Menopause is a renovation project on the brain

Menopause is a renovation project on the brain

Menopause is a natural biological process that occurs in women as they age, typically between the ages of 45 and 55. It marks the end of a woman’s reproductive years and is characterized by the cessation of menstrual periods. During menopause, there are significant hormonal changes in the body, particularly a decline in the production of estrogen.

Neurology professor Lisa Mosconi has conducted research on the impact of menopause on the brain. In her book titled “The Menopause Brain,” she explores the neurological symptoms associated with menopause, the potential cognitive changes that can occur, and the available options for menopause care that includes the brain.

According to Mosconi, menopause affects not only the body but also the brain. The brain is intricately connected to the ovaries and responds to the hormones they produce. As estrogen levels fluctuate during menopause, it can lead to various brain-related symptoms such as sleep difficulties, low mood, cognitive issues, and hot flashes. These symptoms are most intense during late perimenopause (when periods are skipped for more than six months) and early postmenopause.

Mosconi suggests that menopause can be seen as a “renovation project on the brain.” As the brain adjusts to the changes in hormone levels, it undergoes structural, connectivity, and energy production changes. Some neuronal connections that were linked to the ovaries are no longer needed and can be discarded, leading to brain changes and potential vulnerabilities. However, these changes also allow the brain to rewire itself, enabling women to enter the next phase of life with increased emotional control, self-confidence, and empathy.

Regarding hormone replacement therapy (HRT), Mosconi explains that it can be a viable option for many women experiencing menopausal symptoms. HRT involves supplementing the body with hormones like estrogen to alleviate symptoms. Recent guidelines have considered HRT to be generally safe for healthy women under 60 or within 10 years of their last period. However, it may not be recommended for women with a personal history of breast cancer due to concerns about recurrence. HRT is primarily used for hot flashes but is also being investigated for its potential benefits in managing other brain-related symptoms like disturbed sleep and mild depressive symptoms.

There is a link between menopause and an increased vulnerability to Alzheimer’s disease. Mosconi’s research suggests that red flags for Alzheimer’s may appear in the brain during the menopause transition, particularly for women with a predisposition to the disease. However, taking HRT solely to prevent Alzheimer’s is not currently recommended, and more research is needed in this area.

Mosconi emphasizes the importance of lifestyle factors in managing menopause symptoms. A balanced diet focusing on whole foods, regular exercise, sufficient sleep, stress reduction, and avoiding toxins like smoking are all recommended for hormonal health during menopause.

If you’re someone navigating this challenging and overwhelming journey and are seeking compassionate support and guidance to uplift and empower you then it’s important to find someone with expertise in the field, empathy and understanding of your situation, tailors support to guide your journey and last but most importantly someone who provides a holistic approach to menopause management that encompasses not only the physical symptoms but also the emotional and spiritual aspects.

As a seasoned counsellor with extensive knowledge and experience in women’s health, who specialises in supporting women during their menopause journey. I stay up to date with the latest research, treatments, and holistic approaches to provide you with the most comprehensive guidance and will create a safe and non-judgmental space where you can freely express yourself, knowing that you’ll be heard and understood.

Monisha Dadlani & AM Team

MsC., MoC. Member of: ACA, BACP

Please refer to the AM articles page for Elise and the AM Team articles.

Please complete the AMindset intake form to start therapy with an AM team member. Our therapists offer a FREE 20-minute introductory session for new clients.

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Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or qualified mental health provider with any questions you may have regarding a medical condition.

Cautioning Against Overmedication in Menopause

Cautioning Against Overmedication in Menopause

The Lancet recently released a series on menopause with a warning against excessive medicalisation and a call for an empowerment approach. The Australasian Menopause Society (AMS) also advocates for empowering women to manage their menopause, post-menopausal health, and well-being, as reflected in their tagline “Empowering menopausal women.” However, a significant portion of women (over 25%) experience moderate to severe symptoms that negatively impact their quality of life. In such cases, menopausal hormone therapy (MHT) is an evidence-based first-line treatment option. In response to the Lancet series, AMS and IMS Past-Presidents Professors Susan Davis AO and Rod Baber AM offer their thoughts.

