Perimenopause and menopause are significant transitional periods in a woman’s life, bringing about a range of physical, emotional, and cognitive changes. These changes can be daunting, but knowing what to expect and how to handle them can make a huge difference.
During perimenopause, the challenges begin both in personal life and in the workplace. This phase can start in your 40s, although it might come earlier, and it can last for 4-8 years[1] or even longer. During this time, the ovaries fluctuate in their production of oestrogen, leading to some debilitating symptoms[2] like hot flushes/flashes (or blooms), night sweats, sleeplessness, fatigue, vaginal dryness, mood swings, anxiety, depression, and even an increased risk of suicide[3]. These symptoms can really shake up daily life and professional performance. It’s no wonder that during this period, 23% of women consider stopping work due to the debilitating symptoms, and 13% actively plan to stop[4]. What’s frustrating is that this should be one of the most productive times in your life, but hormonal fluctuations can make it hard to concentrate, lead to memory loss, and cause low moods.
As you transition from perimenopause to menopause, which is defined as the time when a woman has not had a period for more than a year due to reduced oestrogen levels[5], there is a significant shift. This stage is calculated retroactively and marks the end of a woman’s reproductive years. The average age for menopause is 51, but this varies depending on factors like geographic location, genetics, and lifestyle choices, such as smoking and alcohol consumption[5]. For some women, this means the end of many perimenopause symptoms, though many continue to experience issues like vaginal dryness and hot flashes.
Now, let’s talk about the post-menopause stage. This is when long-term health problems such as heart disease and osteoporosis might develop. After menopause, a woman can lose up to 20 percent of her bone density in the next 5-7 years due to the lack of oestrogen[6]. Oestrogen also helps protect the heart and keep cholesterol levels in check, reducing the risk of fat build-up in the arteries and keeping the blood vessels healthy. Considering the average life expectancy of women in the West is around 89 years, the average woman will spend about 40 percent of her life in this period. Therefore, making lifestyle changes can be crucial for living a fulfilling and productive life.
However, it’s not all doom and gloom. Lifestyle modifications can be a game-changer in managing menopause symptoms. Adjustments in diet, exercise, and stress management can make a significant difference. For instance, a healthy Mediterranean-style diet rich in fruits, vegetables, and whole grains can help reduce hot flashes and improve overall health[7]. The Mayo Clinic suggests that aerobic activities and strength training can alleviate symptoms like weight gain, insomnia, hot flashes, and mood swings, as well as maintain a healthy heart[8]. Moreover, a study in Complementary Therapies in Clinical Practice found that yoga and mindfulness-based stress reduction can significantly reduce the severity of hot flashes and improve sleep quality[9].
On the medical side, Hormone Replacement Therapy (HRT) is a common treatment for menopause symptoms. This involves taking oestrogen (especially in patches or gels) and progesterone (for women who still have their uterus and/or ovaries), and possibly testosterone, to replace the hormones that the body stops producing during menopause[10]. HRT can be very effective in reducing symptoms like hot flashes, night sweats, anxiety, and brain fog, and it can also help prevent bone loss and protect the heart. However, it’s important to be aware that HRT is not without its risks. Some studies have linked it to an increased risk of certain types of cancer and blood disorders. Historically there had been an increased risk of blood clots associated with oestrogen which has now been reduced with the introduction of taking oestrogen in patch or gel form via the skin. As with any medical therapy, women considering HRT should discuss the potential benefits and risks with their healthcare provider to make an informed decision[11].
If you’re looking for alternatives, therapies like acupuncture, herbal supplements, and mindfulness practices might also help manage menopause symptoms, although it is to be noted that there is minimal scientific research to back these theories. One of the very few, is a research study by Prof. Nancy Avis which found that acupuncture significantly reduced the frequency of hot flashes compared to a control group[12]. The participants were randomly assigned to one of two groups. One group (the treatment group) received acupuncture treatment for the first 6 months and was followed for a further 6 months. The other group (the comparison group) did not receive acupuncture in the first 6 months but received it in the second 6 months. After the first 6 months, the treatment group reported 36.7 percent fewer hot flashes per day, compared with before they started treatment. In contrast, the comparison group reported an increase of 6 percent.
Additional alternative treatments such as herbal supplements like black cohosh and red clover are often used to relieve symptoms, though their effectiveness can vary, and they can interact with other medications. The National Centre for Complementary and Integrative Health notes that while some women report relief from herbal supplements, the scientific evidence is mixed, and these products can have side effects or interact with other essential medical treatments[13].
Besides herbal remedies, mindfulness practices, including meditation and deep breathing exercises can help manage stress and improve emotional well-being. Professor Jennifer Britto John from the Chettinad Hospital and Research Institute in her 2022 study found that Cognitive Behavioural Therapy interventions significantly improved the quality of life and reduced the severity of menopausal symptoms[14]. Support groups also offer a great platform for women to share their experiences and learn from others going through similar challenges. These groups provide emotional support, practical advice, and a sense of community. Both online and in-person support groups are available, making it easier for women to find a group that fits their needs. According to Dr. Yazdkhasti, in her paper ‘Empowerment and Coping Strategies in Menopause Women: A Review’, women who participated in support groups reported reduced feelings of isolation and improved coping strategies[15].
