Perimenopause: Transitioning into your Second Spring

Everybody has heard about menopause. The clichéd understanding is that it’s that time in a woman’s life when she suffers hot-flushes and a dry vagina. However, little else is widely known or discussed about this oft-maligned feminine life-stage.

When you consider that ‘knowledge is power’, this shallow understanding of a significant rite of passage in a woman’s life does women a great disservice. It means that women are largely ill-prepared for the multi-layered experience of growing old within the feminine continuum; many women are unaware and uneducated about menopause’s numerous and varied potential challenges, which can make for a much more rocky-ride. And on the flipside, we are also largely ignorant of the unexpected rich and rewarding gifts that ‘The Change’ can offer us, if only we are prepared and open.

The first thing we need to clear up is that it is during the perimenopause, rather than menopause, when most of the action happens. Menopause is defined as the time when a woman stops menstruating—when she finally stops ovulating—and had not done so for the last 12 months. The average age that a woman reaches menopause in Australia, the USA and the UK is 51. Usually by this time most of the hormonal tumult starts to settle (not to say that many post-menopausal women don’t experience a number of physical and emotional symptoms too!). What people don’t realise is that the lead-up to menopause, known as ‘perimenopause’ is the real the marathon that we need prepare for, as it can last anywhere from 4-10 years.

The Stages of Menopause

Women commonly enter the perimenopause from around the age of 45 (however Dr Sara Gottfried suggests it can come upon women as early as the age of 35!) when they begin to experience a number of emotional and physical symptoms. I see this in many of my late 40-something girlfriends who bemoan the litany of perplexing new symptoms they are experiencing; often with little understanding or recognition that they are in fact on the path of perimenopause.

One of the first signs that you are in the perimenopause is that your menstrual cycle changes. You may notice it becomes much shorter or longer, or more erratic in general, and you may experience heavier than normal bleeding or exacerbated PMS symptoms.

By the time you reach menopause, your oestrogen levels drop as much as 90%. However, in the perimenopause stage, women can often experience a depletion in progesterone that actually causes an ‘oestrogen dominance’. This initial under-supply of progesterone can cause a number of symptoms in addition to the aforementioned changes in your menstrual cycle; these may include reduced libido, bloating, breast swelling and tenderness, mood swings (especially irritability and depression), weight gain around the belly and hips, and premenstrual headaches.

During the perimenopause, a woman will begin to experience anovulatory cycles (no ovulation) as her egg supply starts to run out leading up to the final stage of menopause when her body no longer ovulates. Along with progesterone, the production of oestrogen and androgens (male hormone precursors that can give us our sex drive) also eventually falls and their production is relegated from the ovaries to other organs like the adrenals and fat tissue.

Approaching menopause, and even into post-menopause, women may experience those stereotypical menopausal symptoms like hot flushes, night sweats and insomnia. According to Dr Christiane Northrup, 85% of women experience hot flushes (in the U.S. they are called “hot flashes”), with approximately 40% considering these hot flushes to be intolerable. Additionally, due to thinning of the vaginal tissue and lack of oestrogen,women may experience dryness (lack of lubrication) in the vagina. Post-menopausal women are also more vulnerable to osteoporosis (thinning bones), which is also caused by oestrogen deficiency.

Perimenopause: the Cosmic Washing Machine!

She finds she has limits. Her energy falters, her mind drifts, her patience snaps. She begins to husband herself, to save herself for what really matters. She has seen enough to guess the trajectory of most events, to hold herself back from repeating old mistakes. She knows now that some energy is wasted. So sometimes she seems parsimonious, unwilling to expend in waste. But other times she is generous. That old coat? Give it away. That pretty pin? Oh, do take it. The half-finished book? No, it’s yours. She does not need to cling to what she has outlasted. Things leave her: she does not need it all. 

— Patricia Monaghan

The perimenopause is a key transitional period, not only in the physical and emotional sense, as your body gradually recalibrates its hormonal output, but also in terms of your whole value system that denotes where you stand within the matrix of your life.

Mirroring the autumnal, premenstrual (Waning Moon) phase of your monthly cycle, when your energy wanes as you prepare to shed your uterine lining, the stage in your life cycle as you move towards menopause represents a time of inward focus and ultimately of letting go of what is no longer serving you.

Elizabeth Davis and Carol Leonard, in The Women’s Wheel of Life, offer a template of 13 feminine archetypes to help women understand and embrace their various life phases. Within this mandala, the Priestess is an archetype that represents an aspect of the perimenopause, and they write: “Ultimately the Priestess finds she must shed her skin in order to truly wield power—a process that can be disorientating, and not a little painful if subject to outside scrutiny and criticism.”

