How to be there for your menopausal person

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Picture by AgyGuru @Deviant art

Over the last decade, due to people like Davina McCall, the menopause has finally got the attention and awareness that it deserves. However, the medication and treatment for this rite of passage for everyone assumed female at birth is still woefully lacking. The information is better but it’s still patchy and unreliable for those of us who are going through it, and to be able to support someone who is going through it is even more hit and miss.

Menopause often takes place at one of the busiest times in their life, with many external pressures, such as bringing up children, pursuing their career and caring for ageing parents.

If we are supporting someone who is going through the three stages of menopause, it can be a confusing and worrying time.

The menopause process is basically puberty backwards; it’s the natural ending of the menstrual cycle and fertility. It sounds simple but it’s a complex process that can be debilitating. Pre - menopause and peri – menopause refer to the time of fluctuating hormones when menstruation becomes either too frequent or hit and miss. Menopause is the time 12 months after the last bleed.

The menopause process usually starts between the ages of 45 -55 years of age, although it can occur anytime up until the mid 60’s, with average symptoms lasting between 4-8 years. But I know women in their seventies who still suffer with the symptoms.

A bit of biology to start with, so from menstruation to menopause, there are dramatic fluctuations in the levels of Progesterone and Estrogen, which impact the body, including the central nervous system, the mood stabilising hormones and neurotransmitters such as GABA, serotonin and dopamine, influencing mood and cognitive abilities.

Estrogen is a powerful hormone as it interacts with serotonin which is one of the happy hormones. It actually stops the brain from taking in enough serotonin at points. It also interacts with dopamine, which is the sense of satisfaction hormone, by decreasing the speed it degrades and the brain’s ability to take it in.

The following is a long list of symptoms of menopause but it’s not exhaustive –

Mental Health

• Moods will become erratic due to the fluctuations in hormone levels which affect the mood hormones as the adrenal glands start to produce Estroldol in place of Estrogen from the ovaries. The adrenal glands get strained and produce a lot of flight and flight hormones in response to them being over worked. Anger and anxiety can become debilitating as there is often no trigger for them, so there is no resolution.
• Depression can be common place as the hormones that stabilise our mood are being affected by the lack of Estrogen regulation. Sadness, lethargy and even suicidal ideation can become debilitating.
• Grief can become overwhelming as this period of life means a lack of fertility, empty nest syndrome and, possibly worse, as our society judges women on their looks and youth, menopause can mean feeling invisible too.
• This is a time when historic eating disorders will be challenged and may become active again. Those in a larger body will find this time period really difficult.

Physical Health

• The hot flashes – without warning being hot and sweaty, unable to regulate temperature, the temperature can feel unbearable and it’s difficult to cool down until the hormone level returns to a manageable level. To add confusion, this can appear as cold chills where the body becomes so cold only a hot bath or shower will warm the body up again.
• Night sweats can cause insomnia; body temperature rapidly increases, that is then followed by excessive sweating. Bedding can get soaked and on awakening here is a feeling of being chilled.
• Insomnia with or without the night sweats means lack of sleep whilst going through the menopause. Hormonal fluctuations affect the brain and mean that staying asleep can be difficult.
• The adrenal glands are expected to do double the work they did before until the hormone fluctuation is over. Add to this insomnia and anxiety and then exhaustion is common place.
• The menopause usually creates weight gain and as it starts to store fat differently resulting in the thickening of the waist and belly area. Bloating also is caused by the hormone fluctuating adding to the feelings of weight gain and unease.
• Ghrelin (the hunger hormone) and Leptin (the fullness hormone) receptors in the brain are impacted by the Estrogen decline, hence major food cravings.
• Hair on the head can thin, whilst hairs on the face thicken, calcium loss and moisture loss also creates brittle nails.
• Burning mouth often takes pace during the menopause; the whole mouth feels like it’s been burnt by a red hot cup of tea. This one remains a mystery it can need painkillers to be able to manage it.
• Joints, muscles and breasts become tender and achy during menopause. Again down to Estrogen decline, inflammation is no longer regulated by Estrogen, combine that with poor sleep, heightened stress and anxiety, the body becomes tense and it hurts.
• IBS can begin during menopause or get worse as the gut becomes sensitised by the major hormone fluctuations.
• Paresthesia (Tingling or 'pins and needles’) in the extremities and sometimes feelings like an electric shock in the nerve endings can be really scary but is usually just the fluctuating hormones in the body impact nerve transmitters.
• The bladder is impacted by the Estrogen decline, the urethra is thinned out and it can result in incontinence or at least frequent urination.
• One of the most well known impacts of the menopause is Osteoporosis the bones will thin by at least 10% causing an increased risk of fractures.
• The heart is also impacted by the menopause there can be major palpitations which are unnerving but not dangerous.

Cognitive Impact

• Memory lapses and brain fog can really affect people; some people felt they may have dementia during menopause. Again, it’s the Estrogen fluctuations which are causing memory lapses.

Sexual Health

• Vaginal dryness is quite common place throughout the menopause, again as a lack of Estrogen which means a lack of lubrication and this also leads to itching around the vulva.
• Libido will drop at this time, because when Estrogen and Androgen drop so sexual desire drops and then added on to the other symptoms it makes arousal difficult for a time.
• The impact of all of this leads to a drop of confidence, confusion, and low self esteem so feeling unattractive and disconnected from the body means sexual arousal again is lowered

These are some of the better known symptoms but there are any others that are emerging. Each person is different and so each menopause, its length and its intensity is different.

The person you are supporting will show at least some of these symptoms, so here are a few tips that could help you both.

• Be patient, it’s the best help you can give!
  • the emotional response will be magnified, this is not you it’s Estrogen !
  • change may become difficult at points, give them time to work through it
  • things will take longer to complete, cognitive issues and exhaustion make life hard
  • sexual desire will return – give it time and find new ways to be intimate

• If you share a bed buy two single duvets, one each it makes temperature control easier, make sure there are fans, ice and blankets available in your living space
• Normalise the memory issues , may people feel they may have dementia during menopause
• Sit with the difficult emotions and don’t try to fix the issue, just support them until they pass
• Be calm when emotions get heightened don’t add fuel to the fire
• If eating disorder issues or neuro- diversity worsen or appear, support them to get help from their GP or a therapist
• Help normalise some of the weird side effects of menopause

 

It will end and your relationship will return to a new but often better way of being.