Given the lack of insight about the multiple manifestations, complexity and needs for healthy menopausal process, it should come as little surprise that in 2015 women between 45-49years old had the highest suicide rate for females in Australia. Women in the 50-54yr bracket claiming second place. The capacity to accurately diagnose “perimenopausal depression” is a huge challenge to medical system (Kulkarni, 2019).
Seismic shifts slowly unfurl inside middle-aged women.
These global changes throughout a woman’s entire being are poorly acknowledged and comprehended by medicine and society. This deficit of understanding means the needs of these women aren’t met. The menopause process is a time when many women need additional support.
Fortunately, there’s a growing groundswell seeding how we understand, acknowledge, respect and support women’s menopausal process.
Women often have to “just get on with “it”.
“It” being career, work, home duties, relationships, caring for children/pets/aging parents, having some semblance of a “life”, etc, while simultaneously experiencing profound hormonal shifts that can impact emotions, thinking, energy levels, sense of identity, as well as body systems as diverse as gastrointestinal function and blood flow, to cognition capacity and libido.
Significantly, the entire menopause process takes place right in the middle, possible peak time, of a woman’s life and career.
Menopause by name – Climacteric by nature
Strictly speaking, menopause is the day a woman hasn’t menstruated for 1 year.
This is one point in a process that unfolds over 6 to 12years. The menopausal process is far from single pointed and clear. Parts of the process can be a hot mess; an individual mix of heroic insight and wise capacity, peppered sweaty hot flashes, profound confusion, billowing weight, and more!
This variability is hard for the scientific method to grapple with. Variables are hard to control and isolate, making it near impossible to measure and comprehend any single moving part. This creates challenges to come up with effectively clinical supports. Women’s hormonal-nervous-psychological-immunological physiology is sophisticated. It challenges the scientific method’s need for clarity and proof.
A more appropriate term for the stages of peri-menopause, menopause and post menopause is climacteric [climb-act-eric]. This phrase evokes a sense of tuning to a new internal environment.
A period of adaptation to a new way of being.
What is the menopause process?
Before and during peri-menopause, the menstrual cycle starts to change because the ovaries reduce their egg and sex hormone production. Gradually, other tissues, most notably the breasts, fat, bone, brain, and blood vessels, adapt and produce sex hormone. Eventually, the post-menopausal environment is stable. Key sex hormones are locally produced and used, instead of coursing through the blood impacting the entire system.
This aspect (there are other aspects to the menopause process, as I mentioned, it’s sophisticated) involves a shift from sex hormones produced by a gland (primarily the ovaries) influencing the entire body, to sex hormones produced in tissues or inside cells influencing a local area.
Scientifically speaking, it is the gradual adaptation from endocrine to paracrine and intracrine sex hormone production.
A key aspect to support this adaptation is to care for the adrenals, the endocrine glands that cap each kidney. Adrenal glands produce an array of hormones, including cortisol, the hormone released when we experience chronic stress. During climacteric, it’s adrenal glands that provide the building blocks needed for the local hormone production. If we feel regularly stressed, our adrenals get caught up responding the stress stimulus, and less able to produce the building blocks. This reduces the capacity of local tissues to manufacture sex hormones.
This is why it is essential that women in the climacteric are supported to manage stress better.