About menopause transition
The word menopause comes from Greek 'meno' meaning month and 'pausis' to stop.
Perimeans 'around the edges' and perimenopause as a stage can last for ten years. Late perimenopuse is when you’ve skipped three cycles in a row and you’re possibly also experiencing symptoms such as hot flushes and changes in cognitive function.
Being in menopause tends to mean no periods for a year. If you menstruate after 11 months then still peri.
The road to skipped period and hot flush back to hot flush and skipped period to full on menopause can take years and each woman's transition is unique in symptoms and timescale. The average age is 51 but some women begin around 40 and others as late as 58.
The menopause transition more accurately is the phase in a woman's life when changes in the hypothalamic-pituitary-ovarian function eventually result in the cessation of the monthly period.
The menopause is over when there have been no periods for 1-2 years and the hormones have balanced out – can be up to 4 years after the last monthly cycle and you very often don't know it's over until you look back with the wisdom of hindsight.
Many “horror stories” and myths about this stage in our life come from a book published in the 1960s sponsored by a HRT drug company. Menopause is a time of uncertainty, things change and there isn't a map to help us navigate. So many myths abound and, until fairly recently, often symptoms were dismissed as made up. Despite increasing facts and scientific studies menopause is a great mystery – it’s more than a “change” - it's a transition. There are some shit bits and unwelcome discomforts, there may be challenges and emotional confusion but transitions also bring opportunities for emotional and spiritual growth and we can choose how we frame this time of change. Every new beginning and each letting go requires courage and faith. In other cultures this stage of life is welcomed as an initiation where we become the wise women of our tribe.
Arming ourselves with information can help us to navigate this uncharted territory with strength and grace.
Side effects of menopause transition
Known as vasometer symptoms - a product of how the brain regulates heat by causing blood vessels to either constrict or dilate. Happen day or night and some women don't experience them at all. Studies have shown how women respond to these symptoms can affect them - if we are extra sensitive or prone to anxiety or depression they can be experienced for longer and with more intensity so keeping calm and accepting that, whilst annoying they are normal, will help. It is so important that we are extra vigilant in taking care of our emotional and mental health.
Studies show that menopause can affect focus and concentration and, as with all menopause side effects, stress is going to make things worse.
Just under half of menopause women report problems with sleep around this time which feeds into brain fog, vasomotor symptoms and stress. Yoga and meditation can help switch us into the parasympathetic nervous system before bedtime which can facilitate a deep sleep. We need to ensure we set rules around switching off technology, avoiding caffeine and not working too late before bed replacing bad habits with relaxing rituals. The menopause transition will be more bearable when we're not sleep deprived
Around this transition women are more likely to experience psychological distress and more negative moods than at other times in life. Partly caused by hormonal changes but also through poor sleep and other effects. If a history of depression, then more at risk, so good practices to support mental and emotional health and reducing stress are of paramount importance.
Sex and intimacy
Changes in our reproductive system can also lead to changes in sexual health, how you feel about sex and your body. Low libido, vaginal dryness and pain are all side effects too although research shows years of sexual satisfaction resuming after menopause.
Hormones are chemical messengers in the body that guide the functions of our organs and must be balanced for us to feel well in our bodies.. Key role is played by hypothalamus and pituitary gland in the lower section of the brain. The hypothalamus controls and integrates parts of the nervous system and many bodily functions such as temperature, sleep and appetite.
Around the age of 35 the body starts producing less eostrogen which is a major buffer against stress Pre menopause our bodies are buoyed up with oestrogen which keeps everything running. When we are young and headstrong, forging ahead in a career, it is convenient to have higher levels of the sex hormone oestrogen but as we age this diminishes which means we have less yin (oestrogen) to balance stress. It is so important now that we have either reduced our external or internal stressors or learned how to deal with them. Stress plays havoc on our oestrogen reserves which can drain us and exacerbate all the symptoms of menopause. Oestrogen is also produced elsewhere in the body (liver, kidney adrenals) but stress can drain these sources too. Adding more oestrogen via HRTwithout dealing with the cause of it (stress) is like pouring water into a bucket filled with holes.
