What is Menopause?

Chapter One: What Is Going On Inside Me?! Welcome To The Menopause Wild Ride! Or Why Is My Brain On Fire?

The first step to thriving through menopause is understanding what it is and learning to welcome this period of change in our lives.  We’ll cover the physical experience of menopause and get an overview of the most common emotional experiences women have during this time

Not everyone knows what it means to be ‘in menopause.’ General information about what it is and how it can present itself to various women will be outlined. I will define common terms and symptoms. 

 Some historical and current schools of thoughts are presented about how menopause can be managed; such as a more clinical, medication-based approach or a more homeopathic style. Discussions and opinions of these various schools of management are worth identifying to help women know their options. 

Chapter Two: Geez, I’m Hot! And You Are So Irritating!

There are a number of physical symptoms that can be a part of one’s menopause experience including, but not limited to: hot flashes, sleep issues (early waking or insomnia), fatigue, night sweats, irregular menstruation adjustment, urinary challenges, dry skin and hair, painful intercourse, reduced sex drive, vaginal dryness. Sounds like a side effect list from a TV prescription disclaimer commercial, eh? 

While my scope of practice is not in the physical medical field, I will provide information that some women may find helpful for the management of their physical symptoms. I’ll briefly visit the different school of thoughts that propose differing approaches to this life change including;  a more direct medical approach (i.e. hormone replacement therapy to adjust them physically), a more homeopathic approach with herbs and supplements and an approach that reveres the ‘old crone’ approach that this experience is what it is and for women to take their mantel of being a guide for others.

Chapter Three: I Am flaring: Anger, Rage, Irritation

There are  places we go when we are hot and I don’t just mean in our skin and blood pressure. In therapy, we often talk about being ‘flooded’ as Gottman has coined the space where we have left the prefrontal context of our brain and are pounding around in our lizard brain. We can barely receive new information due to us sifting through our impulses to freeze, fight or flee as we calculate the ways we want to pummel someone or something for how much we feel. We may come out swinging or rehearsing how to exact pain on others, as long as we can get away from it ourselves. 

These emotions are varied as they present many subtleties, but the overall experience is tinged with BIG feelings and hot, uncomfortable emotional surges. I will break down anger, rage and irritation. There are more that one can experience, of course, but these three, at least, give some guidance to that family of unpleasant big feelings.  

The tools of Scaling, HALTS and Garden of Values will help others start to identify how to gauge and manage this for themselves. 

Chapter Four: I Am Waterworks: Sadness, Grief, Depression

These emotional experiences have such an array of ways that they show up in us. They are also ones that may be seen by some as signs of weakness or embarrassment, yet they can be constant companions for some of us. 

Sadness is really an emotion that has tendrils of variations (weeping, gutted, longing or nostalgia) but it’s hallmark is that we feel unhappy. Depression is a more complex experience, as it can have a combination of emotions that make up one’s depressive episodes, which can also be physical as well as emotional. One can experience insomnia, anedonia (an experience where things are really ‘meh’, joyless) and weight loss or gain, even aching limbs.

Grief is another complex experience. Looking at Elizabeth Kubler Ross’s and more recently, David Kessler’s work in defining the stages of grief; denial, bargaining, anger, sadness, acceptance and meaning is a useful and needed blue print to help us see where we are in these stages as one goes through the life changing events in menopause. 

I will give examples of how these emotions show up internally and externally for some women in their menopause journey as well as some processing tools including journaling, group work and the benefits from movement and meditation. Women can benefit from the clarity provided here.

Chapter Five: I Am Wincing: Shame, Emotional Hurt/Pain, Guilt, Overwhelm

Experiencing shame, emotional pain, and overwhelm are dark places to end up. We don’t talk about them enough to normalize those experiences so sometimes women get stuck like quicksand. I have many clients who have come to me describing these states of shame and overwhelm and finding great relief in knowing they are not ‘broken’ and they are not alone. I will break down shame as a stand alone physical and emotional experience that is highly personal in how it shows up in all of us. 

Guilt is less insidious than shame in that it is changeable and usually related to an experience or behavior. When we feel guilt and our inner voice says, ‘we did something bad’. It is such a hard place to be stuck in. Emotional hurt/pain are by products of shame and guilt. Then we can get overwhelmed, we have all been there at one time or another when we are awash in emotions and it really sucks. We can feel all of these in our heads and in our bodies.  

Identifying what shame, guilt, emotional pain/hurt and overwhelm look like inside of us is a paramount in beginning to manage it. This chapter I will paint a helpful picture of what these experiences are and some tools, including expectation management and a values exercise, to help process them. 

Chapter Six: I Am Uncomfortable: Anxiety, Self Doubt, Insecurities

Often we find ourselves wiggling in our own skin, and not from the effect of a favorite tune playing, or when experiencing anxiety we keep circling back to the pieces we do know and we can’t finish the loop so, we circle back, again and again. When we go into anxiety, it is not a switch; it is like water flowing in, it can have varying speeds of the rush, but it is there. 

