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March 7, 2022 by BHP Leave a Comment

Thinking about the menopause in energetic terms

I often have women clients who are going through the peri-menopause or who are post-menopause and I am curious about how I might better support them therapeutically. I want to share some thoughts from a recent talk by Joanna Groves where she invited us to think about the peri- and post-menopause in more practical and energetic terms. The menopause is defined by 12 months without menstruation; on average this happens at 51 years old. The peri-menopause, the period when the sex hormones are reducing, can start from the late thirties to mid-forties and the symptoms can last for 4 or more years after the menopause.

Groves asked us to pay attention to the pressure of trying to maintain ‘normal’ life during a time of physiological and psychological change and to take seriously the stress this places on women’s physical and mental health. She outlines the physiological and psychological changes that occur during the peri-and post-menopause. There are common physiological symptoms including heart palpitations, sweating, sleep problems and fatigue, these are often accompanied by other changes such as food intolerances and sensitivity to alcohol. Along with anxiety and depression there are other psychological symptoms such as memory and concentration problems, confusion and a loss of confidence and self-esteem. The pressure to maintain work, family responsibilities and a relationship and manage everyday crises can become overwhelming, like trying to stop a burst pipe with a teacup and one hand tied behind your back.

The ‘fight, flight or freeze’ response is caused by Cortisol, the stress hormone. Cortisol is produced and managed by the adrenal glands and is a survival response, an alarm reaction to threat or danger. In contemporary life we’re not at risk from predators but we need cortisol to help us deal with an emergency or carry on under pressure. Cortisol helps us keep going partly by repressing non-essential functions such as digestion and the immune and reproductive systems. When the crisis is over or the pressure reduces cortisol levels drop and the body returns to equilibrium. But what if the pressure is continuous and we are in constant crisis? Eventually the adrenals become exhausted and we become energetically depleted, this can result in anxiety, depression, headaches, difficulties sleeping, digestive problems and burn out.

If all that wasn’t enough to contend with. Groves suggests that during the peri-and post-menopause as our emotional resilience reduces; we no longer have the energy to keep difficult emotional experiences supressed. Buried feelings of grief, loss and shame can re-emerge and memories of trauma can resurface. Long established relationships are examined and sometimes break up. What felt safe and secure no longer feels so and this can feel like a kind of madness.

Groves’ advice is to acknowledge that this time is a process of transition that will eventually lead to a new stage of life, a kind of post-menopausal rebirth with renewed energy. She highlights ways to reduce stress and conserve resources during this transition.

One key message from Groves is that ‘energy follows attention’ i.e. what we focus on consumes or generates energy. She invites us to reflect on this through several different aspects:

  • The importance of getting enough rest and sleep, this might mean delegating some responsibilities, reducing working hours and includes sensory rest such as time without a phone.
  • The physical benefits of movement and keeping mobile through activities like walking, stretching, swimming and gardening; movement creates energy.
  • Gut health and nutrition are two aspects that may need adapting, for example reducing the consumption of sugar and alcohol.
  • Relationships and friendships, it helps to prioritise friendships that sustain and nourish and to limit those that are draining. Family and romantic relationships can come under scrutiny and may be revived or changed irrevocably.
  • Finally Groves emphasises (self) compassion, this might include physical and/or holistic treatments, new creative experiences, practices such as meditation and psychotherapeutic support.

At the same time as outlining these practical approaches, Groves acknowledges that in a culture driven by productivity and achievement attempts to cut down responsibilities and become less productive may feel like ‘weakness’ or ‘failure’. Women in my practice have asked – if I can’t do what I used to do what am I good for – and said – I feel worthless like there is no place for me.

On a more positive note Groves identifies a paradigm shift around the menopause. It is not just women that go through this transition but those who accompany them, friends, colleagues, parents and especially partners and children. Hopefully by welcoming a wider range of experiences including accounts from transgender women we might develop ways to support and improve life transitions for us all. Meanwhile, as therapists we can offer a conversation to help understand and contextualise what is happening to those who find themselves at the centre of this particular life transition.

 

To enquire about psychotherapy sessions with Angela Rogers, please contact her here, or to view our full clinical team, please click here.

Angela Rogers is an Integrative Psychotherapeutic counsellor working with individuals and couples in Hove.

 

Further reading by Angela Rogers –

Poetry: A space to ponder

Relax: Watching people using their hands

What is Andropause and what happens to men when their testosterone levels decline?

