I recently watched the utterly brilliant movie ‘Are you there God? It’s me Margaret’ It was out Saturday night movie and my three children were howling with laughter throughout. It brought up so many thoughtful and beautiful questions from my two boys about puberty, and a narrative around the celebration of hormone cycles and what it is to go through puberty as a girl. It got me to wondering though where it its sister movie? The one that celebrates the menopause?!
We've all had countless conversations about hormone cycles, periods, and pregnancy, but how often have we delved into the topic of menopause? This is a topic that has been historically avoided, perhaps due to shame, perhaps because we associate it with becoming old and invisible, whatever the reason its time to demystify and give space to a topic that and affects every woman worldwide, and has relevance for everyone: menopause.
Dispelling Misconceptions
Alright, let's set the record straight from the get-go. Menopause is not something to fear or hide away from—it's a powerful transformation in a woman's life. It's time to debunk those old-fashioned myths that label menopause as weakness or instability and something ultimately to feel ashamed of. Trust me, it's quite the opposite! Menopause is a testament to our strength and resilience as women, and it's high time we celebrate it!
What is Menopause Anyway?
Menopause marks the time when our ovaries gracefully retire from producing eggs which results in a decline in our hormones and can lead to a bit of a hormonal dance! The word ‘menopause’ literally means the ‘end of monthly cycles’ (the end of monthly periods or menstruation), from the Greek word pausis (‘pause’) and mēn (‘month’). The transition to menopause typically begins when a woman is in her mid-to-late 40s (known as the perimenopause) but it’s important to be aware that some women will start the menopause transition at a younger age than this and some at an older age. The average age for a woman to reach the menopause in Norway is 51. Around 5% of women will go through an early menopause, between the age of 40-45, and 1% under the age of 40.
Lets Talk Hormones
Hormonal changes play a significant role during menopause. Here is a brief synopsis of the different hormones important in menopause (and actually at all times!) and their roles:
Estrogen: Estrogen is a primary female sex hormone responsible for the development and regulation of the reproductive system. During menopause, estrogen levels gradually decline. Estrogen plays a role in bone health, cardiovascular function, and the maintenance of vaginal tissues. As estrogen takes a bit of a backseat we might experience some exciting changes – like irregular periods, hot flashes that make you feel like you're vacationing in the tropics, and mood swings that might make you go from laughter to tears in the blink of an eye!
Progesterone: Progesterone is another essential hormone involved in the menstrual cycle and pregnancy. Progesterone helps regulate the menstrual cycle, promotes sleep, and has a calming effect. During menopause, progesterone production declines. Its decrease can contribute to sleep disturbances, mood swings, and irregular periods.
Follicle-Stimulating Hormone (FSH): FSH is produced by the pituitary gland and plays a crucial role in the menstrual cycle. During menopause, as the ovaries stop releasing eggs, FSH levels increase significantly. Elevated FSH levels can lead to symptoms such as hot flashes, night sweats, and changes in menstrual patterns.
Testosterone: Testosterone is a hormone produced in the ovaries and adrenal glands. It plays a crucial role in maintaining bone density, muscle mass, libido, and overall well-being in women. Testosterone levels decline gradually during menopause, similar to estrogen and progesterone. And you might wonder, what does that mean for us? Well, this decline can bring about some changes, such as a drop in our libido and energy levels.
The Perimenopausal Period: The change before the change
The perimenopausal phase, which precedes menopause, can start several years before your final menstrual period. Think of it as a warm-up to the main event. On average, most of us will expreince preimonopause symptoms for around 4 years before menopause itself. However, around 1 in every 10 women experience them for up to twelve years! During perimenopause, hormones can go haywire, causing mood swings, irritability, and anxiety. Perimenopause is confronting. It is a baptism of fire that forces you to confront yourself - your past, your present, and your future!
It's important to acknowledge the physiological, emotional and psychological changes during this phase. Common symptoms of perimenopause include:
mood swings
heightened anxiety
low mood
difficulty sleeping and sleep disturbances
dry itchy skin
headaches
hair thinning
joint pain
vaginal dryness
Emotional Rollercoaster
Oh, emotions, emotions! Buckle up, my friends, because during both perimenopause and menopause itself they can take you on quite the ride. We're talking mood swings, anxiety, and even moments of feeling down. Blame it on those hormonal changes that turn everything into a rollercoaster of emotions. But fear not! It's all part of the journey, and we're here to support each other through it with open hearts and understanding.
Depression:
Studies indicate that during the menopausal transition, the risk of experiencing depressive symptoms increases. Approximately 20-40% of women may experience depression during perimenopause and early postmenopause. Women with a history of depression are more susceptible to developing depression during menopause. The hormonal changes, particularly fluctuations in estrogen levels, are believed to contribute to the increased vulnerability to depression during this phase.
Anxiety:
Anxiety symptoms are also common during the menopausal transition. Approximately 10-20% of women may experience increased anxiety during perimenopause and early postmenopause. The hormonal changes, along with other factors such as sleep disturbances, hot flashes, and life stressors, can contribute to the development or exacerbation of anxiety symptoms. Women with a history of anxiety disorders may be more prone to experiencing anxiety symptoms during menopause.
