“We are looking at millions of women who feel like the rug has been pulled from under them — blindsided by their bodies, let down by their brains, and failed by their doctors who also may not realize those symptoms are ‘just’ menopause.”

Dr. Lisa Mosconi

The past few years have been tough since I crossed my 40th birthday. As each day passes by, the days get tougher. I wake up feeling overwhelmed and exhausted, even though I had a full night’s sleep. It is like a heavy cloud has settled over me, and I can’t seem to shake it off. Lately, these unexpected spurts of anger and sadness have been taking over my life, and I don’t know how to handle them. It affects everything – my relationship with friends, parenting, relationship with family, and even my sense of self.

There have been days when I have been having arguments over the disappointment of unmet expectations which add up as extra baggage. It starts over something small, as it always does – a misunderstanding, disagreements, a forgotten action. But it quickly escalates, and before I know it, I end up with an argument. I could see the frustration of people around me, and it broke my heart. I did not want to be this way, but I couldn’t seem to control it. After the argument, I retreated within my shell and pondered over the vacuum that I felt. I felt so alone, so misunderstood.

I’ve been staying aloof more and more, thinking maybe I am the problem. Maybe I am just too much to handle. I couldn’t understand why I was feeling this way. I try to be a good mother and a good person, but it feels like I am failing at everything. The kids see the tension around me, and I worry about how it is affecting them. I want to be there for them, but some days, it feels impossible to muster the energy.

I decided to talk about what I’ve been going through. I hoped they might offer some support or at least a listening ear but I felt judged, criticized, and even more alone.

In my desperation to find answers, I started reading more about what could be causing these emotional rollercoasters. That is when I stumbled upon information about menopause.

It was like a light bulb went off in my head. Could this be it? Could these emotional outbursts and mood swings be related to menopause? I had never considered it before, but now it seems to make so much sense.

I read about the hormonal changes that happen during this time and how they can affect emotions and behaviour. It felt like a weight was lifted off my shoulders to finally have a potential explanation for what I’ve been experiencing. But at the same time, it left me feeling scared and uncertain. If this is menopause, what do I do now? How do I navigate this new chapter of my life?

As women unfortunately we are never informed, learned or prepared for menstruation, marriage or menopause which marks a significant transition in a woman’s life, characterized by the end of menstrual cycles and a variety of physiological and psychological changes. This article delves into the different stages of menopause, lesser-known facts, the impacts it has on women, how to prepare for it, hormonal influences, behavioural changes, and what to expect from the perspectives of women and their families or friends. Scientific references and examples are included to provide a comprehensive understanding of this phase.

Stages of Menopause: Menopause is a gradual process that unfolds in three stages: perimenopause, menopause, and postmenopause.

Perimenopause, also known as the menopausal transition, can begin several years before menopause. During this stage, the ovaries gradually produce less estrogen, leading to irregular menstrual cycles and various symptoms such as hot flashes, night sweats, mood swings, vaginal dryness, and sleep disturbances. Perimenopause can last anywhere from a few months to up to ten years, with the average duration being around four years. It sometimes kicks in the early 30s itself.

Menopause is diagnosed when a woman has gone 12 consecutive months without a menstrual period. The average age of menopause is 51, but it can occur earlier or later. The symptoms experienced during perimenopause often continue, including hot flashes, mood changes, and decreased libido. As per the hormonal changes, estrogen and progesterone levels drop significantly, leading to the end of menstrual periods.

Postmenopause refers to the years following menopause. Symptoms may persist, but they often lessen over time. Women in postmenopause are at increased risk for osteoporosis and cardiovascular disease due to lower estrogen levels. Hormone replacement therapy (HRT) and lifestyle changes can help manage symptoms and reduce health risks.

Lesser Known Facts About Menopause

Photo by Jovan Vasiljević on Unsplash
  • Early Menopause: Approximately 1% of women experience menopause before the age of 40, known as premature menopause, often due to genetic factors or medical treatments such as chemotherapy.
  • Cognitive Changes: Menopause can affect cognitive functions, including memory and concentration. This is due to hormonal changes impacting brain function.
  • Symptom Variability: The severity and duration of menopausal symptoms vary widely among women. Some may experience intense symptoms, while others have mild or no symptoms.

Impacts of Menopause: Menopause impacts women in multiple ways, affecting physical health, emotional well-being, and social interactions.

  • Physical Health: The decline in estrogen levels during menopause can lead to several health issues. The decline in estrogen and progesterone levels during menopause has far-reaching effects on the body:
  • Estrogen: Low estrogen levels are responsible for many menopausal symptoms, including hot flashes, night sweats, and vaginal dryness.
  • Progesterone: Reduced progesterone can lead to irregular periods and affect sleep patterns.
  • Osteoporosis: Lower estrogen levels decrease bone density, increasing the risk of fractures.
  • Cardiovascular Health: Postmenopausal women have a higher risk of heart disease due to changes in lipid metabolism and increased arterial stiffness.
  • Emotional and Psychological Well-being: Menopause can significantly affect a woman’s emotional health both her mood and thus her behaviour.
  • Mood Swings: Fluctuating hormone levels can cause mood swings, anxiety, and depression. Hormonal changes can make women more susceptible to irritability and mood swings. The transition can trigger anxiety and depression in some women, necessitating psychological support or therapy.
  • Cognitive Effects: Some women experience memory lapses and difficulty concentrating during menopause. In my case, I even felt mocked for being forgetful to the extent wherein people thought that whenever I lost hold of my points during a discussion or argument, I opted to be forgetful about certain events or statements. But, that made me frustrated even more, especially towards myself for being forgetful. Had I not been forgetful, I would exactly known my past statements and could have maybe been more strong towards my point of view.
  • Social and Interpersonal Effects: Menopause can also impact relationships and social interactions:
  • Intimacy Issues: Vaginal dryness and decreased libido can affect sexual relationships.
  • Social Support: Women who receive support from family and friends often cope better with menopausal symptoms.

