How to improve your mood during menopause

What is menopause?

Climax is a Greek word that literally means “step of the ladder.” It’s poetic if you don’t take into account all the symptoms and unpleasant manifestations that women face during menopause. This is an important stage for absolutely every representative of the fair sex, which makes certain adjustments throughout life. She does not become inferior, as many believe, she just begins to walk a little differently.

Menopause is not a disease, but a natural process conceived by nature itself that affects every woman over 40 years of age. In medical practice, menopause is a condition of the body in which there is a gradual decline in reproductive and then menstrual function. All this takes place against the background of general age-related changes.

The process begins with hormones. First, the production of estrogen and progesterone decreases. As a result, the normal course of the menstrual cycle is disrupted, the possibility of fertilization is reduced, and menopause occurs. All this is programmed genetically and is absolutely normal, but the process causes changes in health and brings some discomfort.

Menopause and menopause

Menopause in women is not the same thing as menopause, although the concepts are very similar and are often used interchangeably. The difference is that menopause is a long process that rarely involves unpleasant symptoms. But menopause itself is a wide range of painful manifestations that often also provoke the development of various diseases. Menopausal syndrome causes insomnia, rapid heartbeat, hot flashes and other very common symptoms.

Men also experience menopause, but the male body enters this stage later than the female body. The hormonal background of the strong half of humanity changes smoothly, these changes do not bring discomfort at all and are practically not felt. Menopause in women is radically different.

Why was I afraid of menopause?

It seemed to me, like many women of my age, that with the advent of menopause, a real, full life ends and a banal existence begins, awaiting the arrival of old age. Is not it? However, after talking with a specialist, I realized that we ourselves impose all the restrictions on our lives during this period, refusing sex and other pleasures. And all because they are not confident in themselves.

We tell ourselves every day that we are getting old and unattractive. That we won’t be able to interest and, especially, keep a man. That sex is no longer needed and cannot bring pleasure. And much more, as long as your sick imagination is enough. Is it necessary to do this?

Age of menopause

What time does menopause normally occur in women? It is not possible to give an exact age, since everything in this matter is purely individual. Even a specialist will not give an exact figure. Hormonal changes, which result in complete loss of reproductive function, can last from 5 to 10 years. At the same time, the amount of estrogen decreases, and the female genital organs regress.

The age of menopause in women is 48 years (plus or minus 3 years). But this process depends on many internal and external factors. The timing is very approximate, because some women experience early menopause, while others can give birth to a healthy child at 50+ years of age. Menopause does not depend on the time of the first menstruation, the first sexual experience, the number of pregnancies and births, sexual partners and similar factors.

If a woman wants to know when approximately the decline of reproductive function will occur, she should ask her mother about it. The factor of heredity plays a very significant role in this matter. Typically, women experience menopause at the same age as their mothers. The following factors may also influence this process:

presence of concomitant diseases;
social living conditions;
psychological factor.

Recently, the age of menopause in women has been decreasing; menopause for many representatives of the fair sex occurs before the age of 40. Early menopausal syndrome may be characteristic of women who:

abuse smoking and alcohol;
had many abortions;
do not have regular sex life;
are overweight;
violate the work and rest schedule;
suffered from cancer;
do not follow a daily routine;
are on strict diets;
addicted to fasting;
have diseases of the endocrine system;
suffer from autoimmune diseases;
constantly experience stress;
suffered gynecological pathologies.

Modern medicine helps to somewhat delay the onset of menopause in women who are at risk. Hormone therapy, physical therapy, a special diet, and so on are used. More details about the treatment of menopause in women, if it can occur prematurely, will be discussed further.

What causes mood swings during menopause?

What causes mood swings in women is often unclear. This could be a character trait, the influence of circumstances, or even bad weather. However, women whose periodic irritability is associated with premenstrual syndrome (PMS) can be confident in the connection between hormone levels and emotions.

It has been proven that changes in hormone levels during the menstrual cycle depend on the interaction of the hypothalamus and pituitary gland - parts of the brain that interact with the woman’s reproductive system.

