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Kate Dyson

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How does the menopause affect our mental health?

We've all heard the jokes, the 'wrath of a woman' and seen the 'brain fog' memes. But outside of the stereotypes around menopause that we all put up with, the reality of feeling like you are literally losing your mind due to hormone fluctuations can be a concerning time. We take a look at the common - but serious - emotions and feelings that many women experience during menopause, and offer some tips on how to discuss your symptoms with your GP to get the best treatment for you.

"I woke up feeling so low, it was like the bottom had crashed out of my world. I didn't know what was going on - it came over me quite suddenly and left me feeling mentally very vulnerable."

We now know that the reduction of estrogen has a profound affect on our bodies - but our mental wellbeing too. We need estrogen and progesterone for our mind and body to function healthily, and it's very normal that as we start our journey through perimenopause that one of the first indicators can be low mood, irritability and even rage. And it can occur suddenly (or feel like that, anyway), or you might experience volatile swings of emotion from happy to sad in just a few moments. How many of us have surprised ourselves with a huge sob over something relatively minor?

"I don't feel depressed, I just feel angry and irritable, all the time! The slightest thing sets me off and even though I know it's irrational, I can't help it. What's happening to me?"

We don't discuss the presence of anger for women during hormonal imbalances - Hollywood has done a great job on the narrative of the idea of a 'woman's wrath'. When you first experience feelings of anger, rage and irritabilty you might question yourself, blame yourself, and it's easy to internalise these feelings. Let us reassure you, these emotions are a very normal response to the imbalance of hormones in your body. Speaking openly about having these feelings, and why, will help others around you manage their responses to you (when you inevitably explode over the wet towels/ empty loo roll/ dishes on top of the dishwasher etc etc)

"My main thing is anxiety. It's come out of nowhere - I suddenly feel panicky over the smallest of things, easily overwhelmed and I'm having the weirdest, intrusive thoughts."

Anxiety is very common in menopausal women - and is maybe the reason so many of us are offered 'antidepressants' when we first visit the GP raising concerns over panic. And when it arises, anxiety can be all encompassing, both mentally and physically (you might feel jittery, a tight chest, even aches around your body). Anxiety occurs in the 'emotional' part of our brain, so 'overriding' the feeling with rational thoughts can help reduce the peak of the anxiety, especially if you experience panic attacks. A couple of simple ways to do that are to countdown from 100 slowly, being conscious of your breath as you do so; or to use the 'something I feel, something I see, something I taste, something I smell' to ground your thoughts and allow your mind to calm. 

Meditation, and breathwork can also help with anxiety; but remember, if you are finding emotions and thoughts overwhelming, speak to your GP. 

"My husband doesn't 'get it', at all. He thinks I'm mad - one minute I'm raging about something and the next, sobbing into the cushion. He says he can't keep up with my moods and to be honest, I can't either."

Look, if your wife or partner's moods suddenly seem to be swinging around the chandelier, it's understandable that you might feel bewildered and thinking 'what the hell?!'. But the worst thing you can do - as a partner supporting a woman going through menopause - is to 'leave them to it'. This is the time to lean in and dig deep to offer unwavering patience and support. The woman you love is still 'there', but this is a signifcant change in her life; a complete shift of gears. So, be patient. Read as much as you can about perimenopause and menopause; know as much as you can to support her (but for God's sake, don't start mansplaining what you've learnt!) Lead with kindness, knowing that she is also pretty bewildered too, and of course, talk. Talk openly about how you feel but be empathetic to what she is going through.

And lastly, tea fixes everything. EVERYTHING. Always make the cup of tea. 🫖

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Speaking with your GP

If you are experiencing symptoms of menopause but worried that your GP won't take you seriously, here's Jude's top tips for managing the conversation:

 1. Knowledge is power: Read the Menopause NICE guidelines for patients so you know what to expect from the appointment. 

 2.  Be prepared: make notes in advance, so you know what you want to discuss. Ideally, keep a record of what you are experiencing so you can discuss how long you've experienced symptoms and whether there is a cycle to them. Write down everything, down to the last leak!

 3. Get the receptionist on side: Receptionists are the font of all knowledge in the surgery so tap into their experience and ask them who they recommend you speak with to discuss menopausal symptoms with (and treatment options.) And ask for a longer appointment so you have the time to discuss and don't feel rushed. 

 4. Ask if there is a menopause clinic in your area: and for a referral if there is. 

5. Don't be afraid to ask for a second opinion: It's understandable to not want to ruffle feathers, but your treatment plan is important and having the right medication for you is key to a better menopause. If in doubt, ask to see someone else. 

 6. Don't be 'fobbed off': Take a partner or friend with you if you are worried about advocating for yourself. Your GP will most likely be very receptive to how you are feeling - if they tell you it's 'just' that time of life, refuse to prescribe HRT, or impose a strict timeline - that's a no-no, and you should ask for a second opinion.