Many women find that a combination of approaches works best for managing menopause symptoms. For example, combining lifestyle modifications, mindfulness practices, and professional support can create a comprehensive plan tailored to individual needs. This holistic approach can help women navigate menopause more effectively and maintain their quality of life.
For many women, post-menopause is a profound period of growth and renewal— a time for rediscovering inner strength and embracing newfound freedom. It’s a chance to celebrate freedom from periods, fear of pregnancy, and possibly from some earlier responsibilities, like children leaving home. This can reignite a renewed zest for life, marking the end of one phase and the beginning of another. With responsibilities shifting, there’s more room to rekindle passions and dreams that may have been set aside. It’s a time to celebrate resilience and add new sparkle to illuminate the journey ahead. But of course, this isn’t the case for everyone.
Menopause coaching offers personalised support and guidance to help navigate the physical and emotional symptoms, improve well-being, and rekindle that sparkle[16]. It can be particularly beneficial for professional women who need to balance their careers with managing their symptoms and continuing to be productive in today’s fast-paced society. Coaching focuses on both the physical and emotional aspects of menopause, providing tools to handle the transition effectively. This can include diet, exercise routines, stress management techniques, intimacy, and sleep hygiene practices.
So, while menopause is indeed a profound journey of growth and renewal with significant transition that can present numerous challenges, women have various options to manage this period successfully. Hormone Replacement Therapy, lifestyle modifications, menopause coaching, alternative therapies, and support groups each offer unique benefits and drawbacks. By understanding these options and seeking professional advice, women can find the best strategies to navigate menopause and maintain their quality of life and professional performance. Remember, menopause is not just a phase to endure but an opportunity for growth, development, and empowerment.
References
[1] Content team at North American Menopause Society, accessed at: https://www.menopause.org 05/07/2024
[2] O’NEILL, Sheila et EDEN, John. The pathophysiology and therapy of menopausal symptoms. Obstetrics, Gynaecology & Reproductive Medicine, 2020, vol. 30, no 6, p. 175-183.
[3] MONTELEONE, Patrizia, MASCAGNI, Giulia, GIANNINI, Andrea, et al. Symptoms of menopause—global prevalence, physiology and implications. Nature Reviews Endocrinology, 2018, vol. 14, no 4, p. 199-215.
[4] Content team at Work Mind, accessed at https://workinmind.org 05/07/2024
[5]Content team at the British Menopause Society, accessed at: https://thebms.org.uk 05/07/2024
[6] Content team at Endocrine.org accessed at: https://www.endocrine.org
[7] Content team at the NHS accessed at: https://www.nhs.uk
[8] Content team at the Mayo Clinic, accessed at: https://www.mayoclinic.org
[9] ALIABADI, Masoomeh Yazdani, JAVADNOORI, Mojgan, MALEHI, Amal Saki, et al. A study of mindfulness-based stress-reduction training effects on menopause-specific quality of life in postmenopausal women: A randomized controlled trial. Complementary therapies in clinical practice, 2021, vol. 44, p. 101398.
[10] Content team at the NHS accessed at: https://www.nhs.uk 05/07/2024
[11] Content team at the NHS, accessed at: https://www.nhs.uk 05/07/2024
[12] Catherine Paddock, 2016, Acupuncture Reduces Hot Flashes, Night Sweats in Menopause, Medical News Today. Accessed at https://www.medicalnewstoday.com 05/07/2024
[13] The Content Team at The National Center For Complimentary and Alternative Medicine, accessed at: https://www.nccih.nih.gov 05/07/2024
[14] John JB, Chellaiyan DVG, Gupta S, Nithyanandham R. How Effective the Mindfulness-Based Cognitive Behavioral Therapy on Quality of Life in Women With Menopause. J Midlife Health. 2022 Apr-Jun;13(2):169-174. doi: 10.4103/jmh.jmh_178_21. Epub 2022 Sep 16. PMID: 36276630; PMCID: PMC9583372.
[15] YAZDKHASTI, M., SIMBAR, M., et ABDI, F. Empowerment and coping strategies in menopause women: a review. Iranian Red Crescent Medical Journal, 2015, vol. 17, no 3. (https://www.ncbi.nlm.nih.gov)
[16] Shokri-Ghadikolaei A, Bakouei F, Delavar MA, Azizi A, Sepidarkish M. Effects of health coaching on menopausal symptoms in postmenopausal and perimenopausal women. Menopause. 2022 Oct 1;29(10):1189-1195. doi: 10.1097/GME.0000000000002050. Epub 2022 Sep 6. PMID: 36070877.
Katie is a compassionate menopause and wellness coach, specialising in midlife health. With over 15 years of experience as an educator, she supports individuals through personalised, client-centred coaching. Katie is passionate about helping clients navigate midlife transitions and achieve lasting wellness.