Continuing our series of mental health articles, we examine the mental impact of menopause and peri-menopause, exploring the reasons why, the effects and some solutions. We also speak to several club members affected by menopause.
Think about the menopause and the symptoms that spring to mind are hot flushes, night sweats and irregular periods. These are all physical issues – but there is a growing wealth of evidence to show that mental health can be adversely affected.
What is menopause?
Peri-menopausal symptoms can start from early 40s, while menopause typically occurs around the age of 51. Menopause is when the ovaries no longer release an egg every month, resulting in the end of the menstrual cycle and, therefore, reproduction. At the same time, hormones, including oestrogen and progesterone, made by the ovaries are reduced.
The main culprit of both physical and mental health issues in the menopause years is reduced oestrogen.
Physically, this can include hot flushes, sleeplessness, anxiety, joint pain, muscles cramps, hair loss, migraines, incontinence, reduced libido.
Reducing oestrogen can also cause mental health issues including decreased cognitive function, such as memory loss and brain fog, as well as mood swings, irritability, anxiety, panic attacks, low self-esteem, reduced motivation and depression.
Look at the research
If you are interested in the research and science see:
- A study by menopause campaign group Pausitivity discovered thousands of women are unaware that declining hormones in their 40s and 50s could also be behind symptoms such as depression and anxiety. Read: It’s time to change the way we view menopause.
- An article in the New York Times that suggests two-thirds of women suffer menopause-related cognitive impairment.
- In another scientific article, Pauline M Maki, a professor of psychiatry and psychology, reports” declines in oestrogen around menopause are associated with declines in cognitive functioning.
We asked a few club members to reveal their experiences of peri-menopause and menopause.
Vicky Begg, 46, suffers with what is classically described as “brain fog” and also anxiety. She says: “I noticed the brain fog when I started my MSc when I was 43. I wasn’t sure whether it was because I was doing something new – a new environment, new learning, new people – and I hoped it might alleviate as I settled into the new routine. But that wasn’t the case.
“I had to be really careful about only listening to what I thought was important, listing and attending to tasks, otherwise it would all became overwhelming.”
Vicky believes the brain fog led to a growing anxiety. She says: “I had increasing anxiety about seemingly ‘common’ tasks and a dread around encountering any difficulties however small or large.”
Vicky has had to learn a new approach to her participation in sport as a result. She says: “I have had to acknowledge a reduced ability relative to my age and relative to the effects of the brain fog and anxiety.
“An example of this would be literally feelings of anxiety while cycling. The feelings would be an inability to relax, tightness in chest, buzzing thoughts, lack of concentration and all relative to what I previously felt in this environment.
“To help with this I have done lots of visualisation of the rides before I go, including who will be there, where we will go, how hard I will have to ride and at what point I am happy to step back from it all and say, ‘see you all later.’
“This might mean that right from the first pedal stroke I am out of it…”
It took Susan Cameron, 52, many years to understand that it was her hormones, relating to peri-menopause, that were causing a range of mental and physical health issues.
She says: “I felt very low at times in my forties and this led to a lot of self doubt and one very bad period of suicidal thoughts.
“I also had physical symptoms that had additional mental effects. For example, really bad and sore joints prevented me sleeping. A lack of sleep caused massive tiredness and all of this led to feelings of anxiety.”
HRT has been very helpful for Susan. She says: “The HRT has generally improved the low and depressed feelings, although it hasn’t stopped the chronic tiredness.
“I also started exercising partly to see if it would help with all of the symptoms and it definitely has. However, I go through periods of feeling like I have no mojo and it takes all my willpower to do the exercise. Then, if I don’t do it, I feel mad at myself so it can be a double-edged sword.”
Nicola Donald, 48, has struggled with symptoms of brain fog and mainly in the work environment. Nicola is an estate agent.
She says: “I struggle to pull tools out the bag so to speak when I’m dealing with situations and it’s only later I think, ‘Why didn’t I suggest that’ or ‘how on earth did I forget that.’
“I work with males and they just don’t seem to have that problem, which frustrates me even more in this day and age of women struggling with equality.
“I’m worried they get a sniff of me struggling because there’s no place for ‘bumbling hormonal women’. While the confident voice in my head says they probably won’t even notice, I do still worry.”
Nicola has found “repetitive exercise”, such as swimming or a gym workout helpful. She says: “Just switching off my brain while my body performs repetitive actions is so nice to wind down. I feel no pressure, and I like that someone tells me swim sets or instruction and I just have to follow it.”
Christina Cox is 53 and still in the peri-menopause stage. She says: “My main anxiety around sleep disturbance. I worry about not being able to sleep.”
Chris has found that exercise is an aid and it is one of the main reasons why she has returned to triathlon.
She says: “When I’ve exercised I’m much more likely to sleep well. The flipside of this strategy though is that I know that, if for any reason, I’ve not been able to exercise during the day then I’m at risk of a poor night’s sleep so I then worry about not having exercised, which can then lead to sleeplessness.”
As well as the physical benefits of exercise that improve mental health, Chris has found that the social side of triathlon – especially participating in the club – is beneficial.
She says: “I didn’t realise quite how much social link-ups are important to mental health until lockdown and I think I’ve been virtually more social than I was before.”
Take home points
Most women will tell you that the more we talk about the subject of menopause the easier it is to cope. So talking and sharing information is a good thing to do.
Men have also found it helpful to join and listen to the discussions so they can understand what their partners or friends are going through.
Menopause does finally end and many post-menopausal women report that their cognitive functions improve once the hormones resettle.
Support groups and websites
Some, but not all, NHS health boards provide specialist menopause clinics. Ask at your GP surgery for information.
In other areas, health boards provide menopause care through general practice and specialist referral when needed.
The British Menopause Society lists menopause specialists.
A growing network of menopause cafes, events and festivals. See www.menopausecafe.net.
Let’s Talk Menopause. See letstalkmenopause.co.uk
Menopause Matters. See www.menopausematters.co.uk
Sandyford Menopause Service, NHS Greater Glasgow and Clyde: www.sandyford.org