Image credit: Shutterstock/Daisy Daisy
The menopause can be a big change in a woman’s life, and for some, it brings a lot of symptoms to deal with. One of these can be anxiety.
Though it’s often underestimated or even dismissed – put down to “being hormonal” – anxiety can be upsetting and debilitating.
But with the help of personal trainer and menopause expert, Kate Rowe-Ham, founder of Owning Your Menopause, we have all the tips you need to deal with anxiety in menopause.
Perimenopause begins when the two main female hormones, oestrogen and progesterone, start to decline.
While we often think of this change in terms of our periods stopping, the hormonal effect can be far-reaching, as Rowe-Ham explains: “We've got oestrogen in every single cell of our bodies, from top to toe. Oestrogen also helps with the production of serotonin, and all those feel-good hormones. Oestrogen supplies you with energy, and with confidence.
“If oestrogen is depleting, you can begin to question yourself on everything you're feeling. That can lead to feelings of anxiety and stress, and for some women, depression.”
When your hormone levels start to change but before your periods stop – and its symptoms, start for most women in their forties. However, this can be earlier or later, and this period of transition usually lasts between four and seven years.
The menopause is technically classed as the time from when it’s been one year and one day since your last period.
Menopause often occurs at a time in life when we’re juggling a lot. Whether it’s caring for elderly relatives, dealing with children leaving home or trying to manage a career and deal with symptoms, the added stress can also have an effect.
“You go into that fight or flight mode, which raises your cortisol levels,” she says, referring to the main stress hormone.
“And oestrogen has an impact on your cortisol levels as well. When you're anxious, your cortisol levels can be raised even further, which can leave you in a continuous state of anxiety.”
There is evidence that a Mediterranean-style diet – one that is rich in vegetables, fruits, lean meats, whole-grains, pulses, nuts and healthy fats, and moderate alcohol consumption – can help with various menopause symptoms, as well as helping to maintain a healthy weight and reducing type 2 diabetes.
Rowe-Ham found that focusing on a healthy diet helped her menopausal symptoms too.
“Breathlessness was one of my worst symptoms,” she says. “And I found cutting back on sugar and alcohol to be really helpful. Too much sugar places more stress on the body, increasing your glucose level, which will increase your stress hormone cortisol and in turn cause more anxiety. As we go through menopause, we often can't tolerate sugar because of our insulin sensitivity too.”
She adds: “The other thing we need to care about is our gut bacteria, which is proven to be central to managing stress and anxiety and depression. So, I think one of the first things a woman can do to help herself is to look at her diet and cut back on sugar and alcohol.”
Exercise in menopause helps our mental wellbeing. However, one of the other symptoms it can bring is aching joints, so how do you exercise if it’s an effort to get moving?
“Try to get outside, and if you can walk, do it for five minutes,” Rowe-Ham advises.
“Five minutes one week, 10 minutes the following week. Any form of movement will be beneficial. It can be really difficult to do, but you've got to try and trust that process of movement and nourishing your body to take yourself out of this place that many of us find ourselves in.”
Taking time out of everyday life to focus on yourself is a good way of dealing with anxious thoughts. Many women find it’s helpful to keep a journal. You can buy a regular diary or notebook for this or use a specific journaling app that will give you daily prompts.
Meditation gives you a chance to switch off from the world. It can take many forms, whether that’s sitting in silence for a while, listening to music, or using a guided meditation.
Headspace is one of the best-known apps for mental wellness and has a range of meditation options.
Sleep can become disrupted during menopause due to night sweats, aching joints and of course, anxiety. It might be difficult to get to sleep in the first place, or you may wake up in the night.
Lying there worrying about how many hours rest you’ll get will only heighten anxiety, so Rowe-Ham suggests focusing on getting into a good bedtime routine, instead.
“Put your phone away an hour before bed,” she says. “That will help with anxiety, and you’ll sleep better.”
Spending time practising mindfulness may also help, as can reading a book. Taking a bath or shower, or doing some gentle yoga poses can also relax both the body and mind to prepare for rest.
Hormone replacement therapy (HRT) is useful for some women. It can restore hormone levels to pre-menopause levels, easing a lot of symptoms. There are many different types of HRT, and not all options will be suitable for all women, so it’s important to talk to your GP or a menopause specialist who can offer advice.
It might take some time to find the correct dose and type of HRT for you, but most women notice a significant decrease in symptoms once this is sorted.
Some types of HRT may increase your risk of breast cancer, but this is very small, and according to the NHS, the benefits of taking it outweigh any risks.
Cognitive behavioural therapy (CBT) can be useful for dealing with menopause anxiety. Talking to a professional about how you’re feeling can help you process your thoughts and feelings. They will work with you to learn coping mechanisms, lessen anxiety and build confidence.
If you live in England, you can refer yourself for CBT via the NHS talking therapies service. If you live in Scotland, Wales or Northern Ireland, you can ask your GP about services local to you.
“Everybody's journey is unique. And you're meant to be here just as you are,” says Rowe-Ham.
“A lot of women are scrolling on social media, comparing themselves to other women, and that will play into those feelings of anxiety and depression.”
Many of us use social media daily, and it’s a great tool for keeping in touch with family and friends. But it can also heighten feelings of anxiety by leading us to believe everyone else has a picture-perfect life.
Remember, what you see online is an edited snapshot that someone wants you to see – especially with celebrity accounts. If you feel inadequate or anxious when scrolling, unfollow accounts that make you feel that way.
Rowe-Ham says: “I think we can compare ourselves and feel: ‘Why don't I have abs like her, or skin like her?’ Don't base where you are on anybody else. You are you, and that is enough.”
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