18
Nov

Is it the menopause or is it life?

The menopause experience explored by our leading Health Psychologist

Dr Deborah Lancastle is a Registered and Chartered Health Psychologist and Principal Lecturer at the University of South Wales. In this article she looks at the challenges of menopause from a psychological perspective – and provides lots of actionable advice to help you understand and take control of your experience.

How many of these do you recognise in your own life at the moment?

Being at the top of your game in your career…

It’s great but you’re under pressure with time demands, difficult decisions, and responsibilities…

Being the ‘filling in the family sandwich’… You have elderly relatives with health concerns, and teenaged or young adult children who need your help and advice. And perhaps even some grandchildren to care for! Everyone depends on you…

Feeling that you have lost important roles…

Maybe you’ve retired, or are unemployed and finding it difficult to get a new job, or are finding your ‘nest’ empty now your children are living independently…

Feeling comfortable, secure (and perhaps a little bored)…

Your relationships, home, work, hobbies, and lifestyle are working well but you’re missing some challenge in your life….

Feeling that the ‘ship has sailed’… You worry that you might never achieve some of the dreams you had when you were younger…

Who is that woman in the mirror…?

Not quite recognising the person you see in the mirror, even though you feel the same inside…

These life changes, joys, and disappointments may be familiar to menopausal women simply because they are at the age and developmental stage when these challenges are most likely to occur!

The menopause can be like other important changes you’ve experienced in your reproductive life, such as puberty, pregnancy, and childbirth. Just as at those times, your body is undergoing hormonal changes that can have unwelcome effects on your physical and emotional wellbeing, but that’s not the whole story.

During puberty, a lot gets blamed on teenage hormones even though career choices, friendship problems, and falling in and out of love also pile on the pressure. In the same way, the menopause happens during a very busy time of life and is just one part of it! And this doesn’t mean that life is ‘bad’ or ‘difficult’ for every woman at this time. In fact, you may be happy and satisfied in many ways. However, you may still feel under pressure, and that you have far too many very important matters to do and think about!

Altogether, the hormonal changes and demands of the menopause can get mixed up with other life challenges that coincidentally happen at the same time, making you feel a bit overwhelmed!

Solution 1: Taking control during the menopause

One way forward is to reflect on your life and try to work out what ‘belongs’ to the menopause and what is part of life in general. Simply identifying the various demands and how they are affecting you (good or bad) can help make you feel more in control and can be the first step to sorting some of them, especially if you feel that there is so much to think about that you don’t know where to start with dealing with it all!

What’s the bigger picture?

It can be helpful here to think about the difference between ‘global’ and ‘specific’ stressors. A global stressor is the whole ‘thing’ that is bothering you, e.g., ‘the menopause’. Because the menopause happens to all women as we age and we can’t do anything to stop ourselves getting older, nothing we do will turn back that particular tide! Although we can’t control the global menopause stressor there are several ‘specific’ stressors that happen during the menopause that may bother us but that we can try to change or control.

If you manage to improve those specific stressors you can reduce the negative experience of the menopause as a whole. For example, you could find solutions to one or more of your problematic physical symptoms, or try out some strategies to improve your psychological wellbeing.

Not sure where to start?

Try the 3 Steps below to start trying to take control of one part of your ‘menopause experience’.

Step 1: Spend some time reflecting on your life at the moment and start a list divided into three sections:

Section 1. What is working well

Section 2. What will need attention at some point, but can wait

Section 3. What you’d like to sort out asap

Step 2: Put the issues in Section 3 in order from ‘most’ troublesome to ‘least’ troublesome.

Step 3: Pick one or two of the worst issues and start to take action to try and solve this issue.

Four simple ways to start to taking action about specific stressors in the menopause:

  1. Download and read the patient version of the NICE guidelines for the menopause to get a sense of the treatment recommendations. You’ll find a link to this at the end of this article.
  2. Look up some decision aids+ for any health problem that is worrying you*. There is a link at the end of this article with an an A-Z list of decision aids for many different physical and mental health concerns. Discuss the information and treatment options with your family and make an appointment with your GP to discuss.
  3. Look for some solutions that might help you with the other demands you have in your life. Are there services that can help the elderly people in your family? Are you eligible for benefits to help you with financial concerns? Are there support groups or organisations that can help you or other family members with advice about other problems?
  4. Plan some treats! Make a list of activities that give you pleasure or take your mind off problems that you can’t solve at the moment. Choose treats that are easy to achieve and that will put a spring in your step and use them whenever you feel the need.

Solution 2: Effective coping

We use the word ‘coping’ all the time without really thinking much about how we cope, whether these strategies are working, and whether there are different strategies that might be more helpful.

Thinking about coping is worthwhile, because effective coping can be our first line of defence against stress and unhappiness.* We are more likely to feel ‘stressed’ when we feel that demands in our lives are greater than the resources we have to deal with them (1).

Some of those resources may be external (e.g., money, time, support) and there may not be much we can do to improve those resources. However, many of our resources are internal (e.g., the ways we cope and the way we ‘see’ things).

Effective coping is one way of increasing our psychological resources to help us deal with the demands of life! Altogether, there are more than 400 different ways of coping! (2) We can organise these into 3 main groups (1, 3):

  1. Problem-focused strategies: Ways of changing the situation to make it go away or get better. For example, seeking professional help, finding out about the problem, trying different solutions, acting on advice.
  2. Emotion-focused strategies: Ways of relieving negative emotions. That’s things like crying, talking to friends, seeking out social support, pretending the problem isn’t happening, distracting yourself with an activity.
  3. Cognitive strategies: Ways of changing the way you think about a difficult experience so that you think more about anything good in that experience. In practice, this might mean instead of dwelling on issues that upset you, thinking more about the support you have from others, the medical help you’ve received, the pleasure you get from family and friends.