Mental Health & Menopause

The four papers published in the Lancet do not present new research findings but offer perspectives on how menopause can be viewed and optimised. It is concerning that the lead article claims that the principles of health empowerment have not been applied to menopause when, in fact, national and international organisations like the Australasian and International Menopause Societies and Jean Hailes for Women’s Health have been promoting this approach for many years. The papers also address the issue of attributing psychological symptoms to menopause, which is not a new concept and has been highlighted in recent reviews. This serves as a reminder to women and clinicians not to attribute every symptom to menopause. The authors acknowledge that the majority of women will not experience severe menopausal symptoms, but 60-80% will experience hot flushes and night sweats for an average of 7 years, with 1 in 3 women experiencing severe symptoms.

The Problems of Finding the Right Medication

While the Lancet series cautions against over-medicalisation of menopause, their messaging on therapy can be confusing. For example, they recommend specific MHT, gabapentin, and oxybutynin, which have mild to moderate efficacy in reducing hot flushes by 1-2 per day, but they also acknowledge that MHT is effective in reducing symptoms by 2-4 per day and improving quality of life. Additionally, the promotion of gabapentin and oxybutynin is concerning, as these treatments are not approved for menopausal symptoms and have limited data. In contrast, fezolinetant, which has been approved for vasomotor symptoms in several countries, is downplayed despite robust evidence, while other non-hormonal therapies lack evidence.

Other Complications with Menopause

The Lancet series also acknowledges the importance of bone loss during menopause and the effectiveness of MHT in preventing fractures but questions the long-term effects of menopause on overall health. This goes against other expert opinions and highlights that this series presents only one interpretation of research findings. The authors seem to downplay the important role of MHT in helping women during menopause and ignore other systematic reviews that support MHT as the most effective treatment for vasomotor symptoms and comparable to other therapies in preventing osteoporosis and fractures without an increased risk upon stopping treatment.

Conclusion

Current guidance from international and national menopause societies, including Australia and New Zealand, emphasises the importance of an evidence-based approach and providing individualised care, support, and treatment for women during this significant stage of their lives. Overall, these papers align with the 2023 Practitioner Toolkit for Managing Menopause, which promotes an evidence-based approach and empowers women through accessible online resources, as recommended by the papers. (Mehta and Manson, 2024; Gersh et al., 2024; Davis et al., 2023)

Monisha Dadlani & AM Team

MsC., MoC. Member of: ACA, BACP

Please refer to the AM articles page for Elise and the AM Team articles.

Please complete the AMindset intake form to start therapy with an AM team member. Our therapists offer a FREE 20-minute introductory session for new clients.

If you are not quite ready, please click here to subscribe to the AMindset Newsletter with articles and podcasts to learn more about your mental health and how AM can help you.

Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or qualified mental health provider with any questions you may have regarding a medical condition.

Third Culture Kid

Third Culture Kid

Third Culture Kid (TCK) refers to individuals who grow up being influenced by three cultures: the heritage culture(s), the host-country culture(s), and the culture of expatriates and other TCKs. Although elements from each culture are assimilated into the TCK’s life and identity, these individuals often have a greater sense of belonging with other TCKs and the international community rather than with the host or heritage culture (Pollock et al., 2010).

Growing up as a Third Culture Kid (TCK) can be a unique and enriching experience, but it also presents its own set of challenges. TCKs are individuals who have spent a significant part of their developmental years in a culture different from their parents’ home culture. This hybrid upbringing often results in a diverse cultural identity, but it can also lead to feelings of rootlessness, identity confusion, and a longing for a sense of belonging. In this article, we will explore the common problems faced by TCKs and discuss strategies to overcome them, ultimately fostering resilience and a strong sense of self.

Identity Crisis and Cultural Confusion:

One of the primary challenges TCKs face is the struggle to define their identity. Growing up immersed in multiple cultures, they often find themselves grappling with questions like “Where do I belong?” and “Who am I?” This identity crisis can be overwhelming and lead to a sense of detachment from any specific culture. To overcome this, TCKs can embrace their unique cultural blend, recognizing it as a strength rather than a weakness. Engaging in self-reflection, exploring their heritage, and connecting with other TCKs can help them develop a robust and multifaceted sense of self.