Communication between a woman's brain and reproductive organs during menopause can occur in different ways. While there is no precise understanding of how hormones affect mood, there are several theories, including those that examine how mood-enhancing mechanisms in the brain are related to hormone levels.

For example, women who use patches with female hormones - estrogen, produce more serotonin receptors, which improve mood. Hormones can also influence levels of endorphins, chemicals associated with a “high” feeling. Scientists hypothesize that a woman's decreased hormone levels may also change her overall well-being.

Stages of menopause

In women after 45 years (on average), reproductive function declines, but this process occurs in several successive stages. Highlight:

Premenopause. The stage lasts approximately 6 years. At this time, irregularities in the menstrual cycle begin: delays appear, and the cycle itself becomes shorter, heavy menstruation is observed less and less often, the volume of discharge decreases, and it becomes scarcer. The volume of discharge in women during menopause generally decreases.
Actually menopause. Menstruation stops completely. This is the shortest period in all hormonal changes in the female body after 45 years.
Postmenopause. With the onset of this stage, the ovaries stop producing hormones, and estrogen levels drop significantly. All changes are hypotrophic in nature: discharge almost completely stops, the walls of the vagina thicken, lose tone, pubic hair begins to fall out, and the size of the uterus decreases. Active changes occur in a time period from one to two years, then postmenopause continues for the rest of life.

Mood swings during menopause

Mood swings during menopause (dysthymia) are common. Their main feature was a long period of constantly recurring low mood, without episodes of hypomania. However, individual episodes of depression were not deep enough to reach the severity of mild to moderate recurrent depressive disorder (F33.0 or F33.1).

Signs of menopausal mood swings

Mood swings during menopause have been repeatedly studied by gynecologists, psychologists and psychiatrists. The average age of patients with mood swings was 47.8 6 years, the duration of the disease varied from 0.6 to 3 years and averaged 2.8 ± 1.1 years. Most of the women were married, some were divorced, and some were single. Of these, 35.4% rated their family relationships as satisfactory, 29.1% as indifferent, and only 10.4% of patients as unsatisfactory.

When analyzing hereditary burden, it was found that 50% of the patients had immediate relatives suffering from various pathologies of the cardiovascular system, 18.7% had migraines, 10.4% had mental illnesses (schizophrenia, epilepsy, alcoholism), 16.7 % - premenstrual syndrome, and in 20.8% - pathological menopause with mood swings. It should be noted that various psychological problems during pregnancy and the postpartum period were noted by some patients who were currently suffering from dysthymia. Some patients associated the onset of the disease with exposure to traumatic factors; pathological childbirth and abortion were possible causative factors.

The clinical picture of dysthymia was dominated by mildly expressed subdepressive symptoms. Typical affective symptoms in this category of patients were depressed mood during menopause, frequent tearfulness, loss of self-confidence or ideas of female inferiority, feelings of hopelessness or despair, and a pessimistic assessment of life prospects.

The actual affective manifestations of mood swings during menopause were often accompanied by an asthenic symptom complex. All patients complained of a constant feeling of fatigue, accompanied by a painful feeling of internal discomfort, weakness, and heaviness throughout the body.

77.8% of women complained of various dissomnia disorders, namely: difficulty falling asleep, restless sleep throughout the night, with dreams of an unpleasant nature, drowsiness during the day. Against the background of mood swings during menopause, difficulties in concentrating, concentrating, and absent-mindedness, which were combined with a feeling of tension and mental discomfort, became especially noticeable. Patients noted increased fatigue and irritability. Fatigue was especially evident during mental stress (including when patients were answering test tasks). Since all the patients were physically able to work, they tolerated moderate physical activity well. Irritation, often for a minor reason, easily poured out on others, who sometimes accidentally “fell under the hot hand,” and was just as easily replaced by remorse and even tears.

Sometimes mood swings during menopause were combined with a variety of anxiety disorders, which confirmed the results of a number of studies about the relatively high comorbidity of dysthymia and anxiety. The mental component of anxiety in this category of patients was weakly expressed. The structure of anxiety was dominated by somatovegetative disorders. Among them were: cardiovascular symptoms (tachycardia, palpitations, various pains in the chest, in the area of the left shoulder blade, changes in blood pressure), respiratory disorders (shortness of breath, dyspnea with “not free” inspiration), urogenital symptoms (frequent urination); Some patients have noted a sharp decrease in libido recently.