Preparing for Menopause: Preparation for menopause involves both physical and mental readiness. Here are some strategies:

Physical Preparation

  • Healthy Diet: A diet rich in calcium, vitamin D, and phytoestrogens can support bone health and reduce symptoms.
  • Exercise: Regular physical activity helps maintain a healthy weight, reduces stress, and strengthens bones.
  • Regular Check-ups: Routine health screenings, including bone density tests and cardiovascular assessments, are essential.

Mental and Emotional Preparation

  • Education: Understanding what to expect during menopause can alleviate anxiety and empower women to manage symptoms effectively.
  • Support Networks: Joining support groups or talking with friends and family can provide emotional support and practical advice.

There are a few options that may help in managing this phase as well.

Hormone Replacement Therapy (HRT): HRT can alleviate many menopausal symptoms by supplementing estrogen and progesterone levels:

  • Benefits: HRT can reduce hot flashes, improve mood, and protect against osteoporosis.
  • Risks: Potential risks include an increased risk of breast cancer, blood clots, and stroke. It is essential to discuss these with a healthcare provider.

Coping Mechanisms

  • Stress Management: Techniques such as yoga, meditation, and deep-breathing exercises can help manage stress.
  • Therapy: Cognitive-behavioral therapy (CBT) is effective in managing menopausal symptoms and improving mental health.

People close to us may still think I’m just making excuses for my behaviour. But now with what I know, I also want to find a doctor who can help me understand what is going on and how to manage it. While it all feels daunting, for now, I’m trying to be gentle with myself. I’m reminding myself that it’s okay to feel what I’m feeling and that seeking help is a sign of strength, not weakness. I hope that by understanding more about what is happening to me, I can find ways to cope better and repair the strained relationships in my life.

While as women, we go through this emotional, physical and mental roller coaster it seems the expectations from the people around us don’t seem to become a little more considerate or kind.

Photo by Gabriella Clare Marino on Unsplash

Women can expect a range of experiences during menopause. Being informed and prepared can make the transition smoother, for example, by being aware of the symptoms and monitoring our health. Knowing the potential symptoms can help women recognize and address them early and regular health check-ups and proactive management of symptoms are crucial. While as women, we try to figure out the symptoms in advance (because mostly we only realize it after the damage is done), support from family and friends is vital during menopause. Understanding and Patience are extremely crucial, as a matter of fact recognizing that menopausal symptoms are not under the woman’s control can foster empathy and support. While helping with daily tasks, providing emotional support, and encouraging healthy lifestyle choices can make a significant difference.

Menopause is a natural and inevitable phase in a woman’s life, marked by significant hormonal changes and a variety of physical and emotional symptoms. Understanding the stages of menopause, being aware of its lesser-known facts, and preparing both physically and mentally can help women navigate this transition more smoothly.

Support from family and friends is crucial in helping women manage the impacts of menopause effectively.

References

  1. North American Menopause Society. “Stages of Reproductive Aging Workshop (STRAW) + 10: Addressing the Unfinished Agenda of Staging Reproductive Aging.”https://www.menopause.org/docs/default-document-library/straw10.pdf?sfvrsn=67b7c029_2
  2. National Institute on Aging. “What is Menopause? https://www.nia.nih.gov/health/menopause/what-menopause#:~:text=Menopause%20is%20a%20point%20in,between%20ages%2045%20and%2055
  3. Mayo Clinic Menopause: Symptoms and Causes. https://www.mayoclinic.org/diseases-conditions/menopause/symptoms-causes/syc-20353397
  4. Freeman, Ellen W., et al. “Associations of Hormones and Menopausal Status with Depressed Mood in Women with No History of Depression.”Archives of General Psychiatry https://pubmed.ncbi.nlm.nih.gov/16585466/
  5. Thurston, Rebecca C., and Hadine Joffe. Vasomotor Symptoms and Menopause: Findings from the Study of Women’s Health Across the Nation.  Obstetrics and Gynecology Clinics of North America https://pubmed.ncbi.nlm.nih.gov/21961716/
  6. Maki, Pauline M., and Emily G. Kornstein. “Guidelines for the evaluation and treatment of perimenopausal depression: summary and recommendations” https://www.menopause.org/docs/default-source/default-document-library/meno-d-18-00170-final.pdf

About the author

Kavitha Pandian

Kavitha Pandian is working in an IT company in the USA as a practice manager. She runs many initiatives including the Save Tamilnadu Farmer, Our Village Our Responsibility, and Adopt a Village and extends financial support and scholarship to underprivileged children for education, and betterment of rural life and has supported the people of Tamil Nadu during major natural disasters including Gaja and Covid. She has received many awards including ‘The Women Achievers Award’ by FeTNA, USA, in 2022. She also was felicitated by the District Collector, Virudhunagar during the 75th Independence Day celebrations, 2022, for her work towards infrastructure.