Menopause Managed - part 2
Firstly, thank you to those who commented on the last blog, it was so insightful to hear of your journeys and different experiences. It really highlighted how one size doesn’t fit all but as a collective it affects us mentally & physically, it’s simply the intensity that varies. One of the comments:
‘It is SO important to be aware - of yourself, your thoughts, emotions and physical sensations. Self awareness is so important. I've gained this through years of practicing mindfulness and it's invaluable to me. And for me, a new found confidence and an indifference to what others think of me - so liberating.’
The same client ‘had a pretty traumatic entry into the big M’. She suffered a panic attack so severe she was rushed to A&E. The reason? A big dip in oestrogen signalling the beginning of menopause. It’s important to flag this stuff up because through the mountain of research she had undertaken panic attacks on this scale had not come up.
This follows nicely into this blog about what we can do. Naturally what follows is subjective. What works for one may not work for you and vice versa. I hope this gives you some insight in how to help manage this part of your life’s journey and even if you pick up just one thing that works and resonates and eases something for you, then that’s wonderful.
Let’s talk yoga first!
It won’t be a surprise that stress is one of the most important things that yoga can help with. When we’re stressed we release cortisol which is fine in ‘normal’ doses, i.e. we respond to the threat as expected, we go into a heightened sympathetic state (shorter breath, faster heart rate, higher blood pressure) but then we return to our parasympathetic state (breath/heart rate slower, blood pressure lowers). Problems arise when we’re chronically stressed and cortisol levels stay high. Here are just a few effects on our body:
Reduces the volume of our hippocampus which plays a major part in processing memory and emotion and is also involved in regulating cortisol during our stress response. High cortisol = less volume/activity = less regulation = higher cortisol levels = issues with memory. It becomes a cyclical loop.
Reduces melatonin, our sleep hormone, hence sleep is affected. Melatonin is also an anti-inflammatory and inhibits tumour growth.
Raises glucose levels which leads to excess visceral fat and therefore is a risk factor for diabetes.
Cortisol helps regulate inflammation but high levels play a role in increasing it and excess cortisol also keeps our blood pressure elevated. An inflamed mind/body and high blood pressure is hugely detrimental to mental and physical health and puts us at greater risk of heart disease amongst others.
Stress can impact our skin making it drier and more sensitive, add that to the reduction of oestrogen which correlates with a decline in collagen and well, hello aging skin. As a side note, collagen is one of the most predominant proteins found in tendons and ligaments hence a loss of elasticity in these as we age.
I could go on but that’s another blog.
I listened to a chat recently with Dr Lisa Mosconi https://daveasprey.com/dr-lisa-mosconi-675/ and women who are chronically stressed show higher brain shrinkage than those going through menopause without stress. Cortisol plays a part in the reduction of oestrogen so managing stress levels is top of the list for me as it positively impacts us in many other ways apart from the physiological aspects.
There has been studies which have shown the efficacy of yoga (poses, breathwork, mindfulness practices) for menopausal symptoms such as insomnia, vasomotor (hot flushes/night sweats), psychological symptoms and of course the benefits of exercise in warding off osteoporosis. In terms of why yoga helps vasomotor symptoms it’s understood this may be due to the benefits on the nervous system. To play Devil’s Advocate there are also studies which show little effect, hence subjectivity, but there are more studies showing a reduction in symptoms than not.
Pranayama (breathing exercises) & mindfulness/meditation practices:
Sitali (sheetali) is a cooling breath useful for hot flushes https://yogainternational.com/article/view/beat-the-heat-sitali-and-sitkari
Ujjayi is one of the most effective ways to take us into parasympathetic mode, if you’re feeling stressed/anxious/struggling with insomnia try 1:2 ratio, i.e. inhaling 2, exhaling 4, 3/6, 4/8 etc.
Sitting for 5-10 minutes practicing either of the above can be both meditative and mindful. Paying attention with intention has a positive affect on brain structures that help us reason with difficult thoughts and emotions. I’ll do YouTube videos!