In a number of cases, somatovegetative disorders occurred in the form of paroxysms and were accompanied by pain. The pain syndrome was accompanied by a variety of somatovegetative reactions, such as: hot flashes, palpitations, increased sweating, lability of blood pressure and pulse, a feeling of lack of air, compression in the chest.

Other cases of paroxysmal reactions included recurrent migraine attacks. There were almost always warning signs of headaches in the form of anxiety, fear, and increased irritability. Some patients characterized the pain as “squeezing with a bandage” or “expansion”. Most women noted pain resistance to simple analgesics. Against the background of a painful attack, patients noted lethargy, depression, a desire to lie down, and an increased tendency to self-sparing and saving strength. Such patients were prone to hypochondriacal fixation on somatic sensations, were easily susceptible to iatrogenism, and were willing to undergo treatment and undergo medical examinations, which was a characteristic feature for them.

In some patients, mood swings during menopause were not dominant; psychopathic manifestations predominated in the structure of dysthymic affect. Dysthymia was manifested by such symptoms as irritability, lack of restraint, stubbornness, demonstrative behavior, outbursts of anger, often aggressiveness, combined with increased demands on others, and conflict. All responsibility for unfavorable life events, mood swings during menopause, which preceded the onset of depression, was placed on others (family members, work colleagues). The mood of such patients was dominated by gloomy pessimism, a sarcastic assessment of reality, and a tendency to dramatize. Complaints about depressed mood were clearly exaggerated, but were deliberately reinforced by mournful facial expressions, sighs, and sobs. At certain stages of dysthymia, depressive symptoms became “habitual” and were subjectively perceived as acquired character traits.

All of the above mood swings during menopause largely led to disruption of social adaptation and success in work and family life.

Along with affective and somatovegetative symptoms, the majority of patients also had metabolic and endocrine disorders characteristic of menopausal syndrome: 52.8% of patients recently noted an increase in appetite and weight changes (most often an increase within 2-3% of the initial body weight) .

Among other metabolic-endocrine symptoms, in 19.4% of cases, various manifestations of the skin were encountered: urticaria, generalized or regional itching.

However, it should be noted that all these symptoms were not pronounced, disappeared spontaneously and caused the examined patients much less anxiety than affective and somatovegetative disorders.

Treatment

Research over the past two decades has identified the role of dysfunction of the serotonergic system in the development of mood swings during menopause. The changes that occur in the functioning of the serotonergic system are not considered specific to this or that form of depression.

The predominance of depressive disorders in patients with severe forms of menopause also indicates the significant role of serotonergic dysfunction in its pathogenesis and suggests the possibility of using antidepressants in the treatment of severe forms of menopause syndrome.

To date, there is good reason to believe that serotonergic dysfunction plays an important role in the occurrence of not only depressive, but also anxiety disorders, as well as mood swings during menopause.

For the treatment of anxiety disorders and, in particular, anxiety symptoms within the framework of mixed anxiety-depressive disorder, tranquilizers are often used, of which benzodiazepine derivatives are usually preferred. This takes into account their effectiveness and the duration of the study period for this class of psychotropic drugs.

At the same time, when treating anxiety symptoms with benzodiazepines, it is necessary to take into account their main drawback: the occurrence in patients of mental and physical dependence on benzodiazepine derivatives, which makes their long-term use undesirable.

The need for equally effective treatment of both symptoms of anxiety and depression has determined the importance of searching for antidepressants that would best contribute to the task of relieving depressive and anxiety symptoms in patients with severe menopause. However, one should also take into account the fact that the addition of anxiety to depression, as a rule, weakens the “response” to antidepressant therapy, and also contributes to the transformation of depression into a form more resistant to therapy.

The discovery, research and introduction into practice of representatives of a new group of antidepressants - selective serotonin reuptake inhibitors (SSRIs) - marked a new stage in the development and progress of psychopharmacotherapy for major depression.