Transient Lifestyle and Loss of Roots:

Frequent moves and a transient lifestyle are common for TCKs, as their families often relocate due to work or other reasons. This constant uprooting can result in a profound sense of loss and difficulty in forming long-lasting connections. To overcome this challenge, TCKs can focus on building a sense of home within themselves. Developing a strong support network of friends, both within and outside the TCK community, can provide stability and a sense of belonging. Engaging in activities that cultivate personal interests and passions can also create a sense of continuity and purpose, regardless of the physical location.

Emotional and Social Adjustment:

Adapting to new environments, languages, and social norms can be emotionally and socially taxing for TCKs. They may experience a sense of isolation, struggle to make friends, or find it challenging to communicate effectively across different cultural contexts. Developing emotional intelligence and cross-cultural communication skills can be invaluable in overcoming these challenges. A comprehensive systematic review found that

TCK were more open-minded, respectful, and flexible toward other cultures compared to their local counterparts (Gerner et al., 1992) and factors that improved adjustment outcomes were emotional stability (Van Oudenhoven et al., 2007) and self-efficacy (Ittel and Sisler, 2012). Alternatively factors that hinder adjustment were repatriation anxiety (Miyamoto and Kuhlman, 2001) and ambivalent attachment styles.

TCKs can actively seek opportunities to engage with diverse communities, attend cultural events, and participate in volunteer work, fostering empathy and cultural sensitivity.

Educational Transitions and Academic Challenges:

Changing schools and educational systems frequently can disrupt TCKs’ academic progress and pose unique challenges. They may encounter variations in curriculum, teaching styles, or language requirements. To overcome these hurdles, TCKs can cultivate resilience and adaptability. Seeking support from teachers, utilizing online resources, and embracing a growth mindset can help them navigate educational transitions and thrive academically.

Conclusion:

Being a Third Culture Kid comes with its share of challenges, but with the right support, mindset and strategies, these challenges can be transformed into opportunities for personal growth and resilience. By embracing their unique cultural background, building strong support networks, and developing adaptable skills, TCKs can navigate the complexities of their upbringing and thrive in an increasingly interconnected world. Ultimately, by embracing their diverse cultural identity while staying true to their core values, TCKs can forge a sense of belonging and create a meaningful and fulfilling life wherever they go.

If these feeling are relatable and you find yourself struggling to feel like you belong, exploring this with a counsellor might help give you a greater sense of who you are and what values you hold close. Ultimately helping you to achieve your full potential.

Monisha Dadlani

Haslberger, A. (2005). Facets and dimensions of cross-cultural adaptation:refining the tools. Pers.Rev. 34, 85-109.doi: 10.1108/00483480510571897

Haslberger, A., and Brewster,C. (2009). Capital gains: expatriate adjustment and the psychological contract in international careers, Hum. Resour.Manage. 48, 379-397. Doi: 10.1002/hrm.2028

Ittel, A,. and Sisler, A. (2012). Third culture kids: adjusting to a changing world. Diskurs Kimdheits-und Jungendforschung/Discourse. J Childh. Adolesc. Es. 7, 21-22. doi:10.3224/diskurs.v7i4.1
Pollock, D. C., Van Reken, R. E., and Pollock, M. V. (2010). Third Culture Kids: The Experience of Growing up Among Worlds: The original, Classic Book on TCKs. Hachette UK.

Monisha Dadlani & AM Team

MsC., MoC. Member of: ACA, BACP

Please refer to the AM articles page for Elise and the AM Team articles.

Please complete the AMindset intake form to start therapy with an AM team member. Our therapists offer a FREE 20-minute introductory session for new clients.

If you are not quite ready, please click here to subscribe to the AMindset Newsletter with articles and podcasts to learn more about your mental health and how AM can help you.

Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or qualified mental health provider with any questions you may have regarding a medical condition.

 

 

Planning a Baby? Be Proactive not Reactive

Planning a Baby? Be Proactive not Reactive

Planning a baby?

