Shifting Your Mindset

When I started to experience symptoms of perimenopause – anxiety, brain fog and a big drop in my mood – I felt like I had lost touch with my body and my emotions. I regularly used gratitude and mindfulness to reframe my experience.

This includes starting and finishing my day by expressing gratitude for three things that I am lucky to have in my life. At the end of each day, I write down three things that I am grateful for that happened that day, including being thankful for the hormones my body continued to produce in perimenopause. This practice helps me connect to my body and accept and work with the ongoing changes, albeit it an erratic process.

Daily Rituals

When I feel my mind wander into a negative spiral, I try rubbing my fingertips together to bring me back to the moment and concentrate on my breath. This helps me to ground myself in the present where I am able, with practice, to turn my thoughts to positive ones.

I reframed my menopause, as I knew that some of the symptoms I experienced were a wake-up call to make adjustments and improvements to my short and long-term health. I knew I had to listen to my body and make better lifestyle choices so I could support it through this change.

Hormonal Changes

Another technique that helped was looking at my menstrual cycle, because we experience monthly highs and lows, with hormones having an impact on everything from our mood to our sleep and energy levels.

For many of us, the symptoms of perimenopause start in our late 30s to early 40s, way before our periods stop, and we have roughly 400 periods during our fertile years. These are an amazing resource that contain personal and valuable information on who we are and how we function.

Tracking Your Cycle

By tracking the highs and lows of our cycle we are able to predict our moods and behaviours and understand why we may be feeling sad and tired, happy and energised, and also learn when to rest, which is essential for managing stress.

Understanding and working with, not against, our cycle puts us in control of our health and wellbeing. When the symptoms of perimenopause begin we are better prepared and are already familiar with how our mind and body respond to our hormonal fluctuations.

Responsibilities

Psychologist Dr. Kirren Schnack has more than 18 years’ experience in psychological assessment and the treatment of adults, children and their families, including those within the sandwich generation.

She says: “People fulfilling this dual role encompass various aspects. Financially, they navigate the needs of their children and may also contribute to the management or financial wellbeing of elderly parents, addressing lifestyle changes, care needs, and the increasing costs of living.

Emotionally, they provide support to children facing challenges, while offering companionship and understanding to elderly parents. Support may also involve helping parents with changing living arrangements as their needs evolve.

Balancing the needs of two generations while also tending to their own personal needs presents a unique challenge.”

Juggling Act

Being in the middle of caring for two generations does of course have its positives – spending more time with loved ones, and experiencing the feeling of giving back can be extremely fulfilling. However, being part of the sandwich generation can profoundly impact your own ‘normal’ daily life, anxiety levels, and overall mental wellbeing.

“It can feel relentless and the constant juggling act often leads to emotional exhaustion, heightened stress levels, and an overwhelming sense of responsibility. If they are not able to make time for their own needs and take care of their emotional wellbeing, it can result in burnout, heightened anxiety, and depression," says Dr. Kirren.

Self-Recognition

According to Dr. Kirren, the importance of carving out time to meet your personal and emotional needs is paramount if you want to navigate daily demands.

“Managing multiple responsibilities is an extraordinary feat, so they need to give themselves the credit they deserve,” she says. “I realise that finding time for yourself can be challenging, but not doing so can worsen the stress you’re already feeling.”

It’s not unusual to feel discomfort, guilt, or worry about others when making time for yourself, but Dr. Kirren believes caring for others effectively begins with caring for yourself: “Identify areas that can be let go to create breathing space and extra time for yourself, utilising pockets of time to prioritise activities that bring you personal joy or you find relaxing.”

Dr. Kirren also expresses how important it is to establish a support system and to delegate: “Be cautious not to take on additional responsibilities. Instead, maintain clear boundaries, learn to say no when you need to, and don’t hesitate to hand over tasks to others you trust.

Remember, self-care is never selfish but a fundamental aspect of effective and sustainable caregiving.”

If signs of burnout, anxiety, or depression arise, consult your GP for additional support.

Recognising the Symptoms

Eight years ago I experienced a breakdown or what I like to call a breakthrough. It took oodles of self love to heal. Back then no-one was making the links between poor mental wellbeing and menopause. In fact not many were talking about menopause openly. If they were they definitely didn’t look like me or any of my friends.

One day the whoosh of another fierce hot flush left me in no doubt, I was menopausal. I could no longer ignore my symptoms, but despite a brief chat about my realisation with my doctor, she offered me a course of anti-depressants.

Lack of Information and Representation

“Have you ever googled the word ‘menopause’ and clicked ‘images’? This was the question I asked in a video I posted on Instagram in early June 2020. It was a week after Amy Cooper, a white woman, had called the police on Christian Cooper, a Black man, in Central Park, NYC. Hours later the world bore witness to the execution of George Floyd. The world seemed to wake up to the racism that has always persisted.

I knew that stress exacerbated menopause symptoms and had begun to find out about ‘racial weathering’, a term used to describe the negative effects that racism has on Black bodies and our health outcomes. But the internet was full of white women with their heads in their hands. So, how were Black menopausal women coping with their menopause symptoms?

Finding Out More

The Swan(1) report: “Black women reach menopause at 49, two years earlier than the national median age… It also appears that Black women spend more time in the menopause transition than white women do”(2). How was this not common knowledge? More Black women reached out to me asking for info. I put out two surveys targeting Black women with British roots to share their knowledge and experiences of menopause.

Most knew nothing about menopause, didn’t realise their symptoms could be attributed to perimenopause and weren’t speaking to anyone about it. Our mothers just ‘got on with it’ and the phrase ‘strong black woman’ was sprinkled throughout. Some had been dismissed by their doctors as ‘too young’ or offered medical procedures they weren’t comfortable with. More nuanced and cultural information was needed.

