Finding your path through Peri-Menopause

Have you been feeling that your energy resources are less consistent than they used to be? It might be that that those spinning plates are beginning to wobble, while a desire for more simplicity, space to pause, or rest is becoming stronger.

This feeling is often felt more strongly during menopause; a natural transition that will inevitably pull you into a different relationship with your self, and your unique inner bodily landscape. An experience that can, at times, be unsteadying as you experience the ebb and flux of physical resources. As an acupuncturist treating symptoms, such as hot flushes, insomnia, low energy and anxiety, I have become very familiar with the map of this terrain. But I have seen too how effectively acupuncture, nutritional support, economising of inner reserves can help women find their bearings through the uncertainties of this period of transition.

A different kind of hormonal dance

This is a time when the familiar hormonal dance of menstruation can no longer be relied upon. Women can find themselves moving into a stretch of unpredictability that includes a broad sweep of changes; an experience determined by the state of your overall health, along with the particular nuances of your biological and emotional history.

The term Peri-menopause, describes an incremental, gradual hormonal shift that commonly begins in our 40s, but can be as early as your 30s, eventually leading up to menopause itself; a time that marks the end of the menstrual cycles.  The existing definition of menopause is when 12 months have passed without a period. 

Peri-menopause, with its uncertain beginning, can bring a host of changes, due to fluctuations of hormones, and the natural ageing process. For many women, this can be a disorientating time, as menstrual rhythms vary, and discord often surfaces that reflects a reduced energetic capacity bumping heads with outer expectations.

It is during this time that you can be directly faced with the growing limitations of your energy resources; a feeling likened to swimming against a tide.  An inner tension can surface that reflects a drop in vitality due to hormonal shifts, and in some cases, increased frequency and intensity of bleeding.

Menopausal symptoms, reflect natural changes in oestrogen and progesterone levels, alongside an increased sensitivity to stress. Oestrogen has mood mediating effects, and when levels diminish during the menopause, it is not uncommon for your sense of well-being to feel undermined, and feelings of anxiety or low mood to be present.  At least until you’re able to acclimatise, and find a footing in this unexplored hormonal territory.

The disorientation of the menopausal transition

Many of these changes will be happening at a time when parents are getting older and are needing more support, or when children are going through their own life transitions, which brings its own unique set of challenges! It often seems as though everything is happening at the same time, which can quickly lead to a sense of being overwhelmed.

It can be punctuated temporarily by loss and endings, as some chapters of your lives come to a natural close or conclusion. Someone said to me recently that during menopause you feel like your body is changing but that you’re not always a willing participant in this change! For many women, this loss can encompass the sorrow of losing someone you love, a changing identity, or the loss of inner rhythms, or resources, that once seemed more predictable.

Changes in mental clarity and vitality due to hormonal shifts, can also undermine your sense of self, confidence and enthusiasm. The mist of brain fog, combined with diminished resources, seeming to betray your ability to be available in the same way as before. This, combined with a sense of your mortality being brought into sharper focus, can bring more persistent feelings of anxiety to the foreground.

Recalibrating your resources

However, this chapter in life also creates an opportunity to wrestle back control by redefining who you are, and what you need, in a different way.  As your body communicates a growing necessity to attend to, and care for yourself in a way that honours your own inner capacity.  Menopause, in this sense, is providing both a doorway into a deeper knowing, and an invitation to slow down.  

A more embodied awareness that life is finite, and passes far too quickly as we grow older, can also inspire a challenge to do something new, which can help you to let go of outworn roles that are no longer nourishing, or sustainable.  Or, as the writer and psychologist, Sharon Blackie suggests “The second half of life, then, gives us the opportunity to rediscover the parts of ourselves that we’ve buried, to find the path we have lost. It might feel as if everything is breaking, when actually it’s just changing. Transformation is part of life, and when we stop transforming, we stop fully living. Knowing that doesn’t make the hard times easier, but it gives them meaning.”

Moving with the river - A Traditional Chinese Medicine Understanding

Traditional Chinese Medicine, of which acupuncture is a part, is informed by holistic principles that value the importance of inter-connectivity, between your outer and inner world; reminding you of your fundamental connection to nature, and the natural ease and vibrancy that flows from harmonising with the larger body of the world.  It is attentive to the perennial philosophy of Taoism, that sees everything in life as an interplay of opposites. This is embedded within the concept of Yin and Yang, which are likened to water and fire. Yin is like water: cold, yielding, receptive, still, slow, gathering; and yang, like fire: hot, active, expansive, productive, and fast moving.

Harmony is maintained by balancing the tension between these two mutually supportive qualities. Just as you need a balance of yin and yang in life to maintain harmony, the body needs to find this inner equilibrium hormonally, as we adapt to a changing outer and inner environment; conditions that will be changing more intently during menopause!   Oestrogen might be thought of as more yin in nature.  As you get older and the steadying, settling qualities of oestrogen (yin) naturally diminish, then symptoms that are more yang in nature, such as hot flushes and inflammation, are able to develop, since they are no longer being tempered by the ‘yin’ cooling, soothing and quietening effects of oestrogen.