How to be proactive and not reactive 

When planning a family, a couple usually sees their GP or their OB to ensure that they are fit and healthy. They take the necessary blood tests and vitamins, time their cycles and go for scans. Several initiatives are proactively made to care for the physical demands of starting a family. But what is done for the mental preparation of starting a family? 

Having a baby and starting a family might be the next natural step, but becoming a parent is a major life milestone for all. Having a baby is probably one of the most life-changing events you can experience.

During pregnancy, the focus is primarily on ensuring you are eating right and the baby is growing well. There is usually little mental preparation on how priorities, values, and expectations will shift (sometimes dramatically). This shift may take others by surprise, including family, partners, employers and friends. It is important to understand that this is a normal part of making the transition to parenting, and will likely come with a wide range of emotions, from excitement and joy to ambivalence and fear. Because the process ties strongly with our expectations of ourselves and what our life will be like, it is important to explore the changes and what they might mean.

For some people, this can bring up many challenges. The decision may involve serious discussions about what life will look like regarding work, childcare and shared values. These are important conversations to have, and working through them with a counsellor can be helpful. The right counsellor will provide a safe space for you to unpack your thoughts and unspoken fears, help you each to consider your belief systems about having children, and even enable you to understand feelings you may not have addressed.

Counselling can be for individuals or couples. I have counselled women who step into pregnancy because they think it is something they must do to reach “the next step” or because their partner wants them to. Many of these women find the transition difficult because the changes feel like big sacrifices that they did not sign up for. Losing their identity, giving up working to manage a home, and living in a body that doesn’t feel like their own are just a few issues that, when addressed and discussed, help to mentally prepare and accept the transition. If couples are present in therapy together, then sometimes, when the other partner hears these underlying fears or concerns, they may be able to reassure their partner that things could be different and more positive for them.

Preparing mentally and emotionally before and during pregnancy can reduce the risk of mood disorders, including antenatal and postpartum anxiety and depression. According to the NHS, 25 per cent of women will experience stress and anxiety during pregnancy, and approximately 80 per cent of new mothers experience mood swings, sadness or anxiety soon after childbirth. Whether or not you feel prepared to start a family, it’s hard to know exactly how you might feel once your baby arrives, so some helpful tips to help to prepare mentally for this new transition include:

  • Manage expectations – understand that the media portrayal of “perfect pregnancy” is a facade and that all transitions come with some bumps along the way.
  • Connect with your partner – Spend time doing fun things with your partner while also making space for important conversations.
  • Establish parenting values – What is important? What do the individual parenting roles look like? Understanding these values will also clarify how important decisions are made regarding how finances are managed, what activities you want your child to engage in and where holidays are spent. It’s far easier to have these discussions on different parenting topics before and far more difficult when you’re stressed and sleep-deprived.
  • When to Worry – Discuss each other’s fears. Fear has a way of activating our nervous system in unhealthy ways. Bringing fears out in the open helps build a deeper understanding of how to support one another. Unmanaged fear is closely associated with anxiety and depression. Set aside a block of time solely devoted to nailing down what, specifically, about the situation or possible outcome is evoking fear or stress. Doing so allows you to appraise the actual concern realistically and also allows for problem-solving.
  • Overestimate recovery time – It took you nine months to get here; give yourself nine months to return. Societal pressures of bouncing back post-pregnancy are not only unrealistic but also stressful. 
  • Try to sleep – no good decisions are made when sleep deprived. Most parents are not truly prepared for the chaos without some good sleep. As much as possible, plan ways to ensure that you get rest after the baby arrives. Enlist help from your partner, family, a paid specialist such as a night nurse, or friends. If you can take a break and rest, you’ll be better able to care for your baby in the long run.
  • Build social bonds – Create a tribe of people who can support and listen to you. This can be both in-person or online. Take time to see friends and pursue passions or hobbies to help retain a sense of self. This can start off by being something small you do for yourself. Read a book, meditate, listen to music, meet a friend for lunch or get a massage. Something that is just for you. 

We have been taught to believe parenting is intuitive. It is not; it is a learned skill. It starts by working on yourself. by Monisha Dadlani

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