Stress and the menopause - what comes first?
You may have been wondering recently if you feel stressed because life is being demanding… or whether you are just not dealing with things as well as you used to?
Well it could be all of the above, particularly in a global pandemic. Or there could be another reason why you’re feeling overwhelmed. And yes, we’re talking about your journey into the menopause.
But what comes first? Can stress bring on symptoms of the menopause? Or does hormonal jiggery pokery, and its effect on your body and mind, hike up your stress levels?
What is stress anyway?
Before we start trying to unravel this chicken and egg conundrum, let’s take a look at how stress can show up. How do we know we are stressed? Well, we watch out for the following big signs.
Put simply, mentally we feel overwhelmed. This can be in response to a situation or changes to our world. Generally it feels like you can’t handle your daily tasks.
You may also find yourself with little tolerance or becoming angry or irritated. Or you feel like you have a ‘thinner skin’ when it comes to dealing with life.
Physically your heart can beat faster and you can get sweaty palms. You may also have headaches, high blood pressure, chest pains or the runs.
Sounds like anxiety
Yes, stress can dress up as anxiety. But when you’re trying to work out what’s what, just remember that feeling stressed is a response to daily pressures or a threatening situation. It typically goes away when the thing that’s stressing you out disappears.
Whereas anxiety, and depression, can have no clear cause and can follow on from long-term stress.
Here’s the science bit
But how can the menopause make us feel more stressed or get in the way of us dealing with stress?
We’ll explain. When you’re stressed your body pumps out ‘fight, flight or freeze’ hormones from your adrenal glands; cortisol and adrenaline. These make you more alert and give you energy. This bodily response was originally built in as a short-term mechanism to protect us against attack from sabre toothed tigers.
But the problem is, in our modern world, being stressed long-term overworks our adrenal glands and upsets the balance of hormones in your body. And, if the menopause is already mucking up your hormonal equilibrium, it’s a recipe for trouble.
Pesky old cortisol
Progesterone and oestrogen help to level out the impact cortisol has on our body – but as these hormone levels start to drop off during the perimenopause, so can our ability to wrestle with stress.
Our clever adrenal glands also try to help by producing small amounts of oestrogen and progesterone when our ovaries start to slope off the job. But they can’t alleviate the shortfall if they are constantly being called on to produce cortisol and adrenaline to fight virtual tigers.
So the vicious cycle continues. In no particular order:
- Stress = high cortisol.
- High cortisol = lower levels of helpful hormones.
- Lower levels of helpful hormones = more chance of symptoms.
- More symptoms = more stress.
But what comes first?
Back to our original question… what comes first? Stress or the menopause? You can see from our brief biology lesson that it can be hard to separate the two. It doesn’t help either that, confusingly, many emotional symptoms of adrenal fatigue (also called ‘burn out’) and the menopause are the same.
So, like splitting the difference between anxiety and stress, it can be tricky working out if what’s happening to you is down to stress or the hormonal flip flop signals of early menopause.
We’ve already mentioned feeling overwhelmed and irritable. But did you know that stress can also cause insomnia, foggy thinking, irritability, low energy, low sex drive and weight gain around your middle? And yep, you spotted it. Many of these are symptoms of the perimenopause and menopause too.
Stress can also cause you to experience hormonal symptoms more severely. And we know that physical stress can stop your period (particularly in long-distance runners and women with anorexia), while psychological stress can stuff up your cycle.
But there’s not enough evidence at the moment that stress alone can bring on the menopause.
What about in real life?
Let’s step away from the theory for a second and talk to two of our tribe members*, Shirley and Judit, who have volunteered to share their experience with us. Their changing hormones affected their ability to deal with their busy lives, so they would say that in their cases the menopause (or actually the perimenopause) definitely came first.
*If you would like to join our tribe too, just head to the bottom of any page on our website to sign up for monthly updates on the latest news, research and how GEN M can help you.
What was your experience of stress before the perimenopause/menopause?
- I’d always had jobs working in pressurised environments but I took these in my stride and usually enjoyed the challenge and variety. I was fairly relaxed and certainly not a ‘stressed person’.
- I had a high-stress job, initially as a barrister and then working in finance in the City. I loved the adrenalin flow and cut and thrust. I had a young family too and was caring for my mother. Lots going on. Sometimes I’d feel overwhelmed, but usually when things weren’t going right at work rather than anything else.
- I knew nothing about the menopause and nobody had ever discussed it with me. I never bothered to research it as I expected it would just happen in my mid 50s and I would look into it then.
I now realise that in my early 40s I began suffering with increasing feelings of anxiety, overwhelm and stress, particularly at work. I struggled to remember things and worried about things I’d previously taken in my stride both at work and at home.
I assumed it was just me having problems juggling work with a family, parents and other commitments. I thought it was what it was like as you get older, life just gets more stressful.
- My first hot flush was on my 45th birthday. I didn’t know what it was at the time but I started feeling not in control, initially about myself and my body but then life generally. This was very unsettling and I felt really overwhelmed. As a direct consequence, I resigned from my full-time job and ‘broke’ from people who I realised weren’t real friends.
How did you know or work out that hormonal change was the root of the problem?
- To be honest I had no idea that many of my symptoms were related to the start of the menopause (perimenopause), I just carried on as best I could. I changed jobs a number of times as I thought it might help – but of course it didn’t.
