormonal changes during these stages impact everything: sleep, digestion, mood, memory, weight, skin, and even our sense of self. According to the North American Menopause Society (NAMS), as estrogen and progesterone fluctuate and decline, they influence:

Bone density and muscle mass
Mental clarity and mood
Skin elasticity and hydration
Gut and heart health
Energy levels and metabolism

If you feel like your body is no longer behaving the way it used to—there’s a reason for that. These shifts aren’t your fault, and they’re not a failure. They’re your body’s way of recalibrating, and they deserve attention and care.

⚡ How Perimenopause, Menopause & Post-Menopause Can Feel

You may experience a mix of physical and emotional symptoms, including:

Brain fog, forgetfulness, or trouble concentrating
Hot flashes, night sweats, and disrupted sleep
Digestive changes like bloating or constipation
Unexplained weight gain, especially around the midsection
Mood swings, anxiety, or irritability
Dry skin, thinning hair, or changes in body composition
Fatigue, even after rest

Perimenopause typically begins in your 40s and can last several years before your final period. Menopause is confirmed after 12 months without a period, and post-menopause continues for the rest of your life. Cleveland Clinic notes that while symptoms vary greatly, support and intentional care can dramatically improve quality of life.

🌱 Tips for Feeling Better in Your Body (and Mind)

1. Eat to Nourish, Not Restrict

Focus on foods that stabilize blood sugar and reduce inflammation:

Protein-rich meals (20–30g per meal) to preserve muscle
High-fiber foods (vegetables, chia seeds, lentils, flax) to support digestion and estrogen clearance
Omega-3 fats from fish, walnuts, and flax for mood and joint support
Anti-inflammatory spices like turmeric and ginger

More ideas: Precision Nutrition’s Guide to Menopause & Nutrition

2. Move with Purpose and Pleasure

Exercise helps ease anxiety, boost mood, and maintain bone and muscle strength. Harvard Health recommends:

Strength training 2–3x a week
Walking, swimming, or dancing for heart health
Yoga or Pilates for balance, flexibility, and pelvic health

Even 15 minutes a day makes a difference—and finding movement you enjoy is key to consistency.

3. Support Your Sleep Like a Ritual

Sleep disruptions are common, but they’re not something to ignore. Try:

Keeping your room cool and dark (night sweats are real!)
Using magnesium or melatonin with your doctor’s okay
Avoiding screens 1 hour before bed
Creating a calming wind-down routine

More tips here from the National Institute on Aging.

4. Balance Stress Hormones (Especially Cortisol)

Perimenopause makes your body more sensitive to stress. Chronic cortisol can worsen belly fat, sleep problems, and even hot flashes. Combat this by:

Taking breaks throughout your day to breathe
Journaling or meditating for 5–10 minutes
Practicing saying “no” and setting boundaries
Spending time in nature or doing something just for you

5. Care for Your Gut = Care for Your Hormones

Your gut helps clear excess estrogen and regulates mood via the gut-brain axis. A happy gut supports a balanced mind.

Add fermented foods like sauerkraut, kimchi, kefir (or non-dairy alternatives)
Eat a variety of plant-based fibers
Consider a probiotic supplement if needed

More on this from Dr. Mary Claire Haver and the Galveston Diet

6. Know When to Seek Support

If your symptoms are affecting your daily life, don’t tough it out alone. You may benefit from:

Speaking to a menopause-informed doctor
Exploring hormone therapy (HRT), non-hormonal options, or supplements
Joining a support group or community of women going through the same thing
Reading empowering resources like The Menopause Manifesto by Dr. Jen Gunter

✨ You’re Not Just Surviving—You’re Blooming

Aging isn’t about shrinking or fading away. It’s about stepping into your full wisdom, power, and energy—with care, compassion, and strength. These years can be some of the most connected and vibrant of your life—especially when you support your body in all the ways it asks for.

Let’s shift the narrative. This isn’t about fighting aging—it’s about embracing you.