Timing is everything
Headache, irritability and mood swings….they’re going to disappear someday. Promise.
Research findings show that certain symptoms commonly linked with menopause decline linearly, meaning that as you move through the transition, those bothersome symptoms will move with you and then gradually diminish. Phew!
A study that appeared in Obstetrics & Gynecology early last year showed a direct association between menopausal symptoms and reproductive hormones at any given time during the menopause. Researchers evaluated menstrual bleeding patterns, symptoms and levels of estradiol, follicle-stimulating hormone (FSH) and testosterone in women over a nine-year period. Stages of menopause were analyzed based on bleeding patterns. All women underwent structured interviews, completed symptoms questionnaires and were followed for bleeding dates and hormone measures.
The results showed that headache was significantly associated with stage of menopause, declining in the pre- to postmenopause transition. Mood swings and irritability were both associated with declining FSH levels. Additional analyses also revealed a link between PMS, perceived stress and all three of these symptoms (i.e. headache, irritability and mood swings).
So what about other symptoms like hot flashes and night sweats and depression? A small percentage of women may have to deal with them a bit longer. In fact, data suggest that they may persist well into the postmenopausal period although the reasons are not entirely clear.
Read MoreWhat’s your sleep number?
[Rembrandt van Rijn, Sleeping Woman, 1658]
On a scale of 1 to 5 would you say that your sleep number (the quality of your sleep) is:
- nonexistent, I never sleep
- occasional, I sleep one or two nights a week
- obstructed, I sleep but I wake up regularly throughout the night
- pretty good, I rarely wake up
- great, I typically sleep through the night
If you are like most peri- post menopausal women, it’s likely that you rate the quality of your sleep about a “3. ” In fact, a review in the journal Current Neurology and Neuroscience Reports suggests that 28% to 64% of peri- or postmenopausal women have some form of sleep disturbances that may aggravated by sleep apnea, periodic limb movements syndrome (restless leg syndrome) and psychological distress (anxiety, major depression).
One of the primary causes of sleep disruption during menopause is declining estrogen levels, which increase peripheral and central temperature, dilate blood vessels and lead to hot flashes. Unfortunately data also suggest that hot flashes double the time spent awake although ironically, they often follow rather than proceed awake times.
More good news: both sleep apnea and periodic limb movements syndrome increase with age. Menopausal women are espeically at risk due to declining progesteron levels and increased body mass index (and associated increases in neck circumference). Both sleep apnea (in which the airways become partially or totally obstructed) and periodic limb movements obviously interefere with sleep quality. In fact, sleep researchers have documented apnea, restless leg syndrome or both in up to 53% of women between the ages of 44 and 56.
The evidence is less certain for mood disturbances and sleep, although studies have shown clear links between reproductive hormonal changes and clinical depression in women going through menopause. What’s more, women in menopause who are clinically depressed have reported more frequent and longer times awake than those who do not have any mood disturbances.
Steps to take
I’ve written previously on this issue and there are a variety of non-pharmacologic steps that might improve sleep quality including standardized herbs and acupuncture.
Hypnosis, relaxation techniques that include breathing and/or biofeedback) may also assist. These strategies are part of a larger approach called cognitive-behavioral therapy for insomnia (CBT-I) which in a small study, was found to significantly improve anxiety, depression, partner relationships, sexuality and hot flashes in menopausal women.
Notably, the benefit of HRT for sleep/mood disturbances remains unclear and studies are inconclusive.
As with any issue associated with menopause, it’s critical to speak to a health practitioner about the issue so that the course of therapy can be safely individualized and personalized.
What about you? How’s your sleep? And what are you doing about it?
Read MoreHi ho, hi ho….
It’s off the work we go.
I’ve seen this joke a zillion times. And I’m not amused.
But seriously. A study reported in ‘Ahead of Print’ edition of the journal Menopause suggests that a majority of menopausal women report daily physical or emotional symptoms that significantly affect their daily personal, professional and social lives.
Researchers surveyed 961 members of the National Association of Female Executives about their knowledge and understanding of hormone replacement therapy. The participants were divided into subgroups based on whether or not they were pre-, peri-, menopausal or post-menopausal.
Among study participants, 88% reported personal experiences with menopause, 95% had physical symptoms and 79% had emotional symptoms. Some 40% said that these symptoms caused problems in at least one area of their lives. More than a third of women who used HRT to treat symptoms cited the health concerns as a reason for discontinuing.