Am I cracking up or is it my hormones? Pre-menstrual Dysphoric and the importance of tracking symptoms

Viagra for women? Medical treatment for women’s sexual problems focuses on the brain rather than the genitals

Filed Under: Ageing, Angela Rogers, Relationships Tagged With: Ageing, anxiety, Menopause

October 18, 2021 by BHP Leave a Comment

What is the Menopause? (part two)

The historian Susan Mattern argues there is no doubt there is some value to naming menopause as a concept. It has provided women with reasons and different perspectives and interventions on what can be sometimes very distressing symptoms. However she points out that modern medicine can have a tendency to locate cause and explanation inside the body vs society and environment.

Mattern writes – “for most of human history, people have seen menopause for what, as I argue, it really is: a developmental transition to an important stage of life; not a problem, but a solution”  (2019, P. 6).

Mattern holds a space for the menopause (what she depicts as a post-reproductive period) as a significant life stage and essential for human flourishing. She argues that for much of human history menopause was not really considered a problem to be treated, and where it was considered it rarely had such negative connotations as it does today. She argues that for many this transition in life can be one of vigour and expansiveness. She uses the metaphor in the title of her book ‘The slow moon climbs’ as aligned with this phase of life.

In terms of historical and cultural meanings and understandings it does seem that our ideas around women’s experiences of menopause has definitely shifted over time. According to Mattern (2019) it is only in the modern era we have considered and discussed the menopause as a syndrome in need of medicalisation. She explores the influence of culture in the experience of menopause today and how the medicalisation of women’s menopausal experiences emerged.

Her book traces a plethora of historical aspects including evolutionary, philosophical, psychological and cultural understandings around the menopause and how meanings have changed.  She gives insight about evolutionary theories of menopause, the role it has played in human society and strategies around reproduction and more general aspects of human society. She also dives into how modernisation has altered our experiences and notions of menopause quite dramatically. In my opinion it is a book packed with fantastic information and well worth a read if you are curious.

There are many aspects in both peri-menopause and menopause that can greatly impact our lived experience. This does not always have to feel detrimental. In some of my research many women have found it a liberating sexual experience whilst also struggling with some aspects. Often there are many different factors and impacts within the menopausal experience: physical, psychological, social, sexual, political, cultural and spiritual. Frequently they can feel like they are in conflict.  Not knowing whether you should treat it medically or not can leave us at best feeling confused, at worst it can sometimes disrupt our whole lives in terms of its effect on personal relationships and work dimensions.

Whatever route you choose and whether you want to seek medical support, psychological support or just better understand the transition through your own enquiries, therapy can be a space to do this. I feel many transitional experiences can be incredibly meaningful and transformative despite the challenges they might bring. It can invite us to explore, challenge and question our beliefs and expectations and change how we feel, think and relate to ourselves and the world.

To enquire about psychotherapy sessions with Susanna, please contact her here, or to view our full clinical team, please click here.

Susanna Petitpierre, BACP Registered, is an experienced psychotherapeutic counsellor, providing long and short term counselling. Her approach is primarily grounded in existential therapy and she works with individuals.  Susanna is available at our Brighton and Hove Practice.

Further reading by Susanna Petitpierre

What is the Menopause? (part two)

What is the menopause? (part one)

Some existential musings from the sea

Nietzsche and the body

Why read Nietzsche?

Reference – 
Mattern, S. (2019 ’The Slow Moon Climbs’ The Science and History, and Meaning of Menopause. Princeton University Press: Princeton & Oxford.
 (Book tracing historical and cultural understandings of this life stage.

Filed Under: Ageing, Society, Susanna Petitpierre Tagged With: age, Ageing, female health, Menopause

October 4, 2021 by BHP Leave a Comment

What is the Menopause? (part one)

I found myself being asked ‘what is the menopause?’ by a friend’s 13 year old son a few weeks ago. All the women in the room chimed in to answer. It was not surprising to me that he asked, nor was it surprising all the women answered. Interestingly I had no idea about the menopause at his age and I had absolutely no clue about peri-menopause until I was in my mid 30s. However, I found myself wondering how much louder the conversation seemingly is right now than when I was his age.

It does seem that the terms menopause and peri-menopause have become widely discussed in the media and medical world recently. In my experience, this does not always translate to it being more understood. It can be incredibly helpful to know discussions are happening as this can normalise the experience, conversely it can leave us feeling more adrift, especially if we find we are not fitting into any standardised categories or stories.

It led to me writing two short pieces (part two will be published at a later date). Both aim to provide a little portion of food for thought about the concept and possible options for personal explorations around the menopause. In my mind, there is no right or wrong way to consider or act in terms of the menopause, it is whatever feels right for the individual.

