Changes in hormone levels during perimenopause and menopause can cause your body stress, as can getting the right treatment, but help is at hand
• Perimenopause and menopause symptoms can make life increasingly stressful
• But stress can also be triggered by hormonal changes
• Discover how rebalancing your hormones and lifestyle changes can help
Stress is an inevitable part of life – you may feel it on a daily basis or have experienced periods in your life that were particularly stressful. You’re probably aware of how stress usually feels for you. Some women have a very physical response, such as a tightness in the back of their neck, heart palpitations, nausea or a headache, while for others it can present as feeling more irritable, teary or overwhelmed.
During perimenopause and menopause, changes in your hormone levels can exacerbate your stress levels. You may have tried relaxation techniques or wondered why you feel so stressed when there is no obvious trigger – understanding the role your hormones play can help you take appropriate action.
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 your bloodstream is increased and your 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.
RELATED: Menopause and brain health: what’s the link?
How do hormone changes in perimenopause and menopause affect stress?
Fluctuations and a decline in hormones estradiol (estrogen), progesterone and testosterone can affect your stress levels.
Progesterone is sometimes known as the relaxing hormone as it has calming, anti-anxiety (anxiolytic) properties. Its effect on your mood can be felt throughout your life. For instance, during the second half of your menstrual cycle, levels of progesterone naturally drop – this is usually the underlying cause of premenstrual syndrome (PMS), which can include mood swings, feeling low or anxious or irritable and premenstrual dysphoric disorder (PMDD), which is a severe form of PMS. Similarly, the huge drop in progesterone levels after childbirth can be the underlying cause of postnatal depression (PND).
RELATED: What is reproductive depression?
As well as helping with mood, progesterone can influence your sleep and your resilience to stress – a study found that women with higher progesterone levels have more psychosocial resilience (they can deal with personal challenges better and improve their wellbeing and mental health) [1].
Estradiol and testosterone also have important roles in your brain. The decline in oestradiol to the amygdala, the emotional centre of your brain, can contribute to mood swings, depression, anxiety, loss of confidence or overwhelm, while testosterone helps to regulate emotions and stress responses.
It is worth remembering that even if the underlying cause of your stress is not hormone related, stress can have an impact on your hormones. Chronic stress can lead to increased cortisol, which can in turn impact and reduce production of progesterone, estradiol and testosterone.
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 estradiol, 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.
How should I treat my fluctuating hormones?
Women who experience mood symptoms with their PMS or PMDD are sometimes prescribed progesterone to help balance out their hormone fluctuations. This is preferable to the contraceptive pill, which is sometimes given to suppress your changing hormone levels, but contains synthetic hormones that can have side effects.
Similarly, rebalancing or topping up missing hormones during perimenopause and menopause can help alleviate mood symptoms. Hormone replacement therapy (HRT) is usually the first-line treatment for the management of perimenopausal and menopausal symptoms [2]. The type of hormones you need and the doses vary between each woman – it is not a “one type fits all” prescription. The hormones estradiol, progesterone and testosterone are usually prescribed separately and it is important that you are given the right type and dose to improve both your symptoms and your future health.
RELATED: Perimenopause, menopause and HRT: everything you need to know
How else can I reduce my stress?
It can be hard to lead a healthy lifestyle when you’re feeling under stress – you might crave sweet or unhealthy foods, or not feel like exercising. While it’s not always possible to remove stress triggers in your life, there are small steps you can take each day to help you manage them and improve your overall wellbeing.
Connect with someone
Seeing friends or family may be the last thing you feel like doing on some days, but moments of social connections are important - bonding with others helps you release more mood-boosting hormones.
RELATED: How friends can ease your menopause
Slow down and breathe deep
Breathing techniques are an effective way to aid relaxation and reduce stress. Breathe in to a count of 4, and out to a count of 4. Even just 2 or 3 minutes of doing this will help you feel much calmer and it’s a great ‘go to’ technique for those times of overwhelm
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.
RELATED: Exercising during perimenopause and menopause
Challenge your thoughts
Negative thoughts and worries can often take control of the way you think and feel, and escalate stress. When you find yourself having these thoughts, challenge them, question if they’re really true and think of practical actions around the worry that would help you feel more in control.
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 go to bed at the same time every night, even at weekends.
Keep a note
You may not have written a diary since you were a teenager but writing down some of your thoughts can help them be less bothersome, especially at night. It helps to look back and acknowledge how worries don’t usually come to pass and see the progress you’ve made at overcoming negative thinking.
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 where you check in with yourself, slow down, breathe more deeply and be more aware of your emotions and your surroundings.
Spend time in nature
Each day, step outside, get some fresh air and spend time in nature in order to improve your mental wellbeing.
RELATED: How walking can ease your mind
How can I handle panic attacks?
If you experience panic attacks here are some helpful hints at dealing with these, specifically:
1. Recognise what’s happening – this can help reduce the fear and severity of it.
2. Focus on your breathing – breathe in for four and out for four and keep focussed on just doing this.
3. Find your focus – if it’s hard to focus on breathing find something small and trivial in your surroundings to focus on to distract yourself as you wait for the panic to subside.
4. Relax your muscles – think through and relax every muscle of your body, starting with your fingers and hands, up to your face and jaw and down to your feet and toes.
5. Picture your happy place and imagine every detail of it, this will distract you while you slow your breathing down.
What’s the bottom line?
If you’re struggling with stress, consult with a health professional in the first instance to discuss balancing your hormones. Many women find their mental health improves when their hormones are balanced. You could also contact a counsellor for talking therapy. Make it a priority to get the help you need to start feeling like yourself again.
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