Is one type of coping best?

No one type of coping is ‘right’ or ‘wrong’, but particular ways of coping can be more or less helpful, depending on the situation, what you are trying to achieve, and whether you can actually do anything to change the situation:

  1. If you can do something to improve the situation you should try problem-focused strategies because removing or reducing the problem will make you feel better.
  2. If you can’t change the situation at the moment (or at all) use emotion-focused or cognitive strategies to reduce negative emotions and/or increase positive emotions.

5 tips for coping with the challenges of life during the menopause*:

To deal with troublesome physical symptoms…

Try problem-focused strategies and take action! Seek medical help, read up about your symptoms, and find out about solutions that have worked for others. Trying out some new ideas can help you feel more in control too – remember the theory on ‘local stressors’.

To deal with feeling fed-up, anxious, and stressed…

Try emotion-focused strategies to reduce your distress! Talk to friends or your partner about your feelings and how they might support you. Distract yourself with activities you enjoy that take your mind off worries and symptoms. Write about your experiences to help you process your thoughts.

To deal with gloomy thoughts…

Try to focus more on anything positive you can find in your life at the moment. For example, if you have a supportive partner, you are healthy, you have some time or money to spend on activities, you love your job etc., think more about those good things if you can! It may take you some time to find the positive things in your own life but doing so can mean you spend less time brooding about issues that upset you – giving you some relief and peace.

To deal with feeling a little lost or alone…

Try increasing the social support you receive, perhaps by joining a club, taking up a new hobby, or learning something at a night class. This new activity may also help if you’re feeling that life is a bit dull!

If that isn’t for you, or you would like to connect with other women experiencing the menopause, try some online menopause forums or menopause blogs where other women talk about their menopause experiences (see links in the Resources box).

Hearing from others ‘in the same boat’ can help you feel less isolated. Be prepared to experiment with different forums, groups, and blogs because we are all different and what works for one person might be unhelpful for another!

To deal with feeling tired and overwhelmed…

See if you can prioritise some TLC for yourself, even it feels impossible with your busy schedule. Many of us would find an hour in a busy week if a loved one needed us, so treat yourself like a loved one!

One tip is to put yourself in your diary in advance. Start with a small ‘appointment with you’ but make it a regular part of your routine and avoid putting anything else in that slot.

Another tip is to think of the way you talk about this appointment. Instead of saying ‘I would like to’, ‘I should’, ‘I have to’ (go for a swim, have a manicure, ring my friend, go to choir etc.,) try saying, “On Wednesday evenings I go swimming” (for example). Even a simple change to language makes this appointment sound like a permanent arrangement that can’t be changed!

The two-minute takeaway…

Dealing with the menopause may feel like an uphill battle sometimes, but it may help you feel more in control if you work out which issues are a priority to deal with and which can wait. It can also help to focus on and enjoy the parts of your life that are working well and giving you pleasure because this can increase your positive emotions and give you some relief from worry and distress. It is also very important to seek professional help from your GP and to increase your knowledge and sense of control by reading and thinking about treatments and solutions.

Useful links and references:

Help to make decisions

Decision aid for menopause

A-Z list of decision aids for many different physical and mental health concerns

Online menopause forums:

Menopause Matters

British Menopause Society Forum

About Dr Deborah Lancastle

Dr Deborah Lancastle (PHD) is a Health and Care Professions Council (HCPC) registered and British Psychological Society (BPS) Chartered Health Psychologist with special interest in the psychosocial aspects of women’s reproductive health. Her extensive knowledge and experience of the psychological principles explaining how women cope with reproductive health issues means she’s well-placed to advise across a range of women’s reproductive health concerns.

Read Deborah’s full biography here.

You might also be interested in…

Coping with your emotions during menopause Asking for help with intimate menopause symptoms – practical tips to deal with ‘embarrassing’ questions

Cognitive behaviour therapy for menopause

+ What is a ‘Decision Aid’?

Decision Aids are guides about different types of health concerns that you can work through on your own before discussing with your family and GP. They are good sources of help because they are based on research evidence and are kept up to date. There should be a date on a Decision Aid telling you when it was last reviewed and revised.

For example, The Decision Aid called “Menopause: Should I Use Hormone Therapy (HT)?” by Healthwise.Net (see resources box) has sections dealing with these common questions about the menopause: What is menopause? What is hormone therapy? What if you don’t take hormone therapy? What are the benefits of taking hormone therapy? What are the risks from taking hormone therapy? Why might your doctor recommend hormone therapy? Decision Aids are written to be easily understood and can be a great starting point for you to think of questions you can ask your GP that give you the extra information YOU really need to help you decide on what can be done to help.

*Health warning: The advice given here is not meant to take the place of formal mental health care. If you are feeling upset, anxious, or depressed, and self-help and TLC don’t help, please contact your GP for advice.

** It is very important that you seek medical advice for any new, changed, or persistent physical symptoms from your GP.

*** Although these coping strategies can help people cope with their emotions they are not meant to take the place of medical or psychological care. Please seek help from your GP if you are concerned about the stress or distress you are experiencing.

**** Check with your GP that it is okay for you to start or increase the amount of exercise you do.

References

  1. Lazarus and Folkman (1984)
  2. Skinner (2003)
  3. Folkman (1997)
  4. Kowalski (2017)
  5. Benyamini (2008)
  6. Vethanayagam (2017)
  7. Phelps (2006)
  8. Lancastle (2008)
  9. Fredrickson & Joiner, 2002
  10. Depypere et al. (2016)
  11. Santer et al. (2008)
Dr Deborah Lancastle Dr Deborah Lancastle Psychologist

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