Life was already pretty overwhelming and exhausting for women going into menopause. Then along came the pandemic and for Teachers, such as Martina in Ireland, life became a lot more complex. It’s no surprise that a new report indicates that women bear the brunt of the additional stress.
‘Throughout all stages of the pandemic crisis, the mental health impacts have been disproportionately felt by women’ shares a new report out of the UK. ‘Women are 43% more likely to have increased their hours beyond a standard working week than men and for those with children, this was even more clearly associated with mental distress’. (Murray, 2020, p. 5).
Changes to working environments, worry about family members, feeling financially stressed, trying to cope with additional mouths to feed at home all day as children go into lock-down as well, let alone our symptoms and lack of sleep – I know how crazy it has been (and still is) for many of you. It’s stressful. With menopause hormonal changes, I also know that the sleepless nights, hot flushes, night sweats and for many, as happened to Martina, the daily exhaustion and anxiety ramp-up too.
“I didn’t like looking at myself in the mirror” emailed Martina to me this week. “I felt so exhausted all the time. I’m a Teacher and the year has been incredibly stressful. I didn’t know how much menopause was taking it out of me as well.”
Stress and anxiety are interesting phenomena. I’ve studied them both for decades, but not in the context of menopause. But rather in the context of sport and exercise science and the accumulation of physical stress in the athlete who is competing. Some is good, too much is bad. When athlete’s train and compete, their muscles, tendons, ligaments, cardiovascular system and gut undergo considerable ‘stress’. For athletes, this is the basis of performance adaptation. In other words, athlete’s need to ‘over-stress’ the body in their training to then allow them to make the physiological adaptations to become faster, fitter and stronger. But when athletes don’t get their training and recovery cycles sorted (especially female athletes who have also got their hormonal health to take into consideration), then they begin to see a drop in performance.
Interestingly, the symptoms of an over-trained, exhausted female athlete doing large volumes of training, are pretty similar to the symptoms we experience in peri-menopause too.
- Changing thyroid function which can lead to glandular fever
- Sore and aching muscles which can lead to fibromyalgia
- Hot flushes
- Stiffer tendons
- Anxiety and brain fog.
Over 60 years ago, Hans Selye (the ‘father’ of research into the stress-adaptation-response) recognised the paradox that the physiologic systems activated by stress not not only harm the body, but also protect and restore it. In other words, some stress is good, too much over a long time is not so good. When we are exposed to sources of stress over long periods of time (years in fact), then the impact of this is that both thyroid and adrenal hormones work harder to re-balance the body. The same phenomenon happens in over-trained, burnt-out athletes. It’s why motivation to train takes a dive, and many then begin to experience immune system health changes. The technical term for this is ‘over-training‘ and it is a well-researched phenomenon in athlete conditioning and optimal training adaptation.
But here’s the thing.
It’s happening to women in menopause as well. You don’t need to be an athlete for your body to go into ‘distress’. We already know this from health and medical research. When we aren’t sleeping, we aren’t recovering. And if we aren’t recovering, we start to feel wired and tired, stressed and anxious and it’s not long before we experience ‘Burn-out’.
The accumulation of stress affects every organ in our body. It makes our menopause symptoms worse. For many of us, it leads to worsening menopause weight gain too.
There is not much escape from our stressful lives these days is there? I’m not just referring to emotional stress either. It’s environmental stress too. As many of my Australian ladies discover, living in a hot environment creates extra ‘stress’ on our body too. That’s why you need to understand that as we transition through menopause, the accumulation of all the various sources of stress can impact hugely on our symptoms and our weight.
When our body is in ‘distress’ e.g. not sleeping, accumulation of inflammation, feeling over-whelmed by our emotional stress, feeling time poor or not eating well (or regularly), then allostatic load increases.
Emotional and physical stress are accumulative – and it’s not just the ‘here and now’ stress. I’m also talking about the decades-long build-up of oxidative or physical stress that manifests as inflammation and metabolic chaos in our body. If your muscles are sore, if you have fibromyalgia, if your gut health has changed, if you have put on weight, and if you are feeling hot and bothered all the time, and you aren’t sleeping, then yes, these are all signs that your body is ‘stressed’.
All these various sources of stress, [emotional, physical and environmental] and how frequently our body is exposed to this stress, is coined in the term ‘Allostatic Load’. From a physiological basis, when the allostatic load increases then it contributes to allostasis. This refers to the body’s ability to try to re-balance itself. It’s why, if we aren’t sleeping and our body isn’t coping, our thyroid, adrenal and pituitary glands are working harder to re-balance up the internal environment too. Many of you may end up with immune-health concerns which remain with you in post-menopause.
I love the Seattle Midlife Women’s Health Study. When I discovered the Seattle Midlife Women’s Health Study,* I learnt that various sources of stress impact on our symptoms, including our weight, hot flushes and sleep. [Refer image below from the Study, p. 4]
Spanning over 23 years, the Seattle Midlife Women’s Health Study, reported on thousands of women between the ages of 45-60 years who had shared aspects of their daily lives and health changes with researchers. One area of investigation was the meanings they attached to midlife and participants described experiencing a diverse array of stressful events from their changing health in menopause to family problems, work-related issues, deaths, frustrated goal attainment and financial concerns. All areas that I’m sure many of us might relate to. But herein lies the problem – whilst all of these very real sources of psychological stress were reported by women in this study, what’s missing are all the other sources of stress that women in their menopause transition experience too.
The research doesn’t take consideration of the various sources of physical stress inside our body as we reach our menopause years. This is known as oxidative stress or cellular inflammation and invariably, for women in their late 40’s and mid-to -late 50’s who are in menopause, oxidative stress has been building up for years. These hormonal changes during menopause then become the catalyst for worsening inflammation, especially in our muscles (including cardiac muscle), joints and gut. It’s why so many women find that their health begins to change and they get placed on all sorts of medications and supplements in mid-life.
Stress management from all sources, during our menopause transition is crucial to the reduction of your symptoms.
I can’t reinforce this enough.
My top 3 tips for you are:
- Follow an anti-inflammatory diet. READ MORE HERE.
- Restore sleep to at least 7-8 hours a night. READ MORE HERE.
- If you are an exerciser, then find balance in the amount and intensity of your exercise, because your muscles are ageing too.
When you allow your body to transition through menopause with lower amounts of stress in your life, your body gets a chance to reduce its allostatic load. This enables your chronic stress hormone, called cortisol, to rebalance allowing progesterone levels to align better with your changing oestrogen levels. You feel calmer and your menopause symptoms and injuries get a chance to resolve too.
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Egger, G. & Dixon, J. (2014). Beyond Obesity and Lifestyle: A Review of 21st Century Chronic Disease Determinants. BioMed Research International, Article ID 731685, 1-12.
Guidi J, Lucente M, Sonino N, Fava GA. Allostatic Load and Its Impact on Health: A Systematic Review. Psychother Psychosom. 2020 Aug 14:1-17. doi: 10.1159/000510696. Epub ahead of print. PMID: 32799204.
Murray, N. (2020). Burnout Britain Report. Overwork in an age of unemployment. CompassOnline Publication.
Woods, N. & Mitchell, E. (2016). The Seattle Midlife Women’s Health Study: a longitudinal prospective study of women during the menopausal transition and early post-menopause. Women’s Midlife Health, 2(6), 1-16.