Medically the menopause is depicted as the final menstrual period (FMP). This is confirmed after one year of menstrual period. Typically it occurs around 51 years old, however UK statistics show this can vary between 44 and 55 years. One in 100 women can experience menopause before the age of 40 (often due to medical interventions).   The peri-menopause is a term used to depict another transition stage before the menopause whereby the ovaries start to make less oestrogen. This typically starts around 40 and can last between four and eight years.

Some people assume the menopause is a medical problem and prefer to manage it with drugs. Medical interventions can be a very positive experience. However, for others this is not always possible or perhaps how they want to relate to this life stage.

Some feel it is best to be with the experience, whilst others want to use alternative routes. Some might see it as an opportunity to face up to changes in their life span and ageing processes and some might not see it as a problem all all.

Whatever your choice or position there are some brilliant options, discussions and spaces which can support women going through these transformations (see some options in the links below).

I feel it is definitely worth exploring all the options and finding out what feels right for you. Therapy might be a space to do this. For me, it is also important to consider that we cannot always place the responsibility on the individual and it is worth considering how history and culture has impacted the medicalisation of these transitions and consequently how and what we think, feel and experience in terms of this life stage. If you are interested in this then you might want to read part two.

To enquire about psychotherapy sessions with Susanna, please contact her here, or to view our full clinical team, please click here.

Susanna Petitpierre, BACP Registered, is an experienced psychotherapeutic counsellor, providing long and short term counselling. Her approach is primarily grounded in existential therapy and she works with individuals.  Susanna is available at our Brighton and Hove Practice.

 

Further reading by Susanna Petitpierre

Some existential musings from the sea

Nietzsche and the body

Why read Nietzsche?

Magnificent Monsters

Death Anxiety

Potentially useful resources:
https://balance-app.com (menopause experience tracking support app)
www.menopausematters.co.uk
www.rockmymenopause.com
The menopause charity.org
https://www.menopausedoctor.co.uk
https://www.menopausecafe.net
https://www.mamaheaven.org/menoheaven-retreats

Filed Under: Ageing, Society, Susanna Petitpierre Tagged With: Ageing, female health, Menopause

October 5, 2020 by BHP Leave a Comment

What is Andropause and what happens to men when their testosterone levels decline?

Schools will soon have menopause on the curriculum. Largely due to the efforts of psychotherapist Diane Danzebrink and her #MakeMenopauseMatter campaign. In 2019 Education Secretary Damian Hinds confirmed menopause will
become part of the Sex and Relationships curriculum for teenagers in the UK in Autumn 2020 alongside periods and pregnancy.

With the recognition that menopause needs to be better understood in the broader context of sex and relationships perhaps now we can begin to talk about men’s experience of changes in their hormones. Testosterone is the main sex
hormone (androgen) in men and the symptoms that men can experience as a result of reduced testosterone are called andropause. The hormone testosterone plays a role in the production of sperm, in the drive to have sex, in building muscle and bone mass, in the way fat is deposited around the body, in the facial and body hair patterns found in males and their deeper voices.

Men will experience hormonal changes as they age, levels of testosterone will start to decline from around 30 at approximately 10% every decade. It is important to note that testosterone reduction can also be affected by other
factors such as injury, cancer treatments, medication and chronic conditions including diabetes, obesity, kidney and liver disease. Symptoms include a lower sex drive, loss of body muscle and an increase in body fat, decrease in bone
density, fatigue, insomnia and difficulty attaining and maintaining erections*.

From research by the Centre for Men’s Health Clinic in Manchester, looking at men over 50 in the UK, Dr Malcolm Carruthers says: “Of the ten thousand men surveyed actually 80 per cent had moderate or high levels of symptoms suggesting they had testosterone deficiency. This shows that its not the rare condition that some doctors claim but actually its very common and almost totally untreated.”

Symptoms described by two patients attending the clinic and suffering from low testosterone, defined as Testosterone Deficiency Syndrome, share features with women’s accounts of menopause.

“Well I was 55 or there abouts and I was getting perspiration in my shirt and was getting really wet, I’m talking serious perspiration, tiredness and I had a lot of muscle aches particularly in my legs”.

“I was a fishing skipper for 23 years and was the type of person that woke up in the morning and rolled out of bed and was on the job, something to do” …  Then when I reached the age of 55 I began to feel that I was flagging and I got all sorts of strange to me symptoms, aches, pains, horrendous sweats and uncontrollable temper.”

What about the mental and emotional aspects of andropause? We need to acknowledge and better understand andropause and the impact on men and their lives and relationships. Symptoms of andropause include mood swings,
irritability, low-self esteem, memory and concentration problems and depression. These are familiar menopausal symptoms for women, however it may be harder for men to acknowledge these symptoms and to ask for help
because they are associated with female menopause.

