Working through the menopausal transition..the first step is the deepest
Back in July of last year, I wrote a post entitled ‘Working through the transition? Or is the transition working you?’ In it, I discussed some research being conducted in the UK that is looking at the effect of menopause and its accompanying symptoms on the work environment and preesenteism, i.e. impact on productivity while at work. Not surprisingly, an overwhelming majority of women surveyed reported that their symptoms, namely fatigue and insomnia, were impacting workplace functioning and relationships with managers and co-workers. Less clear, however, were the roles of other factors, like perceptions and stress.
This raises one of the most common and yet inconsistently addressed issues during menopause: quality of life.
Quality of life is a subjective construct and one that is significantly influenced by a multitude of factors that intersect at any given time, factors such as how well we function, what we think about our lives, how we deal with stress, the type of social and economic support we have and overall wellbeing. And when you throw a bunch of symptoms like hot flashes, depression, anxiety, insomnia, backache, joint pain or forgetfulness on top of any of these, well, all hell can and does break loose!
When researchers looked at 184 women in both early and late transition to menopause who were part of the larger, Seattle Women’s Health study, they learned just how intricate the interrelationship between all these factors truly is. Indeed, among women in their mid to late 40s who were juggling work, families and relationships, the degree to which symptoms interfered with work most relied on how they perceived their health, their life stress and how depressed they were or were not. The findings:
- Symptoms like hot flashes, mood issues, sleep issues, pain, or concentration had a significant impact on work productivity.
- However, when researchers started to tease out and analyze the symptoms over time, they found that how symptoms influenced how women felt about their health was most important. If women felt that their health was excellent or very good, symptoms tended affect their work productivity to a lesser extent than if they perceived their health to be poor or only moderate.
- Perceived stress levels reportedly influenced both work productivity and social/intimate relationships.
- Depression and difficulty concentrating were the final straws in the work/relationship back, affecting performance and the ability or interest in socializing or engaging in intimate or family relationships.
The one thing that these reports and the UK reports had in common were nighttime awakening.
So, let’s take a look at this. How we feel about our wellbeing affects work productivity, as does stress. If we are depressed or have difficulty concentrating, the ability to focus and be productive, either at work or in our worlds in general, starts to fall apart. Frequent awakening during the nighttime hours as a result of both aging and hormones can cause fatigue, depressed mood and concentration issues. In turn, this can influence how well we function at work and at home and the quality of our relationship, to ourselves, our children and our partners.
The conclusion is that we need to step back, take stock and think about how we feel and how that is affecting our wellbeing and our lives.
The solution isn’t simple. Part of it lies in learning how to best address symptoms like sleep disturbances, depression or focus. The other lies in openly communicating to our work colleagues, our managers, our partners and our friends how productivity and our relationships may be suffering and actively involve them in finding solutions to improve wellbeing.
It’s hard work, no doubt. But the more insight we have, the better we are able to deal. And while it starts within, without it, the menopausal tendrils can extend far and widely into our lives.
The first step? Step back deep within yourself, and take stock. It may ultimately be the insight that you need to turn those symptoms on their side where they belong.
Read MoreAin’t no “woo woo” going on. Mind, body, relaxation and health
Relaxation.
It’s so elusive for many of us. And yet, so important to our overall health and wellbeing. In fact, researchers are finally discovering how relaxation actually counters changes that occur in our bodies that result from exposure to constant stressors.
For decades, Dr. Herbert Benson, founder of the Mind-Body Institute in Cambridge, MA and an associate professor at Harvard University, has been writing about the relaxation response, a “mind-body intervention that elicits deep changes in the physical and emotional response to stress.” Strategies that elicit the relaxation response include meditation, yoga, tai chi, Qi gong, deep breathing, controlled muscle relaxation and guided imagery. And although many would like to point to the “woo woo” factor at-play, an evolving and wide body of published literature is indicative of how interested the medical community is in the mid-body connection and the positive changes that these practices promote, including a slowing or heart rate, a reduction in blood pressure, improvements in blood sugar and fats, and even boosts in our immune system. However, what has long eluded researchers is what actually happens in the body to achieve these improvements.
