Menopause is a healthy and natural part of a woman's reproductive evolution. Yet, in the United States, menopause is steeped in negative stereotypes, and many women anticipate menopause with trepidation.1

However, research suggests that menopause is a highly individualized experience, determined in part by the attitudes and beliefs a woman holds about this transition. In fact, many studies show that a woman can improve her experience, and reduce symptoms, simply by exploring a new, more positive menopause mindset.1-3

What is menopause?

Menopause marks the natural end of a woman's menstrual cycle and fertility. By definition, it occurs after you've gone a year without having a period. Beginning in your late 30s, your ovaries start to produce less estrogen and progesterone – the hormones that regulate your menstrual cycle. Over time, these two hormones continue to diminish, your ovaries eventually stop producing eggs, and you stop having periods.4,5

For most women, menopause occurs between the ages of 40 and 58, with the average age in the United States being 51.4,5

Menopause experiences vary widely

Each woman's experience in the months or years leading up to menopause – called perimenopause – is different. Menopause symptoms vary across cultures, ethnic groups, and socioeconomic status. For example, women from Japan and the Indian subcontinent are much less likely to report having hot flashes than women in the United States and Europe.6

This may be attributed, in part, to differences in how these cultures view menopause, as well as differences in diet and lifestyle. The takeaway from all this? There is not one "universal" menopause experience. Instead, your menopause will be determined by the interaction between your unique biology, your culture, and your personal outlook.6

Some women only notice the eventual cessation of their period, while others experience a variety of physical symptoms, including:

  • Menstrual cycle changes. Periods can last for fewer or more days than usual. You will likely begin to skip periods for a month or months at a time. The blood flow during your period can become heavier or lighter.4,5
  • Hot flashes. A hot flash is the sudden feeling of heat or warmth in your body, with or without sweating, reddened skin, or a rapid heartbeat. Hot flashes usually last about 1-5 minutes.4,5
  • Night sweats. These are hot flashes that occur at night and usually interrupt your nighttime sleep.4,5
  • Vaginal atrophy. Thinning of the vaginal tissues can cause vaginal dryness, soreness, or burning, and discomfort during sex.4,5
  • Changes in mood and cognitive function. Some women report mood swings, feeling irritable, anxious, or distracted, and short-term memory problems. Women in perimenopause are also more likely to report feelings of depression. It's unclear whether these symptoms stem from changes in hormone levels or whether they are a consequence of other factors. For example, night sweats might cause loss of sleep, which leaves you feeling irritable and foggy, and can increase your risk for depression. Other stressful experiences common to midlife – caring for aging parents, being an empty nester, or health and body image issues – can also play a role.6

Why mindset matters

Your thoughts have power. In a number of studies, researchers found that women who viewed menopause in more negative terms reported more frequent and severe physical symptoms; whereas women who viewed menopause in a more positive light reported fewer and less severe symptoms.2,7

Of all the factors that influence menopause, you have the most control over your personal outlook. Fortunately, positivity and resilience – the ability to adapt to life's changes – are acquired skills that anyone can develop.8

Cultivate a more positive menopause mindset

 To foster positivity about menopause and resilience, try the following:

  • Practice mindfulness. Mindfulness is the intentional act of paying attention to the present moment, without judgment. During a mindfulness practice, you are encouraged to notice and accept your thoughts and feelings without trying to change them. Over time, mindfulness helps you reduce stress by improving your ability to accept change and keep things in perspective. In a recent study of perimenopausal women, those who had higher mindfulness scores reported fewer menopausal symptoms.In a smaller study, women who completed an 8-week mindfulness-based stress reduction (MBSR) course reported a 39-percent reduction in hot flash symptoms.9
  • Focus on the positives. Finding gratitude in any situation takes practice. Start by identifying how menopause positively affects you. For example, many women find freedom in the cessation of their menstrual periods. To acquire a more hopeful outlook, keep a daily gratitude journal in which you write down the things you are grateful for.
  • Work toward a goal. Menopause symptoms can be unpredictable. It might feel as if your life and body are out of control. Taking action toward a personal goal can be very empowering. Whether you choose to cultivate a hobby, pursue an interest, volunteer with a local organization, or join a social or civic group, even small accomplishments can have a big impact on your health and wellbeing.
  • Connect with others. Having close relationships to rely on help you get through tough times. Commit to being present with your partner and loved ones. And remember, you are not alone in this transition. Talk to other women and your family members about your experience. Sharing your truth is important in its own right, and discussing menopause with others can help lift its social taboo.
  • Practice self-care. Everyone is different, and self-care can take many forms. Take time to accept your body, your feelings, and your needs. Then give yourself permission to do something for yourself. Say no to a commitment? Exercise? Take a nap? Relax in a warm bath? Eat a healthy snack? Schedule time with a friend? They are all on the table.

Cognitive behavioral therapy (CBT) with a licensed mental health professional can help you challenge and reframe negative thought patterns.10 CBT is a widely used type of individual or group counseling and is recommended by the North American Society for Menopause as an effective treatment for hot flashes and night sweats.11 In one study, women who participated in eight hours of CBT reported a 50-percent reduction in hot flashes and night sweats – which is about as effective as hormone replacement therapy.6

Your next chapter

Remember, you don't have to let society dictate what menopause means for you. Instead, use these transitional months or years as an opportunity for self-discovery and personal growth. By working now to reshape your views around menopause and aging, you also reshape the possibilities for this next chapter of your life.


References

  1. Ayers B, Forshaw M, Hunter M. The impact of attitudes toward the menopause on women's symptom experience: A systematic review. Maturitas 2010;65:28-36.
  2. Sood R, Kuhle C, Kapoor E, et al. Association of mindfulness and stress with menopausal symptoms in midlife women. Climacteric 2019;22:377-382.
  3. Pérez-López F, Pérez-Roncero G, Fernández-Iñarrea J, et al. Resilience, depressed mood, and menopausal symptoms in postmenopausal women. Menopause 2014;21:159-164.
  4. Menopause. Mayo Foundation for Medical Education and Research. https://www.mayoclinic.org/diseases-conditions/menopause/symptoms-causes/syc-20353397. [Accessed October 2, 2019]
  5. Menopause 101: A primer for the perimenopausal. The North American Menopause Society. http://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/menopause-101-a-primer-for-the-perimenopausal. [Accessed October 2, 2019]
  6. Hunter M, Rendall M. Bio-psycho-socio-cultural perspectives on menopause. Best Pract Res Clin Obstet Gynaecol 2007;21:261-274.
  7. Make your menopause a positive experience. The North American Menopause Society. http://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/make-your-menopause-a-positive-experience. [Accessed October 2, 2019]
  8. The road to resilience. American Psychological Association. https://www.apa.org/helpcenter/road-resilience. [Accessed October 2, 2019]
  9. Carmody J, Crawford S, Churchill L. A pilot study of mindfulness-based stress reduction for hot flashes. Menopause 2006;13:760-769.
  10. Faubion S. The Menopause Solution. A Doctor's Guide to Relieving Hot Flashes, Enjoying Better Sex, Sleeping Well, Controlling Your Weight, and Being Happy!; Rochester, Minn. Mayo Foundation for Medical Education and Research; 2016;184.
  11. Hickey M, Szabo R, Hunter M. Non-hormonal treatments for menopausal symptoms. BMJ 2017;359: doi: 10.1136/bmj.j5101.