Stress and menopause

Stress is a major cause of medical issues in both men and women, with 70% of primary care visits being related to stress and lifestyle.

We have a normal biological process that has kept humans safe since the beginning of time – our fight flight or freeze response to an external event. We call this our stress response. An external “stressor” triggers the sympathetic drive of our autonomic nervous system, we produce hormones such as adrenaline and cortisol from our adrenal glands and this causes a raised heart rate and blood pressure, raised respiratory rate and more sugar in our blood for energy. The result is that historically if there is danger, we can run away or fight. In nature, this happens all the time. Generally, this is a short-term event. The animal will either get away and will resume what it was doing before or will be caught. This is referred to in Robert Sapolsky’s book “Why zebras don’t get ulcers”.

Unfortunately, in our modern busy lives, while this response is still useful for us in situations of danger or short term for increasing focus and alertness, there is much overstimulation of our sympathetic nervous system from how we process external events happening daily.

Stress and menopause

When menopause starts, it is usually at a time in our life when there can be multiple life changing events happening. Women in their 40s and 50s are potentially caring not just for their own children but often parents too. It can be a time when a child is leaving home or family bereavement occurs losing parents. It is also a common time for relationship issues or divorce.

In addition to the above, we have fluctuating hormone levels which lead to symptoms that mimic those when stressed; such as palpitations, hot flushes, mood swings, heightened anxiety, anger/irritability, fatigue, poor sleep and depression.

Talking about the autonomic nervous system above – there are 2 paths – the sympathetic nervous system, which is activated by stress, and the parasympathetic nervous system which is involved in most of our normal daily functions hence it can be known as the “rest and digest” or “feed and breed” system. So, during perimenopause and menopause, women are already experiencing symptoms due to fluctuating hormone levels. If we are experiencing chronic stress, our sympathetic nervous system is being activated more than it should be. This means instead of producing our sex hormones we are producing the hormones adrenaline and cortisol. This further disruption of our sex hormones means that stress just exacerbates the symptoms of menopause.

Pre-menopause, the body has more sex hormones, as they decrease coming into perimenopause and menopause, stress starts to have a greater effect.

We can put our bodies under stress in many ways, not just from relationship issues, work stress, time pressures etc but also a bad diet can cause inflammation in the body and is a form of stress. The consequence of prolonged exposure to stress is fatigue, weight gain, burnout and exhaustion.

How can we deal with stress during menopause?

There are multiple lifestyle changes that you can adapt to help deal with both stress and menopausal symptoms. Do not get overwhelmed and perhaps try 1 small change first and see how that helps then add in others.

1)    Diet – A bad diet is actually a stressor for your body and will not only make menopausal symptoms and the long-term consequences worse but also causes your body to adapt a “stressed” state. Processed foods high in carbohydrates and sugars cause an increase in inflammation and cortisol in the body. Please see my separate blog for more on diet during the menopause.

2)    Exercise – exercise does wonders for stress control. It does not have to be a gruelling run or punishing yourself with something that you do not want to do. Find an exercise that is right for you. This can be any form of dance or movement, alone or with friends. A brisk walk out in nature, swimming, yoga or pilates. Exercise deepens breathing and relieves muscle tension. Aim for 150 minutes of activity per week doing something intense enough that you would not be able to sing but can still talk.

3)    Sleep – Prioritise sleep like you would eating. Giving ourselves the opportunity for adequate rest helps us to deal with stressful situations. There are different stages of sleep that help us to process traumatic events and stress in a healthier way. For more on sleep see my blog on sleep and the menopause.

4)    Stress reduction techniques:

·      Meditation and deep breathing exercises – will decrease the negative impact of stress and help to shift your body back into the parasympathetic drive. There are numerous types of breathing exercises such as box breathing. Box breathing involves:

- Breathe in through your nose deeply and slowly for 4 seconds, feel your lungs expand

- Hold your breath there for 4 seconds

- Slowly exhale for 4 seconds

- Hold for 4 seconds and then repeat.

There are numerous deep breathing exercises to try, breathing into your belly can be useful feeling your belly expand. Also lengthening your outbreath can help to calm down anxiety.

Guided meditation can be helpful for many to get started and there are multiple apps and online videos to help with this. There are also many types of mediation from breathing and relaxing exercises, to body scans to loving kindness mediations. It is worth looking at each to see which is most helpful for you.

·      Mindfulness – mindfulness can be grouped with meditation but this is something most people can do easily, even if they find meditation not something they want to do. Perhaps breathing exercises are not for you? Instead find some calming music, close your eyes and just concentrate on that music, the notes the words, the tones etc. Try a mindful walk. Leave your phone at home. Go out into nature, feel the ground beneath you, listen to the sounds – are their planes overhead? Can you hear birds singing? If there are tress or bushes, look at the patterns on the leaves. The repeating patterns of nature are known as fractals. Think about branching trees, ferns and acorns. Looking at fractals can actually decrease stress by as much as 60% according to studies. Take pleasure in some small routine you have such as savouring a morning coffee – look at how it looks, see the steam coming off, notice the smell and and taste and really just be in that moment.

·      Journaling/gratitude – physically writing things down can be helpful to “offload” stressful thoughts. Also starting to make a regular habit of writing down 3 things you are grateful for in a daily basis causes a shift in health behaviours. The more gratitude is practiced the more a shift in thinking happens.

5)    Social connection – talk/share/cultivate friendships. An important predictor of happiness and longevity is social connectedness. Practice self-care, remember to fit your own oxygen mask before attending to others. If your family need you, you need to be well. Make sure you have time for yourself to see friends.

6)    Plan your own time – As well as seeing friends, ensure you have time in the week for relaxation – a bath in the evening or a book hobby or class will help make life more enjoyable and the stressful times easier to deal with.

In summary, the menopause can be a stressful time and it can cause symptoms of stress such as palpitations sweats, fatigue and depression. External stress can make these symptoms worse. If you feel you have a lot of stress in your life then the time of the perimenopause and menopause is the perfect time to start looking at your lifestyle and seeing what you can do to minimise stress and changes you can make to help you cope with stress. This will help not just your overall wellbeing but will make a difference to your experience of menopausal symptoms.

If you would like to have a lifestyle consultation or coaching around the menopause, please CLICK HERE.

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