October is menopause awareness month, so we wanted to take a closer look at something that affects half of the worlds’ population at some point in their lives – and therefore indirectly affects the other half who call women their mothers, wives, sisters, girlfriends or pals.
In 2021, figures showed that 26% of the global population of women and girls were aged 50+ and considered postmenopausal. But what is it?
The menopause is one point in a continuum of life stages for women that marks the end of the reproductive phase. If a person experiences periods, they will eventually go through the menopause – the time when ovarian function decreases and levels of the hormone oestrogen start to decline, and pregnancy can no longer naturally occur.
The most common age to experience the menopause is between 45-55 years of age, but it can happen earlier. It’s usually a gradual process, beginning with perimenopause when the fist symptoms are observed, and lasting until one year after the last menstrual period.
The hormonal changes can cause physical symptoms that vary greatly between women. Some may have few, if any, symptoms. Others may have severe and debilitating symptoms that affect daily activities and quality of life. These symptoms can include:
Irregular menstruation cycles (until they eventually stop completely)
Hot flushes and night sweats - a sudden feeling of heat, often along with sweating and palpitations and general discomfort
Vaginal dryness, pain during sex or incontinence
Difficulty sleeping
Changes in mood, including feelings of depression and anxiety
Poor memory or concentration, often known as brain fog
Change in weight
Increase in risk for cardiovascular disease and osteoporosis
In addition to the impact of the physical symptoms, the effect on mental health will also be hugely variable for each individual.
Firstly, the physical symptoms themselves can impact wellbeing. Having hot flushes that you can’t control, feeling pain or discomfort, or experiencing brain fog can be distressing, embarrassing and confusing. It can also feel disorientating and overwhelming to experience changes to the cycle that you may have been familiar with for approx. 30 years, as the body you thought you knew starts to behave differently and outwith your control.
One of the symptoms of menopause is a change in mood – being unable to predict your moods or experiencing acute feelings of rage, despair or sadness can be very difficult to navigate alongside daily life. This can be one of the causes of increased anxiety, as you worry about how you might react in certain situations – however, you might experience anxiety even if you don’t have mood fluctuations. Going through the menopause may make you feel anxious about the future: what your body will be like, how you will feel, what value you will have in society, and what will be left of your ‘self’ once the menopause is done. Ultimately, you may just not feel like you anymore, which can have a negative effect on self-esteem and self-worth.
The social response to your experience can also have a major impact on your mental health. If you have supportive family, friends and colleagues, this can be enormously positive, but some women can be left feeling misunderstood by family, ignored by doctors, or discriminated against by employers. Some experience stigma from those who do not fully understand what the menopause is, or have outdated views about what it means. This may leave you feeling frustrated, angry or alone
The social expectations on women can also play a part. At this stage of life, women may be juggling many roles – they will likely be in some form of work, perhaps have children living at home, and be caring for parents or older relatives, while also trying to carve out time for partners, friends and themselves. To experience menopause symptoms on top of the ‘normal’ expectations can be overwhelming, especially if you try to continue as before with no support or interventions.
There are different treatments on offer for managing the symptoms of the menopause, including HRT therapy (the artificial replacement of hormones to re-balance the system), cognitive behavioural therapy and non-hormonal medication. Some women find these helpful, whereas others prefer to manage the process themselves. Everyone is unique, so it’s important to try different things to find what works for you.
The menopause can be a challenging time for women, but the conversation is beginning to bring it out into the open, and as such, understanding and awareness is improving. The most important thing to remember is that the menopause is a life stage, part of the natural process of being a woman, and certainly nothing to be ashamed of. Some of what you may experience during the menopause is out of your control, and some aspects may require medical intervention, but there are some things you can control - the key is self-care.
Making sure you look after your body with a nutritious and balanced diet, as much sleep as your body will allow, and regular exercise (especially lower-impact, strength training activity) will put you in as strong a position as possible to manage the physical symptoms. Spending quality time with loved ones, mindful activities (such as writing in a diary or spending time in nature), and making time for the things that bring you joy can help you weather the impact on mental health, to allow you the chance to come out the other side stronger and more appreciative of you.
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