I can help you chill out about the menopause

The menopause is getting more attention recently and as a culture, we are beginning to expect more openness about symptoms, personal experiences and treatment options. It’s great for us to have more access to this information-but I often get asked about what actually helps?

There can be a message which women receive about the general time of mid-life being a one of poor physical and emotional health. And for women who are approaching perimenopause or in perimenopause, it can bring up some feelings of concern about the often published and talked about unpleasant side effects. In fact, research in the Menos trials showed that women who had negative beliefs and expectations prior to going into the menopause transition had a more difficult experience of menopause.

What isn’t talked about so much is the increased self-actualization and confidence that women feel they connect with at this time. I’ve worked with women from so many varying backgrounds and experiences who come to view this time as one to re-evaluate core values and more easily prioritise new interests, and increased health, fitness and self-care.

Medical treatments for menopause

For hormonal treatment, HRT is the gold standard option for many women who need to mitigate the effects of decreased estrogen. NICE guidelines also state that HRT should be prescribed at the lowest possible dose for the shortest possible time, and require an annual review by the prescriber.

Prescriptions for HRT have increased hugely over the last year or so since the Davina McCall programme and the wider open discussions about HRT options. However, HRT may not be the magic bullet for everyone. It may take some time to try different HRT preparations before you and your doctor find the most suitable HRT and dose for you, so there is a bedding in process which may take weeks to months.

It is also not appropriate for all women to take HRT for various reasons including
for women who have had certain types of breast cancer. Some women would prefer a non-medical approach altogether. There can also be other medicines which may be an option if HRT is not suitable including anti-depressants, all of which require medical assessment and consultation.

It’s a good idea to have a consultation with your GP and/or menopause specialist nurse to get personalised care on your individual circumstances and options, but also to ensure that symptoms we may presume are due to menopause are not attributable to something else.

CBT and clinical hypnotherapy

CBT (Cognitive Behavioural Therapy) is recommended in the NICE guidelines as a non-hormonal treatment option, which may be helpful for hot flushes and night sweats. It involves looking at the significant link between thoughts, physical reactions (such as hot flushes), behaviours and feelings and how these work in a cycle, sometimes call the vicious cycle.

By becoming aware and modifying thoughts, we can set off a new cycle which is more healthy and where the client is more in control - a virtuous cycle. The CBT approach I use, which is informed by the British Menopause Society teaching, uses a biopsychosocial approach, meaning it looks at how physical health and emotional health interact.

It involves a good deal of psychoeducation, providing evidence-based information and dispelling myths that we might have been holding onto, as well as teaching coping strategies to improve physical and emotional health. This approach moves the woman from a passive recipient of medical care, into learning strategies to self-manage the experience of menopausal symptoms and
mid-life to feel more empowered.

The North American Society of Menopause recommends both CBT and Clinical Hypnotherapy for non-hormonal management of menopausal symptoms. It should be noted that in the USA clinical hypnotherapy is delivered by a healthcare professional which differs from the British hypnotherapy training requirements. It is felt that the combination of deep relaxation and suggestions in relaxation enable women to begin to create new ways of responding to menopausal symptoms which are more adaptive and less reactive. Working together I can guide you to feel more empowered and calm so that you’re able to:

• be more aware of when flashes or brain fog occur
• feel more prepared and in control in those moments
• understand the science behind sleep and manage insomnia
• manage low libido and low energy
• manage the feeling of overwhelm at work or at home

By offering a combination (or a choice) of these therapies I can support you through this time of transition. It also gives you the regular, repeated, protected time to explore your thoughts and feelings around this time of your life, and the physical changes you may be experiencing.

It’s important to remember that mid-life is a transition and a change process. Any change management needs time, support, motivation, knowledge and review/reflection. I would generally suggest six sessions, and for many, this is a good number to see positive change. However, everyone is different and some women will want to spend more time on this process.

If you are approaching midlife, it can be a good idea to have some sessions to prepare for how you would like to plan for your future health and lifestyle. If you find you’re in the middle of menopausal side effects, or just want to re-evaluate your mid-life choices, please get in touch, I know I can help and I’d be delighted to support you. There's every reason these could be some of your best years yet.