It's important to note that these statistics represent general trends and that individual experiences can vary. Some women may not experience significant depressive or anxiety symptoms during menopause, while others may be more affected. If you are experiencing symptoms of depression or anxiety during menopause, it is advisable to seek support from a healthcare professional who can provide appropriate evaluation and treatment options.
Self-Identity and Self-Esteem
Now, let's talk about something that's close to my heart—self-identity and self-esteem. Menopause often brings a moment of reflection and self-discovery. Our bodies might be going through some changes, but guess what? It's all part of the beautiful process. Don't let anyone tell you that you're any less fabulous! Embrace the new you, celebrate your wisdom, and remember that age is just a number. Menopause and the perimenopausal period often trigger a reassessment of self-identity and self-esteem. The physical changes that accompany this transition, such as fluctuations in weight, changes in skin and hair, or shifts in energy levels, can challenge a woman's perception of herself. Society's unrealistic expectations and ageist stereotypes exacerbate these pressures. However, it's important to emphasise that menopause is not the end of youth but the beginning of a new chapter - a second spring! Encouraging women to embrace their evolving selves, celebrating their wisdom and experiences, can foster a positive self-image and strengthen their sense of identity.
Empathy: A Key Ally
Empathy is our secret weapon in tackling menopause head-on. Whether you're a woman experiencing it or a supportive soul by her side, empathy is the key. Take the time to educate yourselves, listen with open hearts, and offer a loving shoulder to lean on. Let's create a safe space where we can understand, support, and uplift each other. To the men reading this, your understanding and support can make a significant difference. Empathy plays a pivotal role in nurturing healthy relationships during the perimenopausal and menopausal periods. Educate yourself about the physiological and psychological aspects of menopause and the perimenopausal phase. Recognise that women may be navigating a complex emotional landscape, and your compassionate presence can provide invaluable support.
Coping Strategies
Navigating the Menopause Maze
When it comes to coping with menopause, we're all unique beings, and there's no one-size-fits-all solution. First and foremost, prioritise self-care. Move that fabulous body of yours, nourish it with wholesome goodness, and get the beauty sleep you deserve. And if you need extra support, don't hesitate to reach out to the professionals who can guide you through this incredible journey. For women navigating the perimenopausal and menopausal periods, understanding coping strategies can provide a roadmap for managing the psychological impact.
Education and Awareness
Knowledge is power. You don’t have choices unless you learn about your options and understand your symptoms. Educate yourself about the physical and psychological changes that occur during menopause and the perimenopausal phase. Understanding the hormonal shifts and their potential effects can help you navigate this transition with greater insight and resilience. Menopause care can be patchy thus being informed means that you can be proactive in asking for the right the support
Self-Care and Lifestyle Changes
Prioritise self-care practices that promote overall well-being. Engage in regular exercise to boost mood and energy levels, promote better sleep, and improve overall physical health. Focus on a balanced diet rich in nutrients to support hormonal balance and overall health. Adequate rest and stress reduction techniques like meditation, deep breathing exercises, and relaxation practices can also help manage symptoms.
Seeking Social Support
Reach out to trusted friends, family members, or support groups. Sharing experiences and feelings with others who are going through similar situations can provide validation and emotional support. Building a strong support network can help alleviate feelings of isolation and provide a safe space to discuss challenges and triumphs.
Hormone Replacement Therapy (HRT)
HRT is an option worth considering for women experiencing menopausal symptoms. It involves using medications containing hormones (such as estrogen or estrogen combined with progesterone, and sometimes testosterone too) to supplement the body's declining hormone levels. As with any medication, the choice to use HRT is an individual one and it doesn’t come without risks, but the official stance on HRT, despite the 2002 study’s findings, is that HRT ‘does not significantly increase the risk of cardiovascular disease (including heart disease and strokes) when started before 60 years of age’. Current research suggests that cancer risks are low in medical terms, while there are benefits to HRT , particularly from newer forms of HRT, in terms of lower Alzheimer’s and osteoporosis risks.
Mindfulness and Relaxation Techniques
Practice mindfulness and relaxation techniques to manage stress and promote emotional well-being. Mindfulness meditation, deep breathing exercises, yoga, or tai chi can help reduce anxiety, improve mood, and cultivate a sense of inner calm. These practices can enhance self-awareness and provide a grounding presence amidst the emotional and psychological changes.
Remember, coping with menopause is a unique journey for each woman. Embrace a holistic approach by combining different coping strategies to create a personalised toolkit that supports your well-being and empowers you to navigate this transformative phase with grace and resilience.
It's time to join forces and change the narrative. Let's challenge the antiquated views of and stereotypes of menopause. Together, we can rewrite the narrative, break down the stigma, and empower women to embrace this transformative chapter with confidence and grace. Let's face this menopause journey with all the zest and determination we've always had! And remember, you're still the incredible, amazing woman you've always been – hormones and all!