Best-selling author and women's health adviser Christiane Northrup, M.D., talks to Beliefnet senior producer Anne A. Simpkinson about the profound changes--physical, emotional, and spiritual--that the process leading to menopause brings.

It might be a good idea to start the conversation by having you distinguish between perimenopause and menopause.

Perimenopause is the process which lasts anywhere from four to 13 years that leads up to actual menopause, the final menstrual period. And so really, all of what I'm talking about takes place in those years before--and possibly for a year or two after--the final menopause.

You take a mind-body approach to perimenopause, strongly tying physiological changes to emotional and psychological ones. The excerpt from your book that we're using lays out your thinking about how hormonal changes can rewire the brain.

Yes, they do.

But your argument is that hormonal changes are not responsible for the intense feelings that women might feel, that they only uncover emotional issues.

If you go through perimenopause, and you begin to have a difficult time emotionally, you need to look at your diet, exercise, and alcohol intake; you will also need to look at what's going on emotionally. The vast majority of the time, you will find that there's some pattern in your life that needs transforming, or at least updating.

Midlife is a time of life when you can either tap in to who you really are--your creative spirit--or you can begin a long decline. You see people all the time who begin to fade at 50. Many others hit their stride and become more powerful than they've ever been. It all depends on how you play it, what choices you make, and what your heredity is like, and so on. I don't want to make the mistake of thinking this is all about a hormonal change. But our hormones definitely uncover emotional issues.

Don't you think that when you talk about physical discomfort and unresolved issues that women run the risk of blaming themselves? Won't many women say, "If I had only dealt with my issues prior to this, I wouldn't be suffering."
I think we women will always [laugh] blame ourselves. There are moments when I say to myself, "What were you thinking for 24 years?" Self-blame is a pattern to expect. But you can say to yourself, "All right, I can wallow in blame, I can feel guilt, or I can say, 'Hmm, I'm not responsible for it, I'm responsible to it. How do I go about changing this circumstance?'"

On prime-time television, do you see any women in this menopausal time with real strength, power, sexiness, beauty? It's like there's a backlash. As the perimenopausal baby boomers get more and more powerful, more and more wealthy, it's like the powers-that-be are doing everything possible to keep us invisible. So Sean Connery stars in a movie with a love interest who is 25 years old.

We have endless opportunities to feel like the culture is doing us a bad turn. Our response has to be: "OK, that's true--so what are we going to do about it? Are we going to feel like washed-up fifth wheels, or are we going to tap into the power that's really there?" That's a choice.

In your book, you wrote: "The most significant way of contributing to your own good health is through the quality of our thought process." Is this what you're talking about?
That's exactly what I'm talking about. Whatever you're thinking in a given moment is what's determining your emotions to a very large extent. When you begin to get a handle on the fact that you can change your thought patterns, choose other ways of being, and when you make that a habit, then you have a lot more power in your life.

It's not being a Pollyanna. It's not saying, "Oh well, this degradation of midlife women doesn't exist." It's saying, "OK, let me be a force to change all that."

Your suggestion in the book to use writing to work with feelings seems like it would be useful. You used it yourself, didn't you?

Yes, I did it in a formal way for seven years with proprioceptive writing. I lit a candle, put on an adagio movement from Bach, sat down, and began to write. I would say, "What do I mean by..." My particular thing is seeing that I'm worthy. I remember that went on for a year, "What do I mean by 'I'm worthy'?" I would write and write and write, and always come out at the end with a new insight.

I learned that thoughts have direction, and that they're usually going towards more feelings--if you get out of the way. It wasn't therapy per se, but it certainly acted like it.