In a novel study published in 2008 in PLoS ONE, Dr. Benson and his colleagues looked closely at 19 volunteers who had practiced relaxation response strategies (e.g. meditation, yoga, repetitive prayers) for as long as 20 years and compared them to 20 novices, individuals with no relaxation practice experience. These novices were provided with training sessions for 8 weeks that included information about how to reduce daily stress and the relaxation response and a 20 minute, individually-guided session comprising diaphragmatic breathing, a body scan and meditation.For 8 weeks thereafter, the novices then used a 20-minute relaxation CD at home and were asked to review the informational brochures. Blood samples and analysis of gene expression between experienced and novel relaxation practices, and pre- and post-training were then compared.
Importantly, while the researchers observed distinct changes in the genes in experienced relaxation practitioners compared to novices, when the novices started to incorporate relaxation practice into their lives, they also started to express similar positive alterations in their genes. Moreover, these changes are directly related to how cells respond to stress and create free radicals and inflammation that can lead to long-term damage. Additionally, type of relaxation strategy that was practiced was of no important; by achieving a relaxation state, individuals could make positive changes in their cellular structures thought to promote health.
Both inner and outer psychological states and environmental factors play a role in how women experience peri and post-menopause, their self-esteem, attitudes and severity of symptoms. If a daily practice of some sort of relaxation strategy can actually alter genes in a way that improves health and well-being, why can’t that daily practice also improve the menopausal/midlife experience?
While I’ve long embraced the idea, I’ve never actually made a concerted effort to incorporate some sort of relaxation strategy into my daily activities. I’m going to change that. Ain’t no woo woo but a woot woot so far as I can tell.
Read MoreGot Sleep? Zeo Personal Sleep Coach helps with those Zzzz’s. Want one?
Did you know that sleep problems have been reported in as many as 40% of women in the late perimenopausal stage and as many as 35% to 50% of women in postmenopause? The culprit? In addition to vasomotor symptoms, i.e. hot flashes and night sweats) lower estradiol and fallopian stimulating hormone levels can interfere with both falling and staying asleep. Add stress, emotional arousal, environment and alcohol or caffeine to the mix and you’ve got a woman on the verge. Personally? My sleep stinks; I wake up several times a night and regularly early in the morning, even though I rarely have trouble falling asleep. In fact, I don’t recall the last time I slept through the entire night.
So, how can I get more of those much needed Zzzzs? Well, I am hoping that Zeo can help.
Zeo is a home-based tool that uses SoftWave™ technology to track sleep patterns. The Zeo system is geared towards helping individuals understand how they are sleeping so that they can address factors (e.g. diet, stress, or environment) that may be profoundly hindering or interfering with their sleep.
Zeo collects information that summarizes the previous night’s sleep, including time spent in each sleep phase (i.e. light, deep and REM sleep), total time asleep, time it takes to fall asleep, and number of times awakened during the night, and displays it in a graph at bedside monitor.This information can then be uploaded so that sleep patterns can be tracked and trended along with individualized input about environmental and social factors that might disrupt sleep from night to night. Zeo also includes personalized sleep coaching. As the company says, the power of Zeo lies in its personalization, so that you can scientifically track your sleep phases and correlate them to the impact that daily habits have on your sleep. What’s more, I have looked at the scientific studies and the technology it uses to track your sleep not only favorably compares with what experts consider the gold standard for measuring sleep (polysomnography) but also does so in a range of healthy and “disordered” sleepers.
I’ve used Zeo for two nights so far. And guess what? It’s telling me that the fatigue I’ve been feeling is truly due to the fact that I’m not getting the restful sleep that I need. So, I am going to collect six nights of sleep information to create a foundation or baseline of my sleep pattern, and then undergo the Personal Sleep Program to see what I can change to optimize my sleep health.