Yoga nidra or other guided meditations that use body scans, visualisation and mantras is a wonderful way to practice present moment awareness and work with unhelpful thoughts and sensations rather than against. It encourages us to accept ALL parts of ourselves. Check out Insight Timer app for 1000s of free ones.
Asanas (poses)
Practicing yoga releases positive hormones to help manage the fluctuations of our hormones. For example we can activate dopaminergic pathways (feel good hormone) through mindful, intentional movement and serotonin (mood, memory and learning) can be increased through strong asana.
A big concern of menopause is osteoporosis. One way to support our bodies is to do weight bearing exercise which yoga is known for. Strengthening our body and improving flexibility are key components in keeping us independent for longer, and improving our balance and coordination helps us avoid falling and fracturing our bones. Some of you will have heard me say, ‘We can only go so far with our own body weight’ so it is important to add weights to help stress the bones and increase density, however there is an article here about how yoga could improve bone density: The 12-Minute Bone-Strengthening Yoga Sequence Backed by Science (yogajournal.com)
Restorative yoga is a wonderful way to help the mind and body rest during intense hormonal shifts which naturally impacts our emotions and how we respond. Combining this with breathing techniques and mindfulness of thoughts and emotions is a way towards accepting what is and letting go of negative and sometimes self destructive thoughts.
My advice would be a mixture of strong asana (noting that strong differs for each of us) for a sense of empowerment and building strength and stability which is incredibly important as we age and restorative to help us wind down and take much needed rest. We don’t need to go go go all the time. But ultimately, you know what your body needs and listening to when it needs a bit more and when it needs a bit less will help nourish you in that moment.
Lifestyle considerations
Reduce stress for all the above reasons but also because it helps support the gut/brain connection. When we’re stressed and experiencing low mood we often make unhelpful lifestyle choices such as not eating as healthily (more sugary, processed food), drinking more alcohol and exercising less which affects our sense of wellbeing and we end up in another cyclical loop.
All the below is taken from Good Mood Food, Charlotte Watts, who is the nutritionist on the Yoga Therapy course I’m attending.
Low fat diets can be harmful during and after menopause; we need good fats to help with hormone production, brain function, immunity and cholesterol metabolism. In fact if you have a low fat diet prior to menopause this can be more problematic, especially in relation to mood swings.
Phytoestrogens (phyto = plant) help to regulate oestrogen and during menopause can act as a weak oestrogen. These can be found in citrus fruits, liquorice, oats, carrots, apples, flaxseeds, celery, herbs (sage, barley, basil) and more!
Soy is a rich source of oestrogen - fermented rather than processed, i.e. miso, tempeh and tofu as opposed to soy milk/mince etc.
Getting into a consistent sleep routine is important which is difficult when our hormones are all over the place. Oestrogen helps with alertness and progesterone triggers sleepiness so supporting hormone regulation can help; vitamins such as B6 and magnesium are worth researching.
Herbs can help the transition to lowering hormone levels such as Dong Quai and Black Cohosh, please note they do have different effects on oestrogen and progesterone. It is recommended you see a herbalist if you wish to go down this route.
Antioxidants protect cells and promote cell growth which is useful for our skin which constantly sheds and regrows cells. With the reduction of collagen and therefore elasticity looking after our skin is paramount. Go for foods such as fruits and vegetables, nuts, grains, some meats, poultry and fish. How do antioxidants affect the skin? | HowStuffWorks
CAVEAT! I am not an nutritionist so please do seek professional advice if you wish to make any changes to your diet.
Last but not least, TALK & SHARE. It is clear that our journeys are individual and our experiences differ but we are in this as a collective. Positive and negative emotions may arise around the menopause; for some it may bring a sense of relief, for others there may be a sense of loss. Let us honour and hold a container for ourselves to experience whatever comes up for each of us.
As always, your experiences matter, please do share. Love Lindsey xoxo
Elise Browning Miller, a senior certified Iyengar yoga teacher states:
“Menopause is a time of change and change, yoga teaches, is inevitable. Coping with unwanted change is above all a spiritual issue. It’s hard when we go through menopause to acknowledge that we’re getting older. Yoga’s emphasis on meeting challenges with acceptance and gratitude acts as an antidote to these negative, self-defeating attitudes.”