Menopause & Me
Croeso –
Welcome
This talk is
all about my journey through menopause and passing on all the things that I
have learnt - either through personal
experience, academic research or simply asking Google….
For those of
you who don’t know me, my name is (now) Rachel Hubbard, and I have been
involved in the fitness industry since way back when, where Jane Fonda was the
Queen and leg warmers with the latest gymshark kit.
Over the
years, my teaching has evolved and changed as I changed…this small part belongs
to my later career from about 2005 to this day.
I hope that
what I discuss with you over the next 45 minutes will be of some interest. Like
many of you, I really feel that menopause is almost like the dirty secret that
was once mental health – but we know things can change and with a huge increase
in the number of females over 50 now in the workplace, there is a growing need
to be able to talk about these issues freely.
In 2015 a
government statistical paper indicated that whilst only 16.9% of women over 50
were still in the workplace – this has now grown to 78.3%. Changing to how women are becoming more
independent, alongside the more worrying lack of pension and having to work
extra in order to be able to survive.
It is
therefore becoming more of a topic of discussion – cos lets face it, for many,
menopause is tough. It is tough for the woman, for their partner (who also
might be a woman of a similar age), families and work colleauges. There are currently around 3.5 million women
in the workplace over the age of 50, and 1 in 4 experience such bad symptoms
that menopause is soon to be classes as a disability where
You're disabled under the Equality Act 2010
if you have a physical or mental impairment that has a 'substantial' and
'long-term' negative effect on your ability to do normal daily activities.
Given that
menopause can last 4 – 10years, then this meets the criteria.
Back to me
though – so why, at the age of 45 did I do a dissertation based on motivation
to exercise for peri and post menopausal women?
And to begin
that story, I need to go further back to when I was a Personal Training and
energetic class tutor – in particular, please note that I used to teach and
“easy” aerobics class on a Monday lunchtime called 35+…ahem, in the days when
over 30 was quite frankly…old. And how I got to do my degree…
I had been
drawn to further study, although not pursuing a degree, but my frustration at
the time of people who wanted to exercise, but simply did not make the changes
– and even worse, made me feel, or I made myself feel, that it was my “fault”
that I didn’t inspire them enough.
I therefore
started by simply taking the psychology modules of the degree – from first year
through to third year, and trying to understand what motivates people
At the end of
doing all of the module I enjoyed, a friend, who worked in the academic office
mentioned that I had enough points to already be half way through my degree and
she quite frankly “bullied” me in the nicest possible way…to go for it and
complete the thing.
At the end of
the course, and in order to get your “BSc” you have to complete a substantial
piece of work ( over 30,000 words and mine was nearly 60!)on one particular
subject. It was a given that mine would be psychology based (and I nearly did a
masters…) and so I thought about something that would also be very useful to my
job.
Back to the
over 35’s aerobics section…
Many of the
women in the group were of a similar age and were friends together, and so they
all started to have symptoms around the same time, and would give me the “look”
and say, “you too will have this”. They
would complain about the physical symptoms, the sweats, the lack of energy, but
very little about the mental health side of things. But they started to stop coming. I will come
back to this.
On the other
hand, I also had a group (4) of women of the same age who had booked me to be
their PT because they knew their body was changing and they wanted to stop the
“middle aged spread” – say red dress.
And so the
dissertation came to be – and as you know, for any part of the dissertation,
you have to start with a literature review. Which I did, but it still didn’t
resonate with me. I kept thinking, menopause sounds a bit like normal life –
irritable, putting on weight, not being able to sleep – and only the hot
flushes being something different.
The correct
name for the menopause is the “
)The transitional period of the menopause, where we start to see hormonal
fluctuation, can last for many years, and may be referred to as the
“climacteric” period (Green, 1976). This transitional phase can begin from as
early as 30 years old, with 51.4 years being considered the mean age for
menopause in western women and in general, most women will have completed the
menopausal transition by the age of 60 (Ouzounian and Christin-Maitre,
2005).
