Why can perimenopause and menopause be so stressful?

While getting the right diagnosis and treatment can be tough, managing the stress of hormonal changes can be even harder

As the average age of menopause for UK women is 51, it’s inevitable that most of us will have experienced stress in some form or another by the time we reach this age. You’re probably aware of how stress usually feels for you. Some of us have a very physical response, such as a tightness in the back of the neck, heart palpitations, nausea or a headache, while for others it can present as feeling more irritable, teary or overwhelmed.

Symptoms of the perimenopause and menopause can feel similar to stress so it can sometimes be hard to determine the exact cause – are you struggling to sleep because of hormonal changes, for example, or because you’re stressed at work?

Menopause can also come at a stressful time of life – one that gives lots of opportunities but also challenges.

How is stress linked to hormones?

You may be familiar with stress being referred to as a fight or flight response – when your body thinks it’s under attack, it releases hormones (adrenaline and cortisol) and chemicals to help you react quickly. This isn’t a bad thing – in the past, it helped our ancestors survive and today it can help motivate us or respond when we’re under pressure.

In this state of acute stress, your heart beats faster, your blood pressure increases, and blood is diverted to your muscles. Glucose in the bloodstream is increased and the digestive and reproductive systems are shut down, while your immune system is suppressed.

This is an effective response in helping you overcome an immediate hurdle or difficult situation – your body is prioritising what’s needed and once the stressful moment passes, your body can return to its normal way of functioning.

However, if your body faces stress in the long-term or during situations that might not usually warrant it, this can have a negative effect on your health. With blood flow prioritised to your muscles, your brain function and other bodily processes are impaired. Not only can you lose the ability to think clearly through the problem and have trouble with memory and focus, but chronic stress can increase your risk of heart disease, heart attack, high blood pressure, stroke and diabetes.

Our hormones are interlinked so it’s not surprising that the increased production of stress hormones can affect the production of oestrogen, progesterone and testosterone.

How hormones and stress can be related

You may find that during the perimenopause or menopause, and for some women the days before their periods, you get stressed by things that wouldn’t usually have bothered you, or that you feel stressed more often than usual.

These three hormones – oestradiol, progesterone and testosterone – all have important roles in the brain so when levels of these hormones fluctuate and reduce, this can lead to numerous symptoms including anxiety, irritability, low mood, poor sleep and increased stress levels.

According to neuroscientist Dr Lisa Mosconi, author of The Menopause Brain, menopause is a time of changes in the brain. The decline in oestrogen to the amygdala, the emotional centre of your brain, can contribute to mood swings, depression, anxiety, loss of confidence or overwhelm, while lower oestrogen in the hippocampus, the memory centre, can contribute to forgetfulness or brain fog.

It’s also harder to lead a healthy lifestyle when you’re feeling under stress – many of us crave sweet or unhealthy foods, or don’t feel like exercising.

RELATED: managing menopause beyond HRT

How can I reduce my stress?

If your stress is triggered by your changing hormone levels, then replacing the missing hormones by taking natural body identical hormones – usually a combination of oestradiol, progesterone and testosterone – will really improve the way that you feel and reduce stress levels, as well as improving other symptoms that you may have.

The theme of this year’s Stress Awareness Month is #LittleByLittle, which highlights how small steps taken each day to reduce stress can accumulate big benefits to your wellbeing over time. The Stress Management Society has the following suggestions:

Connect with someone

Reach out to someone you can rely on for support or connect with someone new. A sense of belonging and community can help reduce feelings of loneliness and relieve stress.

Breathe deep

Breathing techniques are an effective way to aid relaxation and reduce stress. Take five minutes to focus on breathing deeply – breathing in for 4 counts and out for 7 is useful.

Get moving

Choose something you enjoy – it could be walking, running, yoga, stretches or doing some gardening. This will help to get the endorphins flowing.

Prioritise sleep

Improve your bedtime routine by having a screen-free wind down and a tidy, peaceful bedroom. Try to avoid caffeine after 4pm and write down any worries during the day so that they don’t spin around in your head all night.

Practice mindfulness

Mindfulness allows you to focus on the here and now, and helps you practice emotional regulation and control. You can designate time for a dedicated mindfulness session or go for a walk where you engage each of your five senses.

Spend time in nature

Each day, step outside, get some fresh air and spend time in nature in order to improve your mental wellbeing.

Resources

Stress Management Society