Self doubt can also seep into women’s menopause journeys. Self doubt doesn’t necessarily show up physically, but it does jangle around in our brains. These experiences are all bedfellows. They need to be explained so women can recognize them when they show up inside and outside of themselves. 

This chapter will outline some ways anxiety and self doubt show up and outline what insecurities are and what they can look like bouncing around in our heads.  It is so important for women to feel aware and empowered by this knowledge. These descriptions and tools, such as scaling, assertiveness, a personal Bill of Rights, a personal mantra, among others, will be explored to help women navigate their changing bodies during menopause.

Chapter Seven: I Can’t Think: Brain Fog, Forgetfulness and Cognitive Challenges.

Cognitive challenges are not really considered emotions but, the experiences of struggling with forgetfulness or brain fog can affect our emotions, increasing anger and irritation among other emotional experiences. Identifying and validating these experiences can improve a woman’s mental health. This chapter also addresses the fear many women have during menopause that they are creeping into Alzheimers or Dementia, and provides some resources and approaches to exploring those apprehensions. Tools to help include: Puzzles, a sense of humor, kindness, empathy towards ourselves and mind maps for practical organization. 

Chapter Eight: I Am Still: Grounded, Calm, Content.

While going through menopause, many women feel like their lives are out of control, sometimes inside and outside of themselves. What does grounded look like when we are embarking on a journey that takes our body where we have never been before? The concept of control, knowing what you can and cannot control, is a supportive part of this practice of grounding. I will break down why that is so important. 

Calm—even the word invokes a sense of breathing out and settling. For each of us, finding what helps us feel calm is personal. Our senses are often involved in our individualized experiences around finding calm. I will be laying out the concept of this scale and how it fits individually to us and how a practice of sensory grounding is helpful to adjust that scale within us so we can find calm and control. 

To be content for some may feel like ‘settling for,’ but actually it is about being okay in an experience we don’t have much control over. A lot of contentment is found in expectation management. Identifying what being content looks like is also a personal experience and definition. It will look differently for each person and that is okay. We will explore what that means especially in the changing world of going through menopause. 

I will outline the tool of simple expectation management and future awareness of our hopes in the 2,2,2 exercise, as well as somatic breathing and other exercises to help.  

Chapter Nine: I Am Up: Joy, Happiness, Love

There are a lot of emotions that span the spectrum of ‘good feelings’. This chapter will help define a few that are prominent in our world and need to be identified and celebrated. Joy, Happiness and Love are all powerful, wanted emotional states. 

Joy is a full body experience. We can almost feel joy as we gaze at our loved one, it squeezes our heart. Happiness seems to be a destination as well, a place that means we have finally arrived: “If I could only be happy!” one might lament. Love, who doesn’t seek or crave that. Around us the word of love infuses stories, music, art and food. We seek love, we give love, we live for love. 

I will talk about the ways we identify joy, happiness and love and how they are paramount to our overall sense of contentment in ourselves as we go through these life changing experiences. That knowledge will help the reader to access these enriching emotions as we battle life changes. The exercises I will explore include the Love Languages, a personal playlist and gratitude practices. 

Chapter Ten: I Am Open: Compassion, Empathy, Gratitude and Trust

Compassion, empathy and gratitude are often talked about on social media, but many people may not really know what they really consist of. It is hard to work on improving something if we don’t know what it is. Women in this era of their lives are learning to explore these concepts more than their women elders ever taught them. This chapter will differentiate between empathy and sympathy as well as gratitude and compassion. The concept of trust (in others and ourselves) will also be explored and how it relates to ourselves and others. The tools to help cultivate more of these practices in their lives will be introduced including Kristen Neff’s work in Self Compassion and sensory grounding practices.  

Chapter Eleven: I am Wrestling: Expectations, Perfectionism and Boundaries

All of us are managing expectations everyday with every decision we encounter. As women we have often been led to believe we needed to make others happy or okay before we tune into our own needs. Women going through menopause are learning more about how to advocate for themselves once they know more about these terms and experiences.  In my practice these are the themes that run through client’s everyday experiences. I will define what expectations are and a three tiered approach to help manage them. I will also discuss perfectionism and how it invades our choices and how it shows up as a critical inner voice and can sabotage our plans. Additionally, defining boundaries helps us manage the first two concerns. Tools I discuss will include: expectation management, healthy striving reframing and assertiveness awareness. 

Chapter Twelve: I Am Not Alone - Practices of Empowerment in Menopause

This chapter identifies the Cultivation List. An introduction to external processing exercises organized in themes of the personal practices of self worth, self compassion, self care, self love and self advocacy. Each practice has a selection of exercises that encourage women to unpack their concerns, process their stories, identify their needs and find some resiliency. These are practices we often give to others, worthiness, love, compassion, care and advocacy and now it is our turn to do so for ourselves. 

Some are written and others are thought provoking and psychoeducational (learning about psychology) to help women navigate the  changes of menopause. Some are extensions of the exercises outlined in the section two chapters. These practices can certainly be used in other times or areas of our life but, I outline them here to help others find how their specificity would be useful in a woman’s journey in perimenopause.