Giving Black Women a Voice

I had been listening to Omishade Burney-Scott on her podcast Black Girls Guide to Surviving Menopause for a year. Hers was the first podcast of this nature – a mid-life Black woman centering Black people during their varied stages of menopause and beyond. I started my own, Menopause whilst Black, out of a need to put UK voices out there.

A podcast featuring Black, British-based women talking openly about their menopause experiences was a welcome change. The more people from across demographics and cultures who speak about their lives, the less people will feel desperate and alone. Just as I felt.

As mentioned, Black people who experience menopause start our transition up to two years earlier than our white counterparts. We are more likely to suffer from physical symptoms such as hot flashes and night sweats for longer. Black people also have a higher propensity towards developing diabetes often brought on by menopause. Relative to white women, Black women are 2-3 times more likely to have fibroids, to develop them at younger ages, to have bigger fibroids, to have more fibroids, and to have more symptoms (3).

Women experience depression at rates twice that of men, so you’d think the percentage of Black women receiving care to mirror that of White women. However, Black women are only about half as likely to seek care and face significant disparities in health care. And it's no wonder.

American gynaecologist James Marion Sims is widely seen as the ‘godfather of modern gynaecology’. A less publicised fact is that he performed his ‘experiments’ on enslaved Black women. There are also recent studies that reveal racial bias in pain perception amongst medical students, which has a negative impact on the treatment and care Black women receive.

Black women often weren’t being listened to when they did work out that something was wrong. Getting a doctors appointment is stressful enough without the anxiety of possible misdiagnosis, micro-aggressions or dismissal added to the mix.

What Can Help?

Truly well thought out menopause care that centres the individual is improving with heightened awareness from doctors and deeper training. But it has a long way to go. So what can Black people do to ensure that we survive and thrive through menopause? And how can people who don’t happen to be Black, help?

Knowledge is power. Oftentimes we ignore the signals that something is wrong in order to carry on, or because we feel we have no choice. We may not have had role models in our mothers who were intentional about rest or setting boundaries with family and friends. We have been eternally praised for being ‘strong’. It’s time to be soft. It’s time to turn the love, care and attention we give to everyone else and pour it into ourselves. Rest is our birthright.

So the answer is in the knowing. In this way when we visit a doctor or healthcare professional we will find it easier to advocate for ourselves.

We need others to listen. Believe Black people. Amplify our voices and speak up proactively for our often marginalised voices. We need allies to ensure that ALL receive the respect and care we deserve. As I am fond of saying, when diversity wins, we all win.

Resources:

1. Study of Women’s Health Across the nation which began in 1996
2. https://www.endocrineweb.com/menopause-different-women-color
3. https://bwhi.org/2019/04/03/its-not-normal-black-women-stop-suffering-from-fibroids/
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4843483

You Are Not Alone

Many people talk of how confusing it feels when they begin to experience menopause and while we may know about many of the physical symptoms, we’re often unprepared for the changes it can bring to our mindset and mood.

When things feel overwhelming, remembering we’re not the only one going through it can help. Research shows over 50% of women experience symptoms like brain fog, word loss, increased anxiety and loss of confidence during menopause. These can all affect the way we feel – and that affects our mood and mindset.

Your mindset is a set of beliefs that shape how you make sense of the world and yourself. It influences how you think, feel, and behave in any given situation. We used to believe people’s mindset was broadly fixed – but neuroscience now shows us how elastic our brains are and that we CAN change our mindset to better support ourselves.

It’s important though that we don’t adopt a stiff upper lip, pretending everything is okay. Rather, we should look to be more compassionate with ourselves, acknowledging that sometimes it feels hard and reminding ourselves there are ways through.

We often think about our sex hormones – progesterone and oestrogen particularly – as being centred in our reproductive system. But they travel throughout our body and oestrogen (amongst many other hormones) is also recognised as being important for our brain function.

Cortisol, the hormone we commonly associate with stress, shares the same pathway through our bodies as oestrogen and progesterone. So when we’re stressed we’re also inadvertently inhibiting the benefits of those hormones. We need to change direction to lift our mood and change our mindset.

Often perimenopause and the menopause get blamed as the cause for increased conflict in relationships. It’s not usually the whole picture but it is true that hormonal changes can lead to increased irritability or anxiety. If you are going through this or feeling like you might be, consider if there are any lifestyle changes you can make or if seeking professional medical advice will help.

Often making these changes can feel hard on your own. Think about your support network, whether that’s family, friends or professionals, and reach out to people you trust can help you take important necessary steps to look after your health. See if there is anything that can be shared to enable you to focus on your health.

Midlife stirs up difficult feelings. For example, sad or fearful feelings to do with getting older and having physical changes, mixed feelings about possible gaps between what you had hoped to achieve and where you feel you actually are, and, for parents, feelings around their children getting older. Increased caring responsibilities for elderly relatives add to the pressure.

Everyone has their own unique set of circumstances. When I see conflict in couples at this stage of life, what it so often relates to is not so much being able to solve these issues as couples, but not finding a helpful way to talk about them together. This results in sad, fearful or angry feelings ‘leaking’ out unhelpfully into conflict.

Set aside proper time to speak about how you are both feeling, actively listening to each other without trying to solve anything. If you do have an argument, take time afterwards when feelings have cooled down to try and understand better what it was you both felt strongly about.

If you hear each other saying something you don’t agree with, rather than try to persuade them of your point of view, instead make an effort to acknowledge what they are feeling to show that you have heard it. Often this can help conversations to be more creative and to take the heat out of having different opinions.