getting through the menopause
by Deborah Clark, Yoga Teacher & Research Masters in Sports and Exercise
the menopause, a.k.a. ‘the change’, is something that all women will inevitably go through. it’s defined as “no menstruation, a cessation of the menses, for twelve months” (Treloar, 1967).
the onset of the menopause transition (perimenopause) is recognised by changes in menstruation (periods may become irregular, heavier or lighter) plus an array of accompanying side-effects such as
- mood swings
- hot flushes
- urinary or vaginal discomfort
a ladies’ experience of the peri/menopause is largely determined by their genetic disposition, lifestyle and diet.
‘the change’ can be a turbulent time and maintaining physical and emotional health during it is the key to managing it.
continuing your yoga practice can be of great comfort during the menopause. Not only does yoga practice help sustain your physical wellbeing, it also helps you to build the mental balance and energetic stability to allow you to adapt to change and embrace the uncertainties and discomforts that come with it.
my perimenopause probably commenced around my 54th year. My periods ceased completely from November 2015 so one year on in 2016 my transition was complete.
I am now 58 years old, I have practiced yoga since I was 18, starting with Iyengar and moving on to a Scaravelli/flow style (Scaravelli, 1991) which suits my physiology and mental well being. My menopausal transition was not without incident but I think being a yoga practitioner and teacher helped me get through it with relative ease.
the old crone vs the silver fox
when I started to suspect I was in the throes of the perimenopause I ‘googled’ and visited the local library. Both sources did not provide much information. The ‘Women’s Health’ section in the library contained plentiful texts for pregnancy and childbirth but to my surprise, there was nothing at all about the menopause.
the only book I was able to source at my local library was Germaine Greer’s ‘The Change’ (Greer, 1992), which I had to order from another branch. Whilst being a fascinating read, Greer’s book is a rollercoaster of examining the ‘climacteric’ as she prefers to call the menopause. Written when she was 53 she is angry with society and it’s treatment of middle aged women on every level. There are no cozy reassurances to be found in this text. She boldly discusses how society despise the ‘crone’ and rails against men being described as ‘silver foxes’ whilst their female peers become invisible/invalid as their sexual currency is depleted. Her observations are harsh in their accuracy and insights.
my mother’s generation embraced hormone replacement therapy with great gusto, estrogen supplements were routinely prescribed by GPs at the first sign of a ‘hot flush’, irritability, vaginal dryness etc. The administration of this estrogen was oral and it’s source was pregnant mares that excreted the required hormone in their urine when kept in a state of fear.
however these HRT treatments resulted in an increased risk of cancers, both breast and uterine, which curtailed their prescription. It was recognised that collecting the urine of terrified horses was probably not the best way for science to deal with menopausal health problems. Most recently manufactured (no scared horses necessary) HRT options have been developed which can be administered topically rather than ingested, this has minimised the most dangerous side effects, but they are still not completely without risk.
contemporary yoga and the menopausal lady
it seems that the feminist concept of the ‘lived in’ body which can embrace and experience change is at odds even with the contemporary representation of yoga. There doesn’t seem to be much place in the spotlight for the older practitioner. The objectification of the young ‘hot’ bodies we see emblazoned on yoga magazines in trendy, expensive Lycra with glistening abs might suggest that staying fit is all about how you look and is reserved for the young. This is not the case it is of paramount importance to maintain ones fitness throughout old age.
losing bone and gaining fat
one of the main side effects of ‘the change’ is a affect it has on a women’s body composition leading to decreased skeletal muscle mass and an increase in visceral and subcutaneous fat (Grice, 2016). Visceral fat is the fatty deposits which accumulate around the organs whilst subcutaneous fat is the more visible ‘pinch an inch variety’. Visceral fat in particular can lead to significant health problems such as insulin resistance and an increased risk of heart disease (Astrup, 1999).
the psychological and physiological effects can lead to reluctance to participate in exercise but lack of exercise exacerbates the health problems associated with menopause.
5 top tips for managing menopause
here are Deborah’s 5 top tips for getting through ‘the change’ and minimising the potential health risks which arise through estrogen depletion
- preparation has a massive impact. Bone density does not improve much after the age of 30, so impact exercise in your twenties is essential to max out on bone density
- in the run up to the menopausal transition during your thirties and forties get into a good regular exercise routine which includes cardio, resistance training and stress relief. You need to build lean muscle and a strong heart, whilst maintaining your bone density. Yoga, Tai chi, qi gung and other embodiment practices are excellent at enabling women to connect with their bodies at a deeper level than standard exercise (Allegranti, 2011).