Eastern traditions of health and wellness understand that you can supplement this natural decline of ‘yin’ by gathering in your energy a little more and protecting your resources, so that you’re not extending beyond your reserves. You can also do this by listening to your body, balancing outward activity with drawing inwards and rest, as well as aligning to the seasonal cadences of the natural world, which may take the form of choosing to conserve your energy a little more in the wintertime, like a tree drawing energy and nourishment back into its roots. Attending to cycles of expansion and contraction, found in the circular sway of the breath and the seasons, or connection and withdrawal by honouring our individual needs for engagement or alone time, can be steadying at a time when familiar menstrual rhythms of storage and release feel chaotic.

Acupuncture points can be used to harmonise the interplay of yin and yang within the body so that all is flowing well within, and you have deep reserves to draw on during times of transition or struggle.  Classical Chinese Medicine sees the Chinese character of each point as expressing a story that can nourish, or brings alive, a vitality within us.  Points like ‘Utmost limit of balance’ keep you balanced when life is difficult, or ‘A Maze of Spring Water’ give fluidity and nourishment to your plans and ideas, helping you to touch into the deep spring within yourselves.

What’s right for me now?

Women often express to me that many of the symptoms and experiences that they are having seem to be communicating a deep need to slow down so that they can follow deeper longings that bring joy and fulfilment. There is a natural urge to draw attention inwards, as a way of conserving our resources. This necessity to withdraw and connect to self seems to grow stronger during menopause. This is beautifully expressed in a an extract from a poem called Endless Lengths by the author, Toko-pa Turner: “All of nature needs these intervals/of movement in reverse//There is a jewel to be gathered in the pause/the condensation of maturity/on the tip of our heart./The essence accumulated which,/if attended with stillness,/won’t fall from us wastefully.”

Asking yourselves the question ‘What’s right for me right now?’can help to shift the perspective to what you ‘can’ do, rather than what you feel that you ‘should’ be doing. This reframing of your internal narrative can encourage you to be more compassionate with yourselves when making small yet necessary adjustments to your work and home lives.  Shifts that preserve and recalibrate your inner resources, and help you to find new ‘jewels’ of meaning and acceptance.

Connecting to the wider ecosystem of support

The fast-paced nature of society, and the constant distractions and anxieties of the modern world can make it hard to fully sink into the bodily experiences of what you’re encountering.  Deeper emotions can sometimes accompany the rushes of heat during menopause.  It’s important that you allow yourselves time to connect with whatever may be surfacing emotionally during this time.

This might require you to turn to the support of friends, family, or professional help.  Any transition will require a loving and caring community so that you can hold deep care and love for yourself help. .  This is particularly meaningful during the menopause when support and sustenance can be provided by a connection to the shared experience of others.

Supporting ourselves during the menopause

There are many ways that you can support yourself during the menopause.  It can be helpful to consider the following practical self-help suggestions as a way of anchoring yourself during the menopausal transition.  Mindfulness, rest and good nutrition all have an important role to play during this time:

1.    Re-thinking the balance or intensity of your exercise routine can be helpful. Incorporating more slow mindful movement practices, such as yoga, tai chi, walking, gardening, swimming are all good ways to improve cardiovascular fitness, strengthen your bones and muscles, conserve vital energy, whilst providing a great source of relaxation. Weight bearing exercises are also recommended to improve bone density and build strength.

2.    Consider eating more phyto-oestrogens, which are naturally occurring oestrogens, to your diet. Phytoestrogens have a similar chemical structure to oestrogen and may mimic its hormonal actions. Sources include: flaxseeds, lentils, chick peas, sunflower, pumpkin and sesame seeds, soybeans, peaches, berries, garlic, tofu, tempeh, and cruciferous vegetables.

3.    Find time during the day to pause, ground in nature and focus on the rhythmic movement of the breath, which can provide an anchor when you’re feeling anxious or unsteady. Are there room for pauses in your life, or ways that you can restructure your time to create more breathing space?

4.    Drink plenty of water to keep your skin hydrated and bowel movements regular.

5.    Activities involving movement, such as dancing, yoga, qi gong or tai chi; learning a new skill, or taking up a new creative pursuit, all help to reduce stress, and keep our energy flowing in healthy, nourishing and restorative ways.

6.    Opening to the nourishment of nature - the simplest gestures of stopping to absorb a beautiful view, sensing the ground beneath our feet, or pausing beneath a tree can open us to the steadying influence of the earth.

7.    Meditation helps us to connect to a deep and quiet place within ourselves, at a time when heat is sweeping through the body creating unsettling ripples on the surface of our skin.

8.    It is well known that bio-identical hormone replacement therapy can be used to help manage some of the symptoms of menopause. Acupuncture is also known as a resource for helping to ease menopausal symptoms.  This has been supported by findings reported in the British Medical Journal, that conclude….”Acupuncture for menopausal symptoms is a realistic option for women who cannot, or do not wish to use {hormone therapy]”.  

Acupuncture uses the body’s own self-regulation capacity to stimulate the production of hormones, whilst also having a normalising effect on mood, temperature, inflammation, and nervous system states.  All of which can positively influence many of the uncomfortable symptoms that are present during this time either in isolation, or used alongside HRT. 

https://www.bmj.com/company/newsroom/acupuncture-may-ease-troublesome-menopausal-symptoms/

(https://www.evidencebasedacupuncture.org/acupuncture-menopause/)

https://news.harvard.edu/gazette/story/2020/08/study-reveals-acupuncture-affects-disease-course/?fbclid=IwAR3cwL4DwNZbkG-wIK70PZn1hI1Xjd60ii_XjoDoRBVP4syN5CLENUUV5_E