Undoubtedly, individualized care is critical to improving quality of life for women in or around menopause. Indeed, the researchers cite this in their conclusion. But when it comes to our professional lives, how can we improve our daily experiences when hormones are wreaking additional havoc on daily stressors and challenges?
I would like to suggest that integrative therapies may offer a path to salvation. For example, pace respiration or meditative breathing can easily be done at your desk or even on a park bench during a lunch break. A 1995 article in Menopause found a decline in the number of hot flashes and average skin temperature among women who practiced breathing exercises.
Paced respiration involves deliberate inhalation and exhalation of air.
- Sit comfortably
- Inhale for 5 seconds through your diaphragm (the goal is to fill your diaphragm, not your upper lung area), pushing your diaphragm out
- Exhale for 5 seconds, pulling your diaphragm in and up
- Repeat several times
Another technique is known as “counting breath:”
- Sit in a comfortable position with your spine as straight as possible
- Count your inhalations and exhalations. When you inhale for the first time, think “one.” When you exhale, think “one.” Next, think “two,” and so on. Continue until you reach 10
- If you have time, start over again and do another set of 10
- The ultimate goal is to 5 sets
Meditation takes time and practice so try not to beat yourself up if your mind wanders while doing either of these exercises. The primary goal is to focus on your breathing and to calm your inner and outer fire.
Any other practices that work for you? I’d love to hear!
Read MoreNews Flash! Menopause – the new glass ceiling
News out of Nebraska today….
Evidently a woman is suing the Union Pacific Railroad for discrimination. The reason: menopause.
56 year old Porfiria Alonzo claims that she was laid off by the railroadbecause the organization perceived “that she was having health problems due to menopause.” Sources say that she was seen crying and upset on several occasions. And despite having attended mental health evaluation (where nothing was found that indicated that she would benefit from counseling), and at the Railroad’s insistence, a second round of evaluations (where once again, nothing was found), she was still barred from returning to work.
No trial date has been set as of yet.
What do you think about this? Is menopause the new glass ceiling?
Read MoreWhat’s it all about
[youtube=http://www.youtube.com/watch?v=uVQSj0AFIyk&feature=related]
Menopause is pretty straightforward. Right?
Clearly it’s not since all of us go through it differently depending on our genetics, physical and mental makeup and our environment. Hence, I thought that it might be to good idea to tackle some menopause terms. Especially since there can be a lot of confusion about what menopause is and whether or not you’ve actually started.
So what’s it all about? Menopause, that is…
Natural menopause – permanent cessation of menstruation. You are not considered to be in menopause until your periods cease for 12 consecutive months and this cessation is not linked to causes other than those that are natural. Menopause can only be determine with certainty if your final menstrual period is known.
Perimenopause – the years leading up to the cessation of menstruation. Perimenopause can last anywhere from 2 to 8 years, and includes the first year after your period stops. Perimenopause is accompanied by a barrage of symptoms as your reproductive capacity starts to end.
Premenopause – The reproductive years leading up to the menopause.
Postmenopause – The period of time following menopause.
Climeractic – a term for a woman’s transition from a reproductive to non-reproductive state during which many physiological, psychological, and sociologically changes occur.
Premature menopause – Usually, menopause that occurs before the age of 40. Note, however, that since there is no reliable measure of age distribution among women transitioning to menopause in developing countries, the cut off of 40 years of age is arbitrary. In some cases, premature menopause is interchangeable with induced menopause, which describes menopause that occurs after surgical removal of the ovaries (with/without hysterectomy) or removal of ovarian function (due to chemotherapy or radiation).
ObGyn.net has an excellent article that goes into further detail about the physiological changes that occur during menopause. I encourage you to visit the reference if you desire more information.
Read MoreWednesday Bubble: More inspiration from Patti Digh – Patti’s Gems
In my first two posts in my series about an interview I had with Author Patti Digh , I reflected on two key life lessons: 1) the importance of taking care of ourselves before we are truly able to take care of others, and 2) the need to go deeper than the symptom to discover who we are and what we truly want out of our lives. These sentiments are linked to two essays and several exercises in Patti’s 37 Days, which, once again, I encourage all of you to read.
The third and final post I am calling “Patti’s Gems.” (If you are reading this Patti, I’m not talking about your girls, although I am quite certain that they are the first thing to come to mind when you see the word “gems!”)
