Surviving menopause with some (self) kindness

A cooling dash to the fridge is a common coping tactic for the 80 per cent or so of mid-life women who experience menopausal hot flushes.

Hot flushes can have a big impact on daily life, especially on sleep, work and mood. But my research shows that the fridge is not the only drug-free solution; learning how to be kind to ourselves can also make a big difference.

Wellbeing is often taken for granted. Our own wellbeing is not a fixed trait, however, but a learnable skill. Fostering psychological resilience through strategies like self-compassion can help us better manage life’s inevitable changes – including some physical health symptoms, like hot flushes.

While hormone replacement therapy (HRT) can help some women manage hot flushes, HRT is not effective or safe for all women. Psychological coping strategies can be powerful tools to help women navigate the menopause transition.

Self-compassion involves treating yourself with the same kindness and understanding you would extend to a friend in need. While many women have a natural gift for empathy, often knowing the right thing to say to make others feel better, research shows that we aren’t so kind to ourselves. Self-compassion doesn’t always come naturally.

Instead, women often fall into a trap of giving endlessly to others whilst leaving no time or energy to care for themselves. This is a recipe for burnout – especially at midlife when commitments are often hectic.

HOW SELF-COMPASSION HELPS

Midlife women are under enormous pressure. By the time they have reached their late forties, they may have new responsibilities for ageing parents. They might also have teenagers, which can be one of the most challenging (and stressful) age groups to parent. By midlife, women may have gained more seniority in the workplace. This seniority, when coupled with our tendency to over-give to colleagues at work, causes additional stress. Add menopause to the mix, and it’s easy to understand why women’s well-being reaches an all-time low point at midlife – at least in wealthy, western countries.

The first sign of the menopause transition (MT) is usually persistent changes in the menstrual cycle, caused by underlying changes in estrogen levels. According to research, estrogen changes during menopause can increase the risk of depression for some women. Volatile estrogen levels also contribute to hot flushes, which are also linked to depression.

But not all women get depressed at midlife, and our research shows that self-compassion is an important protective factor that helps them cope.

One intriguing study we completed at the University of Melbourne showed that for a given frequency of hot flushes, women high in self-compassion found the symptoms to be less troubling. Specifically, self-compassionate women reported that hot flushes interfered less with key daily life experiences such as sleep, work, relationships and mood. In turn, this was associated with a reduced risk of depressive symptoms.

This is an important finding, because it shows that self-compassion may help women cope with their menopausal symptoms. The truth is that menopause isn’t always smooth sailing, but self-compassion has the potential to help women manage the transition without feeling overwhelmed.

SILENCING THE INNER CRITIC

Many women might notice that they tend to be self-critical, rather than self-compassionate. They don’t know how to begin to silence their inner critic. Fortunately, self-compassion is a learnable skill – and a great investment in well-being. Women can learn to be more self-compassionate through cultivating the three facets of mindfulness, self-kindness and common humanity.

Mindfulness involves being aware in the present moment, as opposed to being lost in day dreams. It involves a grounded and peaceful clarity of mind. Mindfulness is the first step to self-compassion, because you need to be aware of your own state of mind before you are able to respond with compassion. A great way to be mindful is to simply feel the weight of the body. During a hot flush, just feel the weight of your feet. You are literally just shifting your focus ‘from heat to feet’.

Self-kindness involves using kind language and emotional tone when relating towards yourself. It is the opposite of saying to yourself “you idiot!” when you are running late, or feeling embarrassed or angry at your body during a hot flush. Self-kindness involves meeting your own body’s fragilities with understanding, and an open heart. Even just placing your hands gently on your heart with a caring intention evokes self-kindness.

Possibly the strongest component in predicting well being outcomes is common humanity. This involves feeling connected to others during a moment of suffering rather than feeling stranded and alone. Think back to a moment when you suffered: did you feel isolated or connected? All too often, suffering is associated with feelings of ‘self’ or ‘isolation’.

Common humanity involves a less rigid sense of self, where on a deep level you acknowledge that suffering is part of the human condition. You feel connected to others through your suffering (e.g. the suffering of a hot flush), rather than feeling isolated or misunderstood. When done wisely, attending support groups, seeing a psychologist or debriefing with friends can all contribute to a sense of common humanity.

Building on our research demonstrating the power of self-compassion, we are now expanding this finding to explore how psychological resilience factors might improve other aspects of health and people’s experience of ageing. For example, have you ever wondered why some people grow increasingly grumpy with age whereas others become more happy, peaceful and content? A recent study of ours found that attitudes to ageing might help account for these well-being trajectories.

In this study, we looked at changes in midlife women’s psychological wellbeing over a ten-year time frame. We found that those who felt optimistic about ageing experienced improvements in well-being in later years, whereas those who felt bad about ageing experienced well-being declines. While there were important limitations with this study (we measured attitudes to ageing at follow-up, not baseline), it shows that psychological makeup may have an impact on how we age.

We are now partnering with some Healthscope Hospitals to explore how emotional training (such as training in self-compassion and positive emotions) might not just improve well-being, but also potentially heart health (indexed by heart rate variability) among patients with health conditions.

Given that cardiovascular disease is the number one killer of both women and men, this research could have important implications for health and well-being in the second half of life.