It was November 2016 and I had just spent the weekend on a yoga retreat. I was sitting with a friend on the Sunday evening on our journey home and we were discussing how our menstrual cycles had changed. I had turned 40 earlier that year, the change had been sudden and quite dramatic. Once a month it have started to feel like the flood gates had opened for two days and my friend was having the same experience. It didn’t occur to me then, that this was the beginning of my perimenopause journey.
Then 18 months ago I began to ache all over. Joint and muscle pain which was not related to the exercise I was doing or the days I was more sedentary. As it continued, I started to wonder if it was a form of arthritis. Alongside these symptoms, I would sometimes have a feeling over being overwhelmed, low mood and often suffered with brain fog or memory loss. Another change was bloating and digestive issues, I had always had a relatively health diet as a vegetarian and something else had changed. As a yoga teacher I felt I was in tune with my body and knew it well. This myriad of symptoms was off putting, as I began to investigate, everything pointed to symptoms of the menopause.
Every individual cell in a woman’s body contains an oestrogen receptor. So, as oestrogen levels start to fluctuate in perimenopause, it affects the whole body. Oestrogen helps to regulate mood, body temperature, maintains memory and menstrual cycle, lubricates the vagina and protects the arteries. Progesterone and testosterone levels also begin to fall at this time, affecting menstrual cycle, sex dive, bone growth and strength as well as muscle mass.
Managing my symptoms took trial and error. Ensuring I had a daily yoga practice which sometimes meant 5 minutes of breathing or 10 minutes in relaxation was imperative. Hatha, restorative and yin yoga is most beneficial at this stage in a woman’s life. I found turmeric helped with joint and muscle pain and began to add it to as many dishes as possible. I changed my eating habits, only eating from 10am until no later than 8pm, to allow my body more time for digestion (This can be adapted to a woman’s lifestyle and the hours they work). I started to make sauerkraut to support that process as well, during the fermentation process it produces probiotics which aid digestion. Also, I began writing a diary to ascertain what foods affected my digestion as well as recording my sleep and generally wellbeing. I began to make the connections between refined carbohydrates, caffeine and alcohol with my mood and how I was feeling. Alcohol definitely didn’t help aching joints and a regular bedtime and wake time became a key component to feeling ‘better’. A diary or journal could take the form of drawings, bullet points or voice memos on your phone. The Balance app designed by Newson Health is an easy one to use to track symptoms and your cycle.
Many women describe the need to retreat, to go and hide away from the world as they venture through perimenopause. If you look back historically, women would reach the menopause (medically defined as 12 months with no periods) and would not live much longer. These days women have 20 – 40 years post menopause, therefore finding support is imperative. However, as women we are often the carers; looking after ourselves tends to be at the bottom our list. Finding and making time for ourselves can often be a luxury however carving out a little bit of time for ourselves for self-care is necassary we navigate the menopause years.
Most recently I’ve been getting up earlier in the morning to ensure I get 15-30 minutes of peace before the day starts. This is when I make it to my yoga mat and often simply lie there supported by some props. Finding 5 minutes in your day can be beneficial whether that become a walk round the block or some time to meditate or consciously breathe. Something I discovered recently is that when women come together oxytocin and serotonin (happy hormones) are released. Connecting with friends to talk is also advantageous. Difficult in covid times but a phone call or video call can have the same effects. I found a 20 minute brisk walk each day also helped when I was feeling lethargic or fatigued and this can be an ideal time to ‘talk & walk’ with a friend.
Each woman’s experience is unique, as the combination of symptoms is unique. NICE guidelines recommend that each woman should be treated individually according to her symptoms. These can include headaches, migranes, dizziness, anxiety, poor memory, low mood, irritability, mood swings, insomnia, bloating, weight gain, digestion problems, hot flushes, night sweats, palpitations, pain and/or enlargement of breasts, dry skin, itching, sore joints, stiffness, osteoporosis, back pain, incontinence, hair dryness / thinning, shorter or longer menstrual cycles, bleeding between periods, vaginal atrophy, vaginal dryness and painful sexual intercourse.
Yoga helps to support so many menopause symptoms including bone health which is imperative as the risk of osteoporosis is higher with the reduction of oestrogen. Forward folds (i.e uttanasana) stimulate the endocrine glands and allow the mind to become calm, stimulating the parasympathetic nervous system. Baddha Konasana (bound angle pose) strengthens the bladder and uterus easing perimenopausal symptoms. Supported Adho Mukha Svanasana (downward facing dog) with a bolster or brick under the forehead helps to relieve hot flushes, as do salamba sarvangasana (supported shoulder stand) and halasana (plough). Back bends stimulate the thyroid and adrenal glands, improve circulation in the pancreas and relieve pelvic congestion (i.e dhanurasana/bow pose). The list is endless and with some homemade props out of pillows, cushions and books, many are easy to practise at home. The props allow the body to soften into the asana, assisting the nervous system and offering support which is something all women need to feel during this time. A sense of being held, helped and aided through this transition.
Hormone Replacement Therapy (HRT) received adverse publicity after a WHI study was published which is now recognised as flawed. Dr Louise Newson explains why that initial study was flawed in her paper published in 2016, Best practice for HRT: unpicking the evidence, for the British Journal of General Practice. The study was not representative of all women, the various stages of the menopause and it was conducted using a form of HRT no longer used. There has since been a WHI apology published as it has been the cause for many women not taking HRT and thereby not benefiting from it. However, there are still women that HRT will be contraindicated for and so it is essential to speak to your GP about your options.
There is no one way ‘fits all’. Yoga, making subtle changes to your diet to improve nutrition, reducing stress, using herbal remedies and taking supplements can all have beneficial effects. Most importantly ensure you see a trained professional when investigating natural or herbal remedies.
I still have long journey ahead; I am under no illusion that I may have to change my plan of action before I reach the menopause, as I experience new symptoms. Being informed has definitely made me feel ‘armed’. Knowledge really is power when it comes to your menopause journey. Bringing women together to share their experiences and enable a sense of camaraderie is important. This was emphasised on my #menopauseyoga teacher training as 24 yoga teachers came together to further their yoga knowledge. We were all at various stages of our menopause journey, by sharing our experiences and what was or had supported our symptoms, we were able to support and help each other .
I’m grateful for my personal yoga practice and after hosting my first Menopause Yoga Workshop at the weekend, know I can facilitate more connections and hopefully support many other groups of women. I’m looking forward to hosting more Menopause Yoga Workshops and classes soon and collaborating with other healthcare professionals to bring women together to support one another.