- during the perimenopause increase your consumption of green leafy vegetables. You might consider taking a supplement of Vitamin D, which a lot of women are deficient in and is associated with calcium uptake therefore bone density. Eat three portions of oily fish and snack on walnuts (Omega 3)
- avoid caffeine and ensure you stay well hydrated. Bladder discomfort and ‘urge incontinence’ can be a feature of the perimenopause and beyond. Don’t suffer in silence, see your GP who can prescribe a very low dose Estriol cream, which addresses thinning and deterioration of the urethra and the vaginal walls. Alternatively if you want to steer clear of any form of HRT use a vaginal moisturiser such as Replens, Boots own brand is excellent
- Use a good lubricant for sex if you experience any dryness
and on the plus side….
ageing and the menopausal transition cannot be separated however there is some silver lining in the way of liberty from the grind of menstrual cycles, increased equilibrium and sex without contraception.
the author Debbie Clark runs Scaravelli inspired classes and individual sessions in and around Basingstoke in Hampshire. She considers growing old to be a privilege denied to many and embraces the opportunities to grow and learn. She is currently undertaking a study entitled: Disembodiment and alienation: What prevents middle aged women engaging in yoga practice which could alleviate the symptoms of menopause? Under the supervision of the University of Winchester, Department of Sports & Exercise. (March 2017)
here is a simple balance building practice with me that you can try at home to maintain strength, stability, co-ordination and balance
or this video helps build bone density and focuses on strength building
references and further reading
Allegranti, B. (2011) Embodied Performances: sexuality, gender, bodies. Basingstoke: Palgrave Macmillan.
Ayers, B., Forshaw, M. & Hunter, M. (2010). The impact of attitudes towards the
menopause on women’s symptom experience: A systematic review. Maturitas.
Barbre, J.W. (1993). Meno-boomers and moral guardians: an exploration of the cultural construction of menopause. In J.C. Callahan (ed.) Menopause: A Midlife Passage. Bloomington: Indiana University Press.
Bartky, S.L. (1999). Unplanned obsolescence: some reflections on aging. In M.U. Walker (Ed.) Mother Time: Women, Aging and Ethics. Oxford: Rowman and Littlefield.
Carmody, J., Crawford, S., Salmoraigo-Blotcher, E., Leung, K., Churchill, L. & Olendzki, N. (2011). Mindfulness training for coping with hot flashes: Results of a randomized trial. Menopause. 18 (6), 611-620.
Chrisler, J.C. & Ghiz, L. (1993) Body Image Issues of Older Women. Women & Therapy, 14, 67-75.
Greer, G. (1992). The change: Women, ageing and the menopause. London: Penguin.
Hunter, M.S. & O’Dea, I. (1997). Menopause: Bodily changes and multiple meanings. In J. Ussher (Ed.), Body talk. London: Routledge.
Joshi, S. (2011) Effect of Yoga on Menopausal Symptoms. In Menopause International. Nagpur, India: NCBI Literature.
Langdridge, D. (2007) Phenomenological Psychology: Theory, Research and Method. England: Pearson Prentice Hall.
Laws, S. (1990). Issues of Blood: the politics of menstruation. Basingstoke: Macmillan.
- S. Lee, J. I. Kim, J. Y. Ha, K. Boddy, and E. Ernst, Yoga for menopausal symptoms: a systematic review, Menopause, vol. 16, no. 3, pp. 602–608, 2009.
Muktibodhananda, S. (1993). Hatha Yoga Pradipika. Bihar, India: Yoga Publications Trust
NHS Choices. http://www.nhs.uk/Conditions/menopause/Pages/Introduction.aspx (Accessed Nov 2016).
O’Grady, H. (2005). Woman’s Relationship with Herself: Gender, Foucault, Therapy. London: Routledge.
Orbach, S. (2009). Bodies. London: Profile Books.
Rostosky, S.S. & Travis Brown, C.B. (1999). Menopause and sexuality: Ageism and sexism unite. In C.B.
Scaravelli, V. (1991). Awakening the Spine. New York: Harper Collins Publishers.
Sergeant, J. (2015). An exploration of women’s identity during menopause: a Grounded Theory Study. University of Roehampton
Travis & J.W. White (Eds.), Sexuality, society, and feminism. Washington DC: American Psychological Association.
TUC (2014). Supporting Working Women Through the Menopause: Guidance for Union Representatives. London: TUC.
Ussher, J. (1989). The Psychology of the Female Body.