The main problem is that we arrive at menopause and we have drained our reserves of oestrogen. As our ovaries produce less sex hormones our adrenals are supposed to kick in and produce the hormones we need but if they are already depleted after producing stress hormones to manage our stressful lives 20 years previously they will be wiped out and unable to deliver our post menopausal hormonal requirements. In western medicine this can translate as high or low cortisol levels, deficiency of sex hormones, thyroid problems, adrenal burn out and numerous other imbalances. Adrenal fatigue is so damaging at menopause and will make all the side effects much worse so it is of vital importance that we support the health of our liver, kidneys and adrenals . From an Eastern perspective we say we haven’t enough yin to continue into the next stage of life. If yin is deficient we cannot nourish ourselves to stay cool, grounded, calm or lubricated. Hot flashes are a good indicator of hormonal imbalance. 80% of menopausal women will experience at least one and the more intense and frequent they’re the more out of balance the hormones. If our hormonal balance is thrown off by a history of over work and excess stress then diet, lifestyle and stress management can help rebalance us. Practices such as good breathing (pranayama), slower yoga practices along with yoga nidra and learning to say no are so important now as we simply cannot tolerate or handle stress at all.
Making changes and stepping into our age of wisdom
We are not the woman we were in our twenties and thirties and this isn’t the problem – the problem arises when we don’t adjust our behaviours to reflect this new reality. Saying no to what doesn’t serve us and eating nutritious food is vital to our well-being. Excess stress is worsened by poor diet and inappropriate lifestyle. If we continue to employ our “full steam ahead” approach we may have always relied on previously at peri and menopause it just won’t work and we will be physically, emotionally, mentally and spiritually tired.
Menopause is the great unmasker – a natural passage – but any unresolved issues and bad habits will rise to the surface. Alcohol, poor diet and cigarettes have a greater toll on our bodies at this time and our tolerance will plummet – more colds and flu, issues with cholesterol, poor sleep and adrenal burnout all leading to more serious illness. If we refuse to change what is problematic in our lifestyle we will get sick. Around menopause anything that hasn’t been resolved will come back to haunt you now is the time to sort your shit out – the same hormonal fireworks are firing as in teenage years so this is a potent time for questioning the way things are and personal growth.Many discomforts around menopause are to do with an ageing body and can be eased with a yoga practice.
It’s really important to recognise that it’s okay not to know what’s going on but equally recognise and accept that you can’t just “power through” as you always have as now is the time we need to soften. Yoga can really nourish the body at this time – a slow practice will build more prana – do less but do it well is the new mantra for this time of change.
In Ayurvedic medicine like increases like so we don’t want to build more emotional and internal heat. Balance is important now so if you’re still practising hot, dynamic styles of yoga or exercise ensure that you include softer restorative, yin and meditative practices too. Choose practices that nourish and support you.
You may feel that the body is unreliable at this time, a sense of the body “letting you down” so nurture your body with good nutrition, massage and oils and you may need to allow time to mourn, possibly experiencing a sense of loss. Whatever emotions that come up at this time it’s important to let them rise, without judgement, instead of pushing them down. Welcome everything in as it arises, meditation can help with this, then you can let them go.
Yoga and meditation will help you stay grounded and nourished throughout as you consider what needs to go and what you need to hold onto.
To age well we need to sleep well, exercise, eat well, avoid being angry and manage stress. A yoga practice underpins all of these factors. When we move out our sympathetic nervous system (fight or flight) into parasympathetic (rest and digest), which we do through a nourishing yoga practice, then our immunity is boosted and our quality of sleep is enhanced. When we learn to pause between our crazy thoughts and slow down we make better choices that support rather than undermine our health.
Yoga supports healthy bones at a time we are more vulnerable to a loss in bone density and osteoporosis. Studies show when we are in the sympathetic nervous system (fight or flight) chronic inflammation which accelerates the ageing process is more likely. A yoga practice can support us physically at menopause, strengthening our bones, supporting our endocrine system thus regulating hormones, helping us to sleep more soundly and enabling us to hold space for the experience of uncertainty, irregularity and lack of rhythm that arises.
References and further reading
Cameron Diaz (2016) The longevity book : live stronger, live better, the art of ageing well.
Claudia Turske (2010) Hormone Balance through Yoga.
Claudia Welch (2011) Balance your hormones, balance your life.
Suza Francina (2003) Yoga and the Wisdom of Menopause.
Workshop notes from trainings attended with Uma Dinsmore-Tili on Womb yoga and yoga for menopause
Image credit: PerderPeso.es