Representatives of the SSRI group demonstrate the most important advances in the pharmacotherapy of depressive conditions. Normalizing serotonergic dysfunction, they have high thymoanaleptic activity, not inferior to tricyclic antidepressants (TCAs), in particular, the “gold standard” TCAs - amitriptyline. Along with this, antidepressants from the group of selective serotonin reuptake inhibitors do not cause significant side effects characteristic of tricyclic antidepressants.

The choice of Sertraline for the treatment of patients with mood swings during menopause and signs of depression is not accidental. This representative of the SSRI is characterized by minimal interaction with other neurotransmitters (norepinephrine, acetylcholine, histamine) and, as a result, has a minimal spectrum of side effects with insignificant severity of single anticholinergic symptoms. When prescribing Sertraline to patients with severe forms of CS, we took into account a convenient dosage regimen (50-100 mg in the morning, once a day, per os).

An assessment of the antidepressant properties of Sertraline revealed its greater effectiveness. By the end of the course of treatment for mood swings during menopause, a significant decrease in depressive symptoms, anxiety levels, and an increase in self-esteem was noted.

A comparative assessment of monotherapy with Sertraline and Femoston showed their effectiveness. When treating patients with menopausal mood disorders with Sertraline, the effectiveness was noted in 87.5% (in 12.5% of patients the effect of treatment was assessed as partial or incomplete), in patients receiving Femoston - in 86% of observations (in 13% of patients the effect of HRT was partial). HRT with Femoston has a positive effect on the dynamics of neurovegetative disorders, and therapy with Sertraline has a positive effect on the dynamics of psycho-emotional disorders.

Treatment of mood swings during menopause with Sertraline has a number of significant advantages: a positive reducing effect in the treatment of affective disorders is achieved in a significantly shorter time (6 weeks) compared to HRT (4-6 months), a noticeable improvement is noted after 2 weeks. The advantage of Sertraline is the virtual absence of significant side effects at a daily dose of Sertraline of 50-100 mg. This indicates that the drug is well tolerated and the use of this representative of selective serotonin uptake inhibitors is safe.

The data obtained allow us to consider Sertraline as one of the first-choice drugs for the treatment of mental disorders during menopause.

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Harbingers of menopause

The level of female hormones in the body begins to gradually decrease after 30 years. There is a natural change in the hormonal balance, due to which difficulties with conception are observed at a more mature age, the first wrinkles appear, and the skin loses its elasticity. By the age of 40, the number of follicles in a woman’s ovaries decreases, which subsequently causes a stop in the maturation of eggs. But hormones continue to be produced for some time, although their levels gradually decrease. Signs of menopause in women are caused by the disappearance of sex hormones. Each representative of the fair sex experiences this period of life differently, so the duration of menopause and the severity of its manifestations are purely individual.

Conditions during menopause may vary. To determine exactly how this process occurs specifically in your case, you need to consult a doctor. He will not be able to predict the time of decline of reproductive function, but he will help prepare the body for this important stage and determine premenopause.

Among the harbingers of menopause, menstrual irregularities can be listed:

reduction of the menstrual period;
absence of menstruation for one to two months;
irregular menstruation;
reducing the volume of discharge and the like.

There are also problems with conceiving and bearing a child. After 30 years, it becomes more difficult to get pregnant. It may be characterized by endometriosis, a disease in which the cells of the inner layer of the uterus grow beyond the endometrium. A typical symptom of this gynecological disease is pain in the lower abdomen during menstruation, which can radiate to the lower back or sacrum. Menstruation can be heavy and prolonged, followed by “spotting” vaginal discharge.

During menopause, a woman’s health deteriorates catastrophically

Menopause does not provoke the development of serious problems in the body. However, its symptoms are very individual. They can create some discomfort and worsen a woman’s condition, more often in cases where there were health problems before.

If hot flashes, dizziness, emotional instability and other signs of menopause significantly reduce the quality of life and interfere with usual activities, the woman should consult a doctor. A gynecologist-endocrinologist will assess her condition and select hormone replacement therapy taking into account the characteristics of the body.

