Perimenopause and menopause — Dealing with the challenges of the change of life

THE ‘change of life’ can be an enormously difficult time for a woman, and there has been increasing focus on the mental health impacts of perimenopause and menopause. “Addressing the mental health impacts of perimenopause and menopause involves a multifaceted approach, having to do with education and awareness, medical support, social support, and mental health services,” explained registered nurse Ingrid Sutton, when asked how women can address the mental health effects of these issues, in light of increasing recognition of their effects on overall well-being and quality of life.She said women have to understand the changes happening in their bodies, set realistic expectations, and consult with health-care providers for personalised advice.“Hormone replacement therapy and other medications can help manage symptoms,” Sutton said. “Regular check-ups can also monitor bone density and cardiovascular health, which can be affected during menopause.”Perimenopause refers to the transitional period leading up to menopause, typically starting in a woman’s 40s, but it can begin earlier. During this time, the body gradually produces less oestrogen, leading to hormonal fluctuations. These fluctuations can cause a range of physical and emotional symptoms including irregular menstrual cycles, hot flashes and night sweats, sleep disturbances, mood changes and cognitive changes.“There can be difficulties with concentration and memory, often referred to as ‘brain fog’, as well as breast tenderness, worsening of premenstrual syndrome, and changes in libido,“ Sutton said.Menopause is defined as the point in time when a woman has not had a menstrual period for 12 consecutive months. It marks the end of reproductive years, typically occurring between ages 45 and 55. The years following menopause are referred to as postmenopause.“Symptoms associated with menopause include hot flashes and night sweats, and similar to perimenopause, these symptoms often persist,” Sutton said. “Reduced oestrogen levels can lead to thinning and drying of vaginal tissues, causing pain during intercourse, there can be continuing or new onset of anxiety, depression, and mood swings, as well as persistent insomnia or disrupted sleep.”Sutton said women can also use the strategies below to help address the changes in their bodies, and lives.Mental health servicesTherapy and counselling can be beneficial. Cognitive-behavioural therapy has been shown to help with mood swings, anxiety, and depression related to menopause. Support groups can also provide emotional support and shared experiences.Lifestyle modificationsRegular exercise, a healthy diet, and sufficient sleep are essential. Physical activity can help manage weight, reduce stress, and improve mood. Mindfulness, yoga, and meditation can also aid in stress reduction.Social supportMaintaining strong relationships and open communication with family and friends can provide emotional support. Sharing experiences with others going through similar changes can reduce feelings of isolation.Self-care practicesEngaging in activities that promote relaxation and joy, such as hobbies, travel, or spa days, can improve mental health. Ensuring regular breaks and time for oneself is also important.“By combining these strategies, women can better manage the mental health challenges associated with perimenopause and menopause, leading to improved overall well-being,“ she said.