Davis and Leonard suggest a pivotal archetype that links the Priestess and the various other archetypes throughout a woman’s life-cycle is that of the Transformer. This archetype can be understood as any transition phase within your life cycle. The Transformer is a kind of ‘cosmic washing machine’ that you must churn through before embarking upon the next life stage. I suggest that we can view the chaos a woman can encounter in the perimenopausal phase as an example of this Transformer archetype in action. When you realise you have hit uncharted territory within your life-trajectory, and you feel more than a little lost and disoriented by the unknown that is permenopause, it is helpful to gain the perspective that out of this chaos comes the precious opportunity for a re-birth of your self, a self that can then carry you stronger, more self aware, more compassionate, into your ‘wise woman’ years.

In my early 40s, I found myself hurtling headlong into my own Transformer that catapulted me into the perimenopause phase. I suffered a health crisis that was precipitated by the exhaustion of holding all the pieces of my life together throughout my 30s. I had single-parented for almost a decade, run a busy, growing yoga teacher training business that had involved a lot of travel, and struggled to maintain a long term defacto relationship that had been on shaky ground for some time. I came crashing down with multiple health complaints including adrenal fatigue, exacerbated PMS, heart arrhythmia and digestive issues (gut dysbiosis and multiple food intolerances). Whilst these health issues were obviously induced by years of compounded stress, not to mention too many antibiotics, there was a new ingredient here—an inner-voice that quietly yet insistently whispered to me that my life needed to change.

This is the voice of perimenopause.

Within the context of understanding the subtle physical and emotional changes of your cycle that is encapsulated in my moving with the moon model, there is an idea that the premenstrual phase can be viewed as a time of “emotional housekeeping” (Joan Borysenko); the perimenopausal life-phase can be regarded in the same way: if you are willing to listen to the signals of our body, you open yourself to the manifold gifts of this life phase. Dr Christiane Northrup explains:

Recall that the emotional and psychological changes of the perimenopausal years are to the entire life cycle as the week before one’s period is to the monthly cycle. All the issues that have been occurring premenstrually and which perhaps had been avoided previously – “Should I quit my job?” “Should I stay in this relationship”? – now come up and hit us between the eyes rather relentlessly, demanding that they be dealt with.

Interestingly, Traditional Chinese Medicine (TCM) views the menopause as a woman’s “second spring”, reflecting the newfound life that is possible for her as she enters a stage where she is able to begin to move her energies away from nurturing others and finally direct them towards nurturing herself.

Dr Northrup also promotes this notion of menopause being the ‘second spring’, if only we heed the messages that our bodies and hormones are sending us: “We must source our lives from our souls now. Nothing less will work. When we dare to do this, we truly prepare for the springtime of the second half of our lives.”

Now, in my late 40s, I feel that I am completing the massive life reassessment that perimenopause propelled me into five years ago. After finally letting go of a relationship that was draining my very life-force, I have now welcomed my husband into my life, and with his full support, I am joyfully undergoing a process of simplification within my life—sloughing off projects and commitments that are no longer serving me or my family. As I continue to stabilise my health, ameliorating many of the stress-related symptoms with which I began this journey, I am able to discern the perimenopausal symptoms that continue, but my attitude is imbued with gratitude rather than resentment, distress or denial. This attitude is fuelled by my deep appreciation of perimenopause as a vital and inevitable process of transformation—the great Transformer at work in my life.

Strategies for navigating ‘The Change’

So, what are some ways we can move more gracefully through the perimenopause so that we can blossom into our ‘second spring’?

Primarily, I suggest taking time out just for you to reflect on what needs to change in your life, now that you are entering mid-life.

You may want to use various tools for this enquiry—meditation, journalling, restorative yoga, and time in nature. I cannot stress enough the importance of carving out this reflective, solitary time to help you gain perspective on what you really need to nourish yourself as you move forward and through the Transformer that is perimenopause.

It also helps if you are as physically healthy and robust as possible as you embark on the potential marathon lead-up to menopause. Your nervous and hormonal systems need to be well balanced, which will minimise unnecessary depletion of progesterone that can cause the common perimenopausal condition of ‘oestrogen dominance’. Moreover, stress-related conditions involving cortisol levels (a stress hormone) that are either too high or too low can negatively affect your hormonal system, as Dr Libby Weaver explains:

If a woman has been in SNS dominance (sympathetic nervous system– ie: ‘fight or flight’ stress response) and then her sex hormone production starts to change, her menopause is far more likely to be challenging and potentially debilitating, with some of the major symptoms being hot flushes, interrupted sleep, and vaginal dryness.

A critical benefit of a nourished, resilient nervous system is that your adrenal glands will be well prepared for the task of taking over much of the production of DHEA (androgen levels), and therefore oestrogen, that needs to take place post-menopausally. Ways to support your nervous and hormonal systems include diet, exercise and effective stress management techniques—yoga being an invaluable component, of course!