Menopause symptoms

The first sign of menopause in women is hot flashes. They are the ones most often talked about by the fair sex when mentioning menopause. This symptom is characterized by a rush of blood to the upper torso and head. This occurs due to short-term dilation of blood vessels and causes redness of the face, neck, chest, and body temperature may also rise. Some ladies also report tinnitus and increased sweating. This sign of menopause in women, such as hot flashes, does not depend on the time of day, and is usually provoked by anxiety, stress or overexertion. The tide can last from a few seconds to a couple of minutes.

Among the symptoms of menopause in women (45-50 years old) are dizziness, which is a consequence of surges in blood pressure during hormonal changes in the body. Another reason is the emergence of foci of excitability of the nervous system under the influence of hormones. Menopause also manifests itself with sleep disturbances: insomnia, daytime sleepiness and causeless anxiety. In addition to these main manifestations of menopause in women, a number of other symptoms from the nervous and genitourinary systems can be mentioned.

Emotional condition

In some cases, changes in emotional state become a sign of menopause. This most often happens to those representatives of the fair sex who themselves are overly emotional and have an easily excitable nervous system. Common problems are tearfulness, touchiness and short temper. There may also be intolerance to bright light or loud sounds. Often women also worry about changes in appearance and loss of former visual attractiveness.

Even the ancient Greeks noted the existence of a connection between a woman’s emotional state and the state of her reproductive organ – the uterus. The word “hysteria,” for example, comes from the Greek hystera, which translates to “womb.”

Astheno-neurotic syndrome during menopause is characterized in some representatives of the fair sex by depression, which either cannot be corrected at all or is very difficult to treat. In this case, severe disorders and behavioral disorders are noted. This is expressed in vulgar outfits, hairstyles and makeup. So a woman during menopause desperately tries to prolong her fading youth at least a little. In this case, consultation with a psychotherapist or even a psychiatrist and constant monitoring, psychological help and support are required.

How to treat depression during menopause

Severe depression is defined as feeling depressed or losing interests and pleasures for two weeks or more. Signs of depression include: daily low mood for most of the day, significant changes in weight or appetite, changes in sleep patterns, feelings of hopelessness, loss of interest in previous activities, persistent thoughts of death or suicide, inability to concentrate, fatigue or loss of energy.

According to research, if you feel constantly depressed, exercise and talking to an endocrinologist who can prescribe hormone therapy can help.

Keep in mind that yoga and meditation may only reduce stress or anxiety if you have mild depression. If you have severe depression, consult an endocrinologist, as this may require medication.

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Autonomic nervous system

The autonomic nervous system of the female body reacts to changes in hormonal levels with frequent and pronounced hot flashes. This condition manifests itself in a lack of air, increased sweating, a feeling of anxiety, nausea, weakness and dizziness, flushing of the skin, a feeling of a lump in the throat, pressure in the chest, and a sinking heart. We can talk about menopausal changes with frequent and unmotivated awakenings in the middle of the night, drowsiness during the day, increased blood pressure in the morning, and respiratory arrest.

A common symptom of menopause in women is also a disruption of the thyroid gland. The condition that the body experiences during menopause causes a restructuring of not only the nervous system, but also the endocrine system.

Impact of menopause on overall physical health

Almost all women undergo some physical changes during menopause. This negatively affects the quality of sexual life during menopause, since changes in one’s own body often frighten and alarm not only the women themselves, but also their partners.

Rules that will help preserve external beauty for as long as possible and prevent the influence of menopause on physical health:

regular exercise (you should give preference to exercises that stimulate blood flow to the pelvic organs);
proper nutrition, which contains the necessary proportion of healthy fats;
complete cessation of bad habits;
regular intake of amino acids, vitamins and microelements;
absence of stress and reasons for irritation;
if necessary, take hormone replacement therapy drugs.

Genitourinary and other systems

In addition to all of the above, menopause in women after 50 years of age can be marked by disruption of the heart and blood vessels, and the occurrence of osteoporosis. With estrogen deficiency, vaginitis occurs, the symptoms of which are vaginal dryness, lack of natural lubrication, prolapse of the walls and decreased blood supply. Cystourethritis may be characteristic, which is manifested by frequent urge to urinate, pain during urination, burning and cutting in the corresponding area. The position of the urethra and bladder may be disrupted.

