Why menopause can be your second spring!

As you embark on a new chapter of your life, seize the opportunity to look after yourself and blossom

Menopause is a time of change – both physical and mental
Self compassion and lifestyle tweaks can help you navigate changes and find greater peace
Reflecting on your life and prioritising your needs can be liberating

Menopause has been all over the news recently. While it’s fantastic that it’s on the agenda and people are talking about what is, after all, an inevitable life stage, much of the discussion can seem a little depressing.

Symptoms of the perimenopause and menopause can be annoying for some women, a real challenge for others, and completely debilitating for others. The perimenopause in particular can be a time of turbulence. Fluctuating hormone levels can bring an array of symptoms and sometimes it feels like the goalposts keep moving – just when you feel on top of them, something else can surface.

But with the right care and treatment, the menopause can also be a time to heal and repair, and then reflect. In Traditional Chinese Medicine menopause is considered a second spring. It’s believed that women’s bodies follow seven-year life cycles so between the ages of 42 and 48 you prepare for menopause, then during 49-55 you experience a second spring. The good news for older women is the years after 56 are considered a rebirth!

A lot can be said about the attitudes to ageing in Asian communities. The Japanese word for menopause is ‘konenki’, which means ‘renewal’ and ‘energy’. It’s been shown that having a positive outlook can make a physical difference – women with a positive attitude are reported to have lower severity of menopausal symptoms [1].

In the UK we don’t tend to have this positive attitude to menopause or ageing but perhaps embracing it could be transformative. After all it’s a chance to take stock, look at your life so far and re-evaluate. And with a third of the female population in the UK either in menopause or post-menopause – you’re in good company. There’s force in numbers!

The first-line treatment for perimenopause and menopause symptoms is HRT, and many women find it effective in managing their symptoms and it can bring long-term health benefits. But rather than simply taking HRT or alternative treatments and ploughing on as before, you could use this time of adjustment – of prioritising your self care – as a chance to think a little deeper into what else could work for you.

Lifestyle adjustments

Perimenopause and menopause symptoms are numerous and varied, including hot flushes, mood changes, weight gain, vaginal dryness, UTIs, irregular periods, hair loss and dry skin. Symptoms can be a trigger to make changes and/or seek treatment.

For instance, if weight gain is an issue, you might re-evaluate your diet and exercise habits. Or if sleep becomes problematic, you might tweak your nighttime routine, while skin changes might prompt you to switch products or look at nutrition.

Menopause is a time of change – both physical and mental – yet so often women overlook their mental health. Mood changes are a common symptom, so just as you might swap a skincare product to one that best suits your new needs, you might want to reassess your patterns of thinking or your work-life balance in order to address symptoms such as stress, anxiety, irritability or feeling low.

Time to reflect

It can be useful to think about menopause as a developmental stage of your life – a renovation, if you like. In fact, menopause reshapes the brain. The decline in oestrogen changes your brain’s structure and this can be responsible for mood disruption.

Simona Stokes is a Counselling Psychologist and founder of the Menopause CBT Clinic®. Her experience of perimenopause prompted her to explore ways of adapting the psychological tools of cognitive behavioural therapy (CBT) to alleviate her menopausal symptoms.

She says: ‘As I entered my 50s, I found myself in unfamiliar territory; sleep became elusive, and my usual energy and drive began to fade. No-one had warned me that menopause meant more than just hot flushes. Faced with lethargy and anxiety, I set out to rediscover and reclaim my zest for life. It hasn’t been easy, but adopting an attitude of curiosity and acceptance has enabled me to find a way to embrace the changes with resilience and a deeper understanding of myself.’

Drawing from her experience, Simona developed EMBERS®, a Menopause-Informed CBT model that uses psychological tools to assist women to understand and overcome the influence of their hormones on their moods, thoughts, and emotions.

‘The rollercoaster of the hormonal fluctuations during the perimenopausal period can leave us vulnerable to the risks of developing emotional difficulties related to the hormonal imbalance, but not everyone experiences severe symptoms,’ says Simona. ‘Mood changes vary from mild to moderate, with only a small percentage developing clinical depression or anxiety. Although perimenopausal depression shares some similarities with common depression, it has its own characteristics and is best treated with HRT and CBT instead of antidepressants.

‘In our society, there’s often pressure to push away difficult emotions in favour of constantly chasing happiness. However, it’s important to acknowledge and make peace with all your emotions, even the challenging ones. By embracing difficult emotions and understanding their underlying messages, you can strengthen your resilience and emotional wellbeing. Opening yourself to all emotions helps you navigate the menopausal transition, fostering greater strength and emotional fitness, and ultimately leading to a more balanced and fulfilling life.’