I had a lightbulb moment when I started studying NLP (Neuro Linguistic Programming) as many of the techniques helped me, particularly with my feelings of stress and overwhelm.
Until then I’d not realised just how much feeling stressed was affecting me. I then started to research the menopause and everything fell into place. I could identify that many of the problems I’d been experiencing, including regularly feeling nauseous, were as a result of hormonal changes.
- At the time, I didn’t know. I couldn’t work out what was wrong with me. I thought I was paying the price of burning the candle at both ends both physically and mentally. It was only when I finally caved and started my HRT journey that I started feeling a bit more like myself, which gave me time to reflect and realise that perhaps hormones were at the root of it all.
What action did you take? What advice did you get?
- I went to my doctor a couple of times earlier on. I was advised I may be perimenopausal and it can last for up to 14 years but that was it really. He just said it was a natural stage. I was never offered any further information or help, or directed to anywhere else.
I was so shocked that the menopausal symptoms may last so long that I thought I would try to ignore it and maybe it would all go away. As my friends would not talk about it, and I felt unable to mention it at work, I thought there was very little I could do. I was in survival mode really and I don’t think I was really thinking 100% rationally at the time.
- I found the NHS singularly unhelpful both times I tried to seek help. First time I was told: “What do you expect, you’re 45.” When I countered that none of the women in my family went into early menopause, it was answered by a shrug of the shoulders. Second time, about five years later when I was totally at the end of my natural remedies tether, it was suggested by the menopause ‘specialist’ GP that I take anti-depressants.
I read a lot of books – mainly research-based. I Googled a lot. I tried all the natural remedies out there. I worked hard on building new relationships, and reconnected with my personal values to pinpoint what I wanted to do with my career next.
What would you tell GEN M readers who are experiencing stress as part of the menopause?
- I think talking to someone about how you are feeling is key. Talk to whoever you feel comfortable talking to, or to a mental health professional if you feel you need it.
Even if you think you’re much too young for the menopause, take time out to find out more about it. At least that way if things start happening to you, you know you are not going mad.
There are lots of resources and people out there who can help with this stage of life. Don’t be afraid to ask for help, as it can literally save you years of misery!
- You’re not making it up. It’s real and you must find the best methods that suit you to deal with it.
I eventually found a real menopause specialist GP who has been really supportive. I have tried gels, patches, creams and different types of tablets. It is still work in progress. Experiment. Research, research, research.
Deal with stress your way
Stressful times, and the menopause, don’t have to end up being negative experiences.
When situations, symptoms or life changes prompt you to take stock of what stresses you – the awareness of what makes you tick and how you can look after yourself better can truly enhance your life.
Like Shirley and Judit, it can be the perfect time to re-evaluate your career, health, lifestyle and relationships. Clinical Psychologist Dr Emma Medard agrees with taking positive action where you can:
“It’s important to acknowledge that stress comes from many sources and we aren’t always in a position to change things. Focusing on the things we can influence helps us feel more in control. It can empower us to respect our needs and take care of ourselves one small step at a time.”
Write it all down
Track your feelings and symptoms on an app or in your diary so you can spot when, where and why you feel stressed. This evidence will also help when you talk to your doctor if you suspect menopausal symptoms are the root of your distress.
Empty your head by dumping all your thoughts in a journal. This alone can help alleviate overwhelm – and be useful in another way too. Take note of the language you use when you’re talking about yourself; are you kind or mean? Are you being a perfectionist or expecting too much? Are you piling the pressure on?
Generally find your best ways of keeping tabs on your mental health so you can start to see patterns and themes. Then you can piece together a plan to help yourself move forward with less stress.
Create your own rules
How are you looking after yourself? As you start to identify what is making you feel stressed, why not put some boundaries in place that help you?
Protect your down time. Turn off your phone an hour before bed. Set a bedtime and stick to it. Block out a proper lunch break. This is not just about rest or breathing space, this is about you taking charge.
And finally, stop multitasking whenever possible. We take a certain pride in being able to spin several plates... but this actually promotes stress, tires us out, and the constant mental switching makes us less efficient. Stay focused on one thing at a time.
Find your coping mechanisms
If you find yourself slap bang in the middle of a stressed state, then there are five things you can do to calm yourself down:
. Yes, that old chestnut. Fill your lungs completely (we take shallow breaths when we’re stressed), breathe in for 5 counts and out for ten.
. Dance round your kitchen. Do some yoga. Walk somewhere. Just don’t decide to pulverise yourself on the treadmill, as high-intensity exercise can pump up your cortisol further.
. You don’t have to sit cross-legged on a mat, clutching a lotus blossom. Just five minutes with your eyes closed focusing on your breathing (see above) will do the trick.
. Find a private space and let it all out. Crying releases endorphins that make you feel calmer.
. Connect with a friend or a family member who makes you feel safe. No-one around? Then simply wrap your arms around yourself or snuggle in a blanket. It activates the same soothing system we had when we were held as a baby.
Don’t soldier on in silence. Share your overwhelming feelings with someone close, a medical professional or a qualified talking therapist.
At GEN M, we know that it’s vital for menopausal women to feel heard and understood. Tell people what you are going through. Ask for and accept help. Just keep talking.