The skin of women after menopause and during the period of active age-related changes in the body becomes thinner, wrinkles, sagging and age spots appear. The main reason for this is poor skin nutrition. Facial hair growth may also increase, and scalp hair may begin to actively fall out. Bone tissue stops renewing itself, as a result of which a woman’s height gradually decreases, fractures become more frequent, which can now occur even if a small force is applied, pain appears in the lower back, spine, joints, and stooping develops.

Early menopause

Early menopause is menopause before age 40. The causes of this phenomenon may be hereditary predisposition, certain pathologies (for example, Shereshevsky-Turner syndrome, ovarian dysfunction, female chromosome defect, etc.), gynecological diseases, chemotherapy, obesity or anorexia, and incorrect hormonal contraception. Early menopause is dangerous due to rapid weight gain, the appearance of signs of aging (sagging skin, wrinkles, age spots on the face), and an increased risk of hormonal, metabolic and cancer diseases.

To avoid early menopause, it is necessary to support ovarian function with special drug therapy. However, you need to know that many hereditary disorders cannot be treated. In this case, medical care will be aimed at making menopause invisible, eliminating its symptoms and prolonging the woman’s youth. During menopause (not only early) chest and abdominal pain and headaches may occur.

Postponement of menopause

In the early stages of menopause in women, treatment will help delay aging and decline in reproductive function. To do this, use the method of hormone replacement therapy (abbreviated HRT). The action of this method is based on the replenishment of certain hormones. Doctors determine the level of one’s own hormones, the female body’s need for them and other substances, and the compatibility of hormonal medications. HRT is not suitable for all women. This method can be used to a limited extent for certain diseases of the excretory and digestive systems, cardiovascular pathologies, as well as for endometriosis.

HRT increases the vitality of the body as a whole, eliminates depression and other unpleasant manifestations of the nervous system, reduces nervousness and improves sleep quality. In addition, the risk of age-related diseases (stroke, bone fractures, heart attack) is reduced, menstruation is prolonged for some time, and the condition of the skin and mucous membranes is improved. With all these positive aspects, it is strictly forbidden to carry out HRT on your own. Only a gynecologist can accurately calculate the dosage that is suitable for a particular woman. When carrying out HRT, regular visits to the doctor are also necessary.

Treatment of symptoms

With the occurrence of unpleasant symptoms, representatives of the fair sex complain about age. Menopause in women, the treatment of which is predominantly hormonal, can be delayed for some time. Estrogen replacement drugs are indicated, for example, Divigel, Svestin, Premarin, Cliogest, Amboisk, Femoston and many others. To improve the emotional state, Belloid, vitamins (intramuscular B1 and B6, as well as oral vitamin E), ATP, and phytoestrogens are used.

Antidepressants, homeopathic remedies, and psychotropic stimulants may be indicated. Herbal medicine and exercise therapy are useful. Physical activity and feasible physical activity are especially necessary. The doctor may recommend exercises that will improve your mood and maintain the tone of the pelvic muscles. To prevent uterine prolapse, for example, you need to do the following exercises:

Walk on tiptoes, first retracting the anus.
Raise the pelvis from a lying position and retract the anus.
While sitting, raise your legs at the knees.
Lie down and hold a small object between your feet.
Take turns raising your left and right legs from a lying position.

If the process of organ loss is already taking place, then more radical actions are needed. Exercises from yoga or the Bodyflex complex are suitable. This will improve tone, lift sagging organs and strengthen muscles.

When prescribing therapy, the severity of the symptoms of menopause plays a decisive role. Depending on how difficult a woman is experiencing menopause, the doctor will select medications and procedures. This will help relieve symptoms and improve the overall health of the fair sex. Just refrain from self-prescribing medications - only a doctor should select therapy.

The diet during menopause should be rich in all necessary elements, vitamins and minerals. It is advisable to limit salt intake, include canned food, cheese, dairy products, prunes, oatmeal, animal and plant products, vegetables and fruits, as well as freshly squeezed juices in your diet. It is advisable to use the recommendations of a nutritionist.