Q. I have cyst in the breast and my doctor advised me I wont be able to take HRT as it a high risk, what can I do, as I still it preimenapause but also suffer for anxiety and emotions?

Benign breast cysts are not a contraindication to using HRT. It is important that you know there are many things you can do to address your anxiety and emotions at this time. Women who have had anxiety before often find that it comes back at the time of the perimenopause. The changes of perimenopause such as increased tiredness, the beginning of flushes and reduced sleep can make anxiety symptoms worse. List the things that cause you anxiety and stress and then prioritise which causes you the greatest, and come up with a few strategies to help. Maybe talking to a trusted friend, learning relaxation exercises and increasing physical activity will also help. Then look at the next thing on your list and try and think of ways to reduce your anxiety in relation to this influence. Taking time out for you is really important at this time if you can.  If this doesn’t help seek support from a psychologist. 

Q. I feel unloved.  Help - what can I do?

Women may experience a lot of other ‘life' changes at the time of menopause, such as children becoming more independent, parents requiring more help or relationships and friendships changing. This can make some women feel ‘unloved' or abandoned. There can be a grieving process as things change and there is a sense of loss. It is important to identify where the feeling of being ‘unloved' is coming from, understand how changes in your life are influencing you, and then think of strategies to help. This may be talking to the person who causes the greatest pain and simply letting them know how you feel. It may be helpful to think about new roles you may like to fulfil, maybe organise more events with friends, join a group in an area of interest, or volunteer. Being socially connected is really important to our wellbeing so it is important to push yourself to do this, as hard as it may seem. It is also helpful to get those feelings out maybe by talking to a trusted friend or relative, talking to a health professional, or writing down your feelings if that feels okay to do.

Q. How do I overcome menopause anxiety? Do I have to submit to taking anti-anxiety or anti-depressants?

Women who experience anxiety at menopause are more likely to have more hot flushes that are more intense and they become hypersensitive to symptoms so treating the anxiety can help with symptom relief. It would be helpful to visit a psychologist for some strategies; this can be in combination with medication or you might like to try therapy first on its own. Many techniques are very successful in dealing with anxiety such as cognitive behavioural therapy (CBT). This involves recognising the unhelpful thoughts that influence anxiety, replacing them with more helpful thoughts and using relaxation and breathing techniques to reduce the impact of the physical symptoms of anxiety. It is also important to reduce stressors as this sets off the anxiety, and try and get a good night's sleep, as fatigue also makes you more prone.

Q. If my anxiety and depression is severe, is being treated with anti-depressants the way to go?

Severe anxiety and depression respond best to treatment with medication such as antidepressants in combination with ‘talk' therapy from a registered psychologist. To find a qualified psychologist either visit your GP or go to the website of The Australian Psychological Society - http://www.psychology.org.au/

Q. Is a lack of motivation to do things normally enjoyed, a part of menopause?

Good question. This is really complex. If physical symptoms of menopause are making you tired and irritable then motivation suffers. Motivation can also be influenced by what else is happening in your life like your emotional wellbeing, satisfaction with your relationships with family, partner and friends, self-esteem and roles. At menopause there is so much else going on and it can make you question who you are, make you irritable or more prone to stress, and then everything suffers. Work out which it is for you, take things one step at a time and don't beat yourself up because you are acting this way. Sometimes we need to accept that things are a bit tough right now, give ourselves a break and seek support and help if we need.

Q. Does child sexual abuse impact on emotional health during menopause?

Yes it can. Emotional health during menopause is more likely to be influenced by previous experiences of depression and anxiety, poor lifestyle, illness, dissatisfaction with relationships and prior traumatic experiences like sexual abuse.  I find many women come to me at menopause and want to work through abuse that they have previously experienced - for some reason this time of life seems to allow things to come to the surface.

Q. A lot of your program referred to women in relationships. There are many divorced women out here who are experiencing menopause without a partner, and that can often provide a different perspective.

You are absolutely right. The research says that women who are divorced or separated at menopause find they are more prone to depression and anxiety, and that women who are in relationships are more likely to take hormone therapy than single women. Really it depends on the woman. Some find facing this time more difficult without support and some find they can just be themselves and go through the changes of menopause without worrying about pleasing or hurting others. What does seem important is having social support of some kind.

Q. What causes personality changes during menopause?

It is not really that a personality change happens it's just women feel different to how they have been in the past. Certainly women can be more irritable, short tempered and tired. Coping skills that used to work so well don't seem as effective anymore, and some women feel that they can't trust their body because of all the changes. Try new coping skills, maybe talking about your feelings if you haven't been a talker before, or writing in a journal to get your frustrations out; exercise can be particularly helpful even though you may not feel like it. The period of perimenopause is the worst and once women are through menopause they start to feel more in control again and a bit like their old selves.

Q. Is it normal to feel like you want to cry all the time?

It can be. Menopause can make us hypersensitive to any little thing - add hormones, irritability, fatigue, hot flushes as well as being a bit more forgetful and tears are right there.

Q. Any tips or techniques for controlling a tendency to become teary at the slightest provocation, and usually not at an appropriate time?

The most important thing to know is that you are not going crazy and that actually this is quite normal, you are okay. It is much better to go with the feeling rather than try and fight it. If you say to yourself "Don't cry, you must not cry, you are being