So, what do I mean by the phrase “Patti’s gems?”
When I first read ’37 Days,’ I felt that in some respects, the evolution of the lessons throughout the book echoed the transitions we make as we move through midlife. And more importantly, that certain chapters truly spoke to transitional “soul changes” to propel midlife divas forward in a positive and affirmative way.
I asked Patti if certain essays were more applicable to this time in our lives than others. “Yes…there are some that speak to part of the fear [about] what I’ve done with my life,” replied Patti. I had a very good resume when I started writing [37 Days]. From all external measures, I was very successful. And yet, I did not feel that internally and it [wasn’t] the work that I needed to be doing in the world.”
It wasn’t the work I needed to be doing in the world.
Are you doing the work that is feeding your soul, the work that you need to be doing versus what you are being told you need to be doing? If the answer is “no, maybe or I don’t know,” take heed; you’re in good company!
Fortunately, there are a number of gems in the book that Patti revealed with a wee bit of prodding, gems that might help to jumpstart those creative juices…
Gem number 1: Don’t stop to wave, you’ll drown.
Channeling the wonderful Eve Ensler, Patti writes that Eve once asked “why are women immobile? Because…they are waiting for permission….” She goes on to pose the following questions to the reader:
Are you waiting for permission to have and express your point of view? Are you waiting for an audience before doing the work you “must do?” Are you asking the questions and truly listening to the answers as if they really matter? Do you care too much about if people are going to like you if you speak your truth?
And at the moment you’re waving, wanting to be acknowledged for waving, be seen, praised…are you really drowning?
Patti tells us to “keep moving, keep seeing, keep knowing and keep saying what you know to be your truth.” Give yourself permission.
Gem number 2: Bust your toast rules
I’d prefer to let you read this essay yourselves because it’s priceless – just think Jack Nicholson in ‘Five Easy Pieces.‘
Here’s a challenge – take a close look at the rules you set for yourself, and ask yourself if you set them to serve “some social norm that is itself made up,” or to serve another person or a group?
Aren’t rules simply made up? Are some rules so ingrained in us that we can’t see them for what they are?
Have you made rules, set boundaries for yourself, followed patterns that you can’t see the forest for the trees? Do those rules make sense? Better yet, do the rules still make sense?
As Patti writes “concentrate on surfacing [your] patterns in order to change them.”
Gem number 3: Burn those jeans
Okay – be honest. How many sizes are hanging in your closet?! And why are you still holding on to the hope that one day, you will fit into those [fill in the blank]?
Patti writes to “replace the word ‘jeans’ with the albatross hanging around your neck, following you around through life, diverting your attention from the real goal, setting you up for failure.” Then ask yourself if the golden egg that you are pursuing is something that you’re setting yourself up for to feel badly (about not reaching it), instead of “good and right and strong.”
So, why are you putting your life on hold to reach the unattainable, unreasonable, un…goal? Do it now rather than “when….”
Gem number 4: Unpack your boxes
This metaphor, for a marriage that begins to unravel and the decisions that arise with regards to whether or not to leave or stay, or better yet, when to leave or stay, has a deeper meaning for many of us.
Patti writes that “piles of boxes are metaphorical architecture — they tell a story.” Unpack your boxes, stay awhile, she suggests. Commit to the swim, or go.
Are you staying in a marriage, a relationship, a job, a career, stagnating because you are afraid to unpack your boxes? Patti quotes Elisabeth Kubler-Ross..”As with migrant birds, so surely with us, there is a voice within if only we would listen to it, that tells us certainly when to go forth into the unknown.
Gem number 5: Trust only movement.
During our conversation, I asked Patti what she meant when she wrote “trust only movement.”
“I’m coming more and more to recognize…that the abstractions we use aren’t very helpful to us in times of need. Could I have a more intense connection with my life by saying yes? Open up for other people to be as full a human as I am? Integrity to speak up? Can I stand tall for what I believe but also open up the possibility that someone else’s belief is as valid to them as mine? To love more, to love myself more in order to love people more, to trust myself and pay attention to my gut in a significant way. And finally to slow down. Moving from abstraction to something that is embodied is really important.”
At the end of the day, it’s all about focusing, doing, fully engaging, feeling, and feeding, nurturing and acknowledging your soul. “Risk your significance” says Patti.
Risk your significance.
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