 

Angela Rogers is an Integrative Psychotherapeutic counsellor working with individuals and couples in Hove.

 

Further reading by Angela Rogers –

Viagra for women? Medical treatment for women’s sexual problems focuses on the brain rather than the genitals

New Year’s Resolutions – Why change might be so difficult?

Viagra: Some ups and downs of the little blue pill

The Menopause – Women of a Certain Age

 

References –
Diane Danzebrink
https://twitter.com/hashtag/makemenopause

Centre for Men’s Health Clinic
Associated Press Television 11.3.2011
https://youtu.be/33aCzR4U9l4

*See an earlier blog about men’s use of Viagra here.

Face to Face and Online Therapy Help Available Now

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Filed Under: Ageing, Angela Rogers, Relationships, Sexuality Tagged With: men's issues, Menopause, sexuality

March 12, 2018 by Brighton & Hove Psychotherapy Leave a Comment

The Menopause: Women of a Certain Age

For many women in the 21st century, the menopause leads to a sense of freedom, independence and creativity. Of course, I want to celebrate this, but I also want to talk about less welcome aspects. Culturally, the menopause is still somewhat feared and is something of a taboo. It is also open to derision and often referred to with euphemisms or jokes.

Sharing the experience

Things might be changing. Recently, a few women celebrities have used the media to share their physical and mental struggles through several years of the menopause. I believe that sharing these experiences publicly is especially important in a culture that does not take the reality of the menopause seriously. Think about the photographs of post-menopausal celebrities on the front pages of women’s magazines, looking glamorous with their obligatory bobbed and highlighted hair, subtle yet sexy make-up and carefully co-ordinated outfits. I do not want to dismiss women’s aspirations for wanting to look good at any age, but the demands for women to look sexually attractive can be punitive. The hostility Mary Beard received for appearing on television apparently unmade-up and with her hair worn long and grey is telling.

Physical symptoms and emotional wellbeing

Physiologically, the menopause is the cessation of menstruation and is medically defined as one year with no bleeding. Other physical symptoms include hot flushes, night sweats and insomnia, dry skin and hair and weight gain. We are likely to feel less sexually attractive, whatever our sexual orientation. There may be a drop in libido and physical changes in the vagina can make sex difficult or painful.

Fortunately, there are hormonal and medical interventions that can treat these physical symptoms with some, but not complete, success. Along with the physical changes in our bodies, psychological symptoms related to the menopause can affect our emotional well-being and leave us feeling vulnerable. Changes in how we experience ourselves, such as being unusually grumpy or depressed, voicing our frustrations or losing our temper can be disconcerting and make us wonder if we are going a bit crazy. This is especially so in a culture where women are rewarded for being nice, kind and caring.

The menopause, life events and relationships

The physiological and psychological effects of the menopause coincide with inevitable life events for women in their 40s and 50s. These include decreasing fertility and the end of child bearing or the hope of ever giving birth. In an age of increased life expectancy, the hope of having time in later to do what we have always wanted may vanish as we see ageing parents need care and support. It is also a stage in life when children leave home, another kind of painful loss that can throw the focus onto the dissatisfactions of a marriage or partnership. Long-held resentments towards a partner can be a factor in a lack of sexual desire. If both partners feel less interested in sex, a less active sex life is part of growing older together. However, clinical research tells us that a decrease or cessation of sexual desire and sexual activity is one of the most pressing and distressing concerns for menopausal women (Kolod 2009). It is probably the most difficult to talk about because of a sense of shame and a feeling the situation is hopeless. Depression is an understandable result. For women not in relationships or without children, or affectionate children, the menopause may be an acute reminder of the lack of an intimate or physically loving relationship.

How counselling and psychotherapy can help

Exploring these questions in a safe and supportive environment is a chance to think about and express the experience of the menopause without judgement. In this setting, losses, regrets and unrealised dreams can be grieved without recrimination. Working with a counsellor or psychotherapist can help us come to terms with these physical and social changes and lessen the emotional distress and negative impact on daily life. It is an opportunity to look at what getting older means for us and the choices and freedoms we have to live our own futures.

Reference: Susan Kolod (2009) Menopause and Sexuality, Contemporary Psychoanalysis, 45:1, 26-43, DOI: 10.1080/00107530.2009.10745985

Angela Rogers is an Integrative Psychotherapeutic Counsellor working with individuals in Lewes and Hove.

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Filed Under: Angela Rogers, Psychotherapy, Relationships, Sexuality Tagged With: Counselling, Menopause, Psychotherapy, Relationships

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