Menopause is a natural physiologic event, and is something all cis gendered women and some transgender men or non-binary people will experience. Typically occurring between the ages of 45-55, menopause marks a major milestone in life, and during this time, women find themselves experiencing changes that fundamentally shift their physical and mental health.
Hot and cold flashes are one of the most talked-about symptoms of menopause, but the effects can be particularly complex for both body and mind. Hormonal changes may bring about surprising physical symptoms as well as changes in personality and mood, and it has the capacity to reopen previous traumas and exacerbate existing mental health concerns.
It may be tempting for healthcare professionals to view menopause through the narrow lens of physiology, but it’s important to take a much wider view of the overall physical and mental health implications it entails.
Understanding the Experience of Menopause
The word “menopause” can be confusing, because it is neither for men nor does it represent a pause in a process that might be restarting. The root words mens and pausis are Greek for “month” and “ceasing” respectively, referring to the end of the monthly female reproductive cycle.
As women age the ovaries begin to slow down, and this gradual drop in activity marks the entry into the perimenopausal stage of life. During this time, periods may become irregular, and these fluctuations may last for months or years.
True natural menopause occurs when periods stop for 12 months and a woman is no longer able to have children. Both perimenopause and menopause are caused by major hormonal shifts accompanied by a variety of symptoms that can be uncomfortable, unexpected, and in many cases worthy of significant concern.
Women in either stage may experience:
- Hot and cold flashes
- Night sweats
- Loss of interest in sex
- Vaginal pain
- Sleep disturbances
- Difficulty concentrating
- Hair loss
- Racing heart
Physical Risks Associated with Menopause
Changes in hormone levels and subsequent physiological processes can happen with or without significant past medical history. In addition to the variety of symptoms associated with menopause, there are some important health risks to be aware of.
Osteoporosis: Estrogen plays an important role in the preservation of bone mass. With a decrease in estrogen, bone density may begin to diminish, putting people at risk for injury. Bone fractures become increasingly worrisome as women age, and the body’s ability to recover wanes over time.
Coronary Artery Disease relates to the narrowing of the blood vessels feeding our hearts from the buildup of compounds like plaque. It can be especially worrying in the coronary arteries, and the loss of hormones like estrogen may be a contributing factor.
Menopause and Mental Health
Menopause is a difficult time for many women, and it’s often much more complicated than just chemistry. Yes, hormones can wreak havoc on our brains, but there are also a lot of personal, emotional, and spiritual challenges that accompany milestones in life, as well as the end of a process that is deeply identified with being a woman. It’s important to take as many possible factors into consideration when considering treatment options and modes of care, even for conditions that may be largely unrelated.
Clinical Mental Health Challenges
Hormones are the messengers for numerous body systems that deliver signals supporting our homeostasis and physiologic harmony. During menopause, the body slows down the production of estrogen and progesterone, which in turn results in fluctuations in the delivery of those messages. These shifts can cause symptoms like mood swings, anxiety, and mild depression.
Menopause can also exacerbate existing mental health conditions such as bi-polar disorder and depression, even if your patients previously had them well under control. Hormonal flux and the personal complexities that come with it can all contribute to a lessening of overall mental health.
Adjusting to a New You
For many women, the physical and mental symptoms are just one component of processing menopause. The experience of both aging and the loss of an intensely personal biological function may evoke similar emotions as a mastectomy or hysterectomy, and in some cases the treatment of both breast or uterine cancer can lead to premature menopause.
There may also be complicated feelings surrounding the inability to have more children, particularly, if adding to family was an open question. Finally, because menopause is an undeniable fact of aging, it can trigger all the complicated questions that getting older naturally brings.
Menopause and Sex
A change in hormone levels can also affect a person’s sex life. Some people may find themselves less interested in sex, less sensitive to touch, or may experience pain during sex. These side effects may create tension between partners, adding stress to an already challenging stage of life and further impacting mental health.
While these may not be as notable as constant hot and cold flashes, they are often just as important and worthy of concern. As a medical provider, you may need to discuss certain hormone therapies to manage these symptoms alongside topical lubricants and treatments to help with discomfort.
Helping Navigate Menopause and Mental Health
Natural menopause is an anticipated part of aging, and while the physical symptoms of this transition often dominate the conversation, mental health issues may actually play a much bigger role in determining our overall quality of life. While hot and cold flashes certainly represent a nuisance, managing the mental health challenges associated with menopause is just as important.
Healthcare professionals need to be aware of the unique issues menopause may entail, and the complexities it may introduce to treatment. Beyond Hot Flashes - Exploring the Complex Relationship Between Menopause and Mental Health created by Premiere’s Kelly Walker DNP MA BS BA FACNM, and Jenna Lapointe LCSW, will help you dive into the mental health complexities faced throughout the stages of menopause. All content created by Premiere is produced by industry experts, and is supported by convenient online access and reporting so you can stay up to date and informed on a timeline that works for you.