I met a Zeo, Inc co-founder at last week’s epatient conference and after a conversation regarding sleep and menopause, he graciously sent me two units to share with my readers. I’ve given one of these units to a reader who is an insomniac and who is perimenopausal. But I’d like to give another Zeo to you. Here’s how:
Tell me in the comments section about your general sleep and how your symptoms or habits might be affecting it, along with steps you’ve taken or not taken to deal with the problem. The caveat? You must be experiencing some sort of menopausal symptoms or be in menopause and be willing to share your experience (anonymously) on Flashfree after a month’s use. If I get enough comments, I will randomly choose one winner to receive a Zeo Personal Sleep Coach monitor. What’s to lose? How about one more night’s sleep?!
[Disclosure: Zeo, Inc. provided me with three Zeo Personal Sleep Coach monitors – one via the epatient conference and two directly. Although this post was neither paid for or solicited by the company, I have eagerly agreed to write a post on menopause and sleep for their blog.]
Read MoreStressed out? No wonder you can’t remember…
I have a friend on Twitter who coined the phrase “can’t remember shit.” This phrase greets me throughout the day because I am constantly forgetting even the simplest things. Why did I enter this room? What was I going to look up? How did I get here? Why can’t I focus? And lists? Fuggedaboutit – they don’t do squat; even when I have them, I forget.
I blame my memory and focus problems on hormones all the time. However, if this were true, then the addition of hormones, in particular estrogen, would balance out the forgetting and boost my attention and focus, right?
Hence, I was intrigued when I ran across a small study in Menopause looking at cognition and stress, which seemed to back an earlier contention that stress plays a huge part in recall ability in menopausal women.
In this rather small trial, 22 postmenopausal women (50 to 83 years) took either placebo or an estrogen tablet (1 mg estradiol daily for one month and then 2 mg daily for two months). After three months, they were asked to ingest a substance that depleted certain compounds (called monoamines) that the body manufactures and uses to stabilize mood, perform a mildly stressful test, and then undergo a series of tests on stress levels, mood, anxiety and cognition.
It appears that at least in this small group of women, taken estrogen was actually linked with poorer cognition following a stressful event, including the ability to recall words and slower reaction time. Because this occurred independently of the depletion of mood compounds or negative mood, the researchers say that the effect of estrogen, which has been shown in some studies to improve cognition, is not as straightforward as previously believed. What’s more, the significant increase in stress and stress reactions during menopause may actually interfere with estrogen benefits in so far as memory and recall go.
Our lives are increasingly busier, especially now that we can be connected 24/7. Personally, I can’t even get a work out into my day without some sort of interruption. That’s why it’s so important to figure out how hormones interact with stress, so that we can make informed decisions — not only about menopausal decisions — but also about general life decisions.
Look, memory recall and attention are undoubtedly linked to aging, at least to some extent. But now? Stress may be playing a role in how hormones impact our reactions, focus and attention span, and memory. So the next time you can’t remember shit? Maybe a few deep breaths can help.
No wonder!
Read MoreWednesday Bubble: The “De’s” have it
This week’s Bubble is truly straight out of bubble-land. Flashing? There’s a drink for that. Not on your game? There’s a drink for that. Finding that you can’t handle the demands of daily life? There’s a drink for that too?
Sigh.
Yes ladies, you can ‘deFlash,” deBug” and “deCompress” with EYL – Enrich your Life drinks.
Look, I’m a huge supporter of alternative therapies, Traditional Chinese Medicine, herbal remedies, etc, so long as they are thoroughly studied. But time and again, we see enriched nutritional products that are long on promises and short on delivery. And while functional foods — foods that deliver more than nutritional benefits — are certainly the wave of the future, I do believe that these foods need regulation and evidence behind them. Japan may be one of the few countries that actually regulates functional foods.
So before you spend your hard-earned dollars on drinking your flashes away, why not do some research and see which alternatives actually pack a powerful punch beyond their marketing claims?
The “De’s?” How about “deceptive?”
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