Climacteric is
the period of life starting from the decline in ovarian activity until after
the end of ovarian function. According to the definition, the period includes
peri-menopause, menopause and post-menopause.
Quote from my dissertation
The menopause is triggered by a gradual reduction of
hormonal level due to the failure of the ovaries to produce sufficient
oestrogen. This can be attributed either to natural causes such as the process
of follicular atresia (or the breakdown of ovarian follicles which results in
less egg cells) or to external factors such as hysterectomy or chemotherapy
(Greene, 1976). The symptoms associated with the fall in oestrogen can be both
physical and/or psychological and can vary in both range and severity from
person to person (Ballagh et al., 2008). Increased general irritability,
anxiety and mood swings and possible depression are some of the early
psychological markers of the menopause (Ballagh et al., 2008). There are
both general somatic symptoms of increased headaches, dizziness or joint pain
along with the more distinctive vasomotor symptoms associated with this period
such as night sweats and hot flushes (Ballagh et al., 2008). Hot flushes are a common complaint of
menopause and are distinguished by the sudden sensation of heat, ranging from
warm to intense that is often accompanied a burning feeling and flushing to the
face and chest, slight heart palpitations, and prickling skin (Ballagh et
al., 2008). The “flash” is usually then followed by profuse perspiration as
the body attempts to cool down.
Unfortunately, as these episodes can occur at any time of the day or
night, sleep deprivation, fatigue and mood changes are common side effects of
night sweats (Ballagh et al., 2008).
In addition to this, lack of oestrogen and progesterone affect libido
and comfort and can further enhance feelings of loss of “femininity”,
self-worth and sexuality (Ballagh et al., 2008). The intensity and
frequency of these climacteric symptoms not only affect women as the go through
the transitional phase, but can often remain at a high level throughout the
menopause phase which may last many years (Bartentsen et al.,
2001).
Great…
Since having the menopause following a Total
hysterctomy, I hit the menopause quite hard and felt that it slowed down my
recovery from the physical operation. So got better physically, but mentally
seemed to get worse.
Again, and I quote…
Women who were physically active in both the peri-
and post-menopausal stage report less severe of vaso-somatic and general
somatic symptoms, as well as improved psychological well-being and higher
levels of self-worth (Elavsky and McAuley, 2005). Indeed, the link between body image and self-esteem is
widely regarded as a strong influencing factor on motivation for exercise. For example, McAuley et al. (1997) examined the connection concerning
domain-specific and global levels of self-esteem over a 20-week training programme.
In addition to measurements of physical changes, these authors examined the
relationship between exercise participation and increased self-worth and found
that increasing physical activity improved self-esteem on both the
domain-specific and the global levels.
Self-worth and self-esteem were also seen to improved at 55% maximum training heart rate (MTHR)
when only slight increases in fitness and body fat were achieved (Elavsky and McAuley, 2007) - nevertheless associated with
enhanced quality of life (Stewart et al., 2003).
Quote
from
the Greek word men- (month)
and pausis (cessation), is defined
as the end of the woman's fertile life, following loss of ovarian follicular
function, usually occurring in the late 40s to early 50s. The transition is not
sudden or abrupt and occurs over several years (5–8 years), and is commonly
referred to as, change of life or the climacteric.
During the transition, a number of signs and symptoms may occur,
including, vasomotor symptoms
(hot flashes, palpitations), psychological symptoms (mood changes,
depression, irritability,
anxiety, sleep disturbances), cognitive symptoms memory problems,
concentration) and, atrophic effects (atrophic vaginitis, bladder
irritability) [1], [2], [3], [4].
Women also report symptoms including night sweats, headaches, fatigue, decreased
libido, severe itchiness, and back and muscle
pains [5]. Such symptoms can significantly disrupt
a woman's daily activities and overall quality of life [1], [2], [3], [4]. Further, during menopause and
aging, with changing hormone levels, women are at an increased change of
chronic conditions such as, cancer, type-2 diabetes, autoimmunity, osteoporosis and
cardiovascular diseases.
