Let’s Talk About It…Menopause
Let’s just put it out there ladies. The symptoms of perimenopause and menopause can make us feel like our whole world has been turned upside down. Our moods change, sleep becomes more difficult, we may feel depressed or anxious and not able to put words as to why. Mood changes, skin changes, and hormone changes can make us feel like we are back to being teenagers. We went through this once, now we must do it again?
Menopause is a natural part of aging and the average age when a woman starts experiencing menopausal symptoms is age 51. Despite women living longer, the average onset age has remained the same. It can occur as early as 40, or as late as 60. Menopause is thought to have occurred when a woman does not get a menstrual cycle for one year. These hormonal changes can last years and can be difficult to navigate.
The main hormone we hear about is estrogen. Estrogen is a board term used for the different forms of the hormone that also includes estradiol, estrone, and estriol. Estradiol is the most potent form of estrogen during the reproductive years. Estrogen regulates the menstrual cycle, helps maintain healthy bones and heart health as well having an impact on mood and skin health.
Common mental health disruptions when women enter perimenopause and menopause:
Anxiety
There is not a lot of information available for why women can become more anxious when transitioning into menopause. Some evidence suggests that women may experience panic attacks (sudden feeling of extreme anxiety; may also cause sweating, trembling, shortness of breath or heart palpitations) due to a drop in estrogen levels. These can also be confused for hot flashes as the symptoms can be quite similar. During a hot flash, your heart may race, and you may feel sweaty and hot, which mimics some of the symptoms of a panic attack. Also, some women feel an aura, which is a sensation most linked to migraines. For women who experience an aura, it may feel like a panicked feeling or a sense of dread. An important distinction between a hot flash and a panic attack is that hot flashes don’t make you feel short of breath.
Depression
Feeling a lack of motivation, tearfulness, a general feeling of malaise are all common symptoms of depression and feel stronger in perimenopause. The changes in the amount of estrogen our bodies produce may be partly responsible for this. If someone is experiencing hot flashes or other physical symptoms, it may affect them wanting to go out and do things with friends and family, leading to isolation. Another symptom of menopause is a disruption in sleeping patterns which can trigger depressive symptoms (persistent feelings of sadness, difficulty concentrating, brain fog, not wanting to get out of bed, loss of interest in activities usually enjoyed, and irritability.) The way a woman feels about aging can also play a role in changes in their mood. Fertility changes and what her place is in society now can have long-lasting effects on mental health.
Sleep
Often, I hear women lamenting that they seem to wake up every morning around 3:00 am and just can’t fall back to sleep. Racing thoughts, overthinking, or other worries may be a factor affecting sleep. Hot flashes can wake women up and make it uncomfortable to go back to sleep without changing clothes or bedding. Ways to combat this are:
Getting regular exercise
Diet: Avoid heavy meals, caffeine and alcohol before bed.
Have a bedtime routine
Sleep Environment
Stress Management
So, how do we protect our mental health during this time? Sometimes it can be difficult to ask for help, or we feel we should just be able to handle everything on our own. Millions of women before us have gone through this, we should have no problem, right? With social media, we have more information than ever on what other women are doing to manage their symptoms, but how do we know what to believe or what will work for us?
1. Talk to your doctor/medical provider. Some women use hormone replacement therapy (HRT) to help alleviate their symptoms; however, this is not an option for all women. Talk to your provider about alternatives (supplements, topical medicines) that may be appropriate for you. Also discuss safe exercise programs with your provider.
2. Be aware of your mood changes. Consider keeping a journal to track patterns in sleep, appetite, and stress levels. This can help you figure out triggers, what helps and what doesn’t help you navigate this time in your life.
3. Making positive lifestyle changes that may include an exercise program, yoga, or an activity you have always wanted to try. Now is the time!
4. Reach out to others. This may be one of the most important steps we can take. We don’t need to face menopause alone, and we don’t have to try and manage it alone.
5. Consider speaking with a mental healthcare professional for strategies to help ease anxiety and depression symptoms. Cognitive-Behavioral Therapy (CBT) is an effective, evidence-based practice that helps people manage mental health and emotional challenges by changing the way they think and respond to situations.
Sources: www.health.harvard.edu/womens-health/menopause-and-mental-health www.uclahealth.org