A Beneficial Practice for Perimenopause: Supported Child Pose with Adrenal (‘Turtle’) Breath

The Supported Child Pose (see image) is a wonderfully rejuvenating restorative posture—excellent for counteracting fatigue and exhaustion. It helps encourage the breath into the back of the body, as you receive a massage into the abdominal area of the belly into the bolster. It also relieves lower back pain and opens the hips. The Adrenal (Turtle) Breathing practice works well with this posture and helps to nourish the adrenals, which supports your hormonal and nervous system, enhancing your energy levels.

How to do it

Come to a kneeling position in front of the short end of your yoga bolster. Open your knees about mat-distance apart, keeping your big toes together, heels apart, and then slide the bolster up between your legs. Lay your torso along the bolster as you keep pressing the buttock bones back onto your heels. Rest one cheek on the bolster turning your head to the side. Let the forearms rest into the floor.

Allow your body to soften and relax for the first few breaths here. Perhaps even taking a few Falling-Out Breaths in which you allow the exhalations to fall out of an open, relaxed mouth.

When you are ready, begin to deepen your inhalations and feel the breath filling up into the lower back, kidney area—on either side of the spine, about 3 inches above the top of the sacrum. Imagine your back-body is a big turtle shell, and as you inhale and breathe into your lower back, your turtle shell is lifting up and away from the front of the body, towards the ceiling. As you exhale, your turtle shell gently softens back towards the floor and your front-body. After a few breaths, add the refinement of a very gentle pelvic floor lift on your inhalations as you imagine you are drawing energy up from you perineum into the kidney area, into your ‘turtle shell’. As you exhale, you can relax the pelvic floor muscles.

Feel this turtle breath circulating within and nourishing each of your kidneys and creating more space for your adrenals. Picture your adrenals as two spongy, pyramidal shaped organs that sit atop the kidneys, and as you inhale, the adrenals gently lift off the kidneys creating more space. After a few more of these turtle breaths, concentrate the awareness and the breath into the medulla (the very core or seed of the adrenals) and imagine you are charging each adrenal, right at its very core, with healing and energising energy, life-force or prana. Continue for 3–6 more breaths, and then come out of the posture in your own time.

This blog is an excerpt from Ana Davis’s book Moving with the Moon: Nurturing Yoga, Movement and Meditation for Every Phase of your Menstrual Cycle and Beyond.

References:

• http://www.mayoclinic.org/diseases-conditions/menopause/basics/definition/con-20019726
• https://www.justasjuicy.com/menopause-and-perimenopause/
• Sara Gottfried M.D.’s The Hormone Cure
• https://my.clevelandclinic.org/health/articles/what-is-perimenopause-menopause-postmenopause
• http://www.webmd.com/menopause/guide/guide-perimenopause#1
• https://jeanhailes.org.au/health-a-z/menopause/about-menopause
• Christiane Northup, M.D., The Wisdom of Menopause
• http://med.monash.edu.au/sphpm/womenshealth/docs/androgens-in-women.pdf https://canceraustralia.gov.au/affected-cancer/cancer-types/breast-cancer/treatment/what-does-treatment-breast-cancer-involve/hormonal-therapies/types-hormonal-therapy/menopause-and-oestrogen-production
• Christiane Northrup M.D., Women’s Bodies, Women’s Wisdom
• Quote from Patricia Monaghan taken from “Seasons of the Witch”, as quoted by Jane Hardwicke Collings: http://www.moonsong.com.au/more-on-maga-the-autumn-season-of-our-lives/
• Elizabeth Davis and Carol Leonard, The Women’s Wheel of Life
• Joan Borysenko, Ph.D., A Woman’s Book of Life: The Biology, Psychology, and Spirituality of the Feminine Life Cycle
• http://www.empowher.com/menopause/content/why-does-chinese-medicine-call-menopause-womans-second-spring-dr-mao-video
• Dr Libby Weaver, Rushing Women’s Syndrome
• My Adrenal Breath technique described in this blog is inspired by Taoist Sexology practitioner Willow Brown’s ‘Turtle Breath’. See: www. yinwellness.com

 

Ana Davis, Founder and Director of Bliss Baby Yoga, has a passion for a feminine approach to yoga, and supporting women with yoga through all ages and stages of their life. Ana is the author of the groundbreaking ‘health bible’ for women, “Moving with the Moon – Yoga, Movement and Meditation for Every Phase of Your Menstrual Cycle and Beyond”. Ana has collaborated with Bliss Baby Yoga fertility specialist yoga teacher Rosie Matheson to create our Online Level 1 Yoga for Fertility Teacher Training, and she is the lead trainer on our popular Online Prenatal & Postnatal Yoga Teacher Training Course and Online L1 & L2 Restorative Yoga Teacher Training courses. Ana also offers private mentoring and yoga sessions online to support women in their teaching and/or their personal yoga practice – with sensitivity and awareness of the unique stages of a woman’s life and monthly cycles, as well as online yoga classes.