Simona explains that Acceptance and Commitment Therapy (ACT) is a form of CBT that offers support for women navigating the challenges of menopause. ‘It helps you reshape the narratives you construct about the difficulties you encounter during this stage of life, enabling you to let go of the struggle against the changes you experience,’ she says. ‘By fostering an attitude of self-compassion and kindness, CBT encourages you to approach this stage of life with curiosity rather than harsh judgement. Instead of resisting the changes, CBT empowers you to explore and navigate them in a more constructive way. Through this process, you can find greater peace and acceptance while going through the menopause.’

Simona suggests these practical tools to help navigate the emotional challenges of menopause:

Emotion Follows Motion: Engage in Physical Activity

Even when you’re not in the mood, physical activity can help shift your emotional state. Start with small steps like taking a short walk, stretching, or doing gentle yoga. Remember, doing something different can shift your focus of attention to something else, and aside from changing your overall energy level, it can make a significant difference in how you feel.

Use Your Body to Calm Your Mind

The breath serves as a potent tool to access your body’s capacity to soothe your mind. Employ the 4/7 breathing technique to induce relaxation, prioritising a longer exhale over the inhale as it fosters a calming effect within the body. Inhale deeply through your nose for a count of four, then exhale slowly through your mouth for a count of seven. Repeat this pattern multiple times, focusing on the rhythmic flow of your breath to quiet your mind and alleviate stress.

How is your relationship?

As well as looking inwards, this is a good time to reflect on your relationships. You may have caring obligations but how well do your relationships serve you?

Since 1990, the divorce rate among people in their 50s has doubled, and it’s expected to triple by 2030. And yet in in every other demographic, divorce rates are steadily declining.

Interestingly, in these so-called Silver Splitters, women primarily initiate divorce (62 per cent of divorces are initiated by women in the 45-55 age category). There are myriad reasons behind this but for some women, children growing up and moving out of the home provides the opportunity to think about their own future.

Women are living longer than ever – in 2018–20 a female in England could expect to live 83.1 years. That means with the average age of menopause being 51, there are hopefully more than 30 years ahead where you can plan to live a full, true life.

How do you feel about work and hobbies?

The menopause can also be a chance to reconsider how you spend your time, and for some Covid put that into sharp focus. The employment rate for 50–64-year-old men and women is not back to pre-pandemic levels and there has been an increase in economic inactivity in older people [2].

Some women have chosen to retire, others have issues in health or caring responsibilities. While many aren’t interested in returning to work, those who are are looking for greater flexibility. Interestingly, women in their 50s are the fastest growing group of new business owners in the UK, suggesting a desire to take charge of their working life.

Whether you’re interested in setting up your own business, reducing your hours or trying something new, it doesn’t really matter – it’s about giving yourself the opportunity to reflect and consider what you want.

Similarly, you may want to think about how you spend your spare time, especially if you find you have more of it now. ‘So many women I’ve talked to see menopause as an ending,’ Oprah Winfrey has reflected. ‘But I’ve discovered this is your moment to reinvent yourself after years of focusing on the needs of everyone else.’

What might you enjoy doing? Did you have any hobbies as a child that you enjoyed but stopped? Or is there a new class you could try? Some women try an exercise class during the perimenopause to help with their symptoms but stay years after symptoms have passed.

This is a good time to forge new friendships – be it from a hobby, a walking group or a menopause meet-up. If this feels daunting, you can meet like-minded people through groups on the internet. One example is balance’s community section where you can share your experiences, be heard and feel less alone.

Emerging from the other side

If you can consider going through the menopause as a time of renovation, then post-menopause could be a chance to reap the rewards. Most women’s brains stabilise after menopause, and it can be a time of balance and liberation.

Journalist Bryony Gordon, whose most recent book Mad Woman covers her menopause and views on mental health, says the menopause ‘can be truly liberating if you are prepared to listen to what it is saying. All the grim things it brings up mentally – the lack of self-esteem, the tendency to self-sabotage – are the issues you need to deal with, if you want to actually enjoy the next 40 years of your life. Sort them now, and you will forever be free.’

It’s a privilege to get older, and with some reflection and reassessing this could be an exciting new chapter that’s well worth embracing.

References

Kwak EK, Park HS, Kang NM. Menopause knowledge, attitude, symptom and management among midlife employed women. J Menopausal Med. 2014;20(3):118–25.
GOV.UK: employment and labour market

Simona Stokes is a Menopause Psychologist and founder of the Menopause CBT Clinic®, which focuses on enhancing the psychological wellbeing of women navigating the menopause. Visit https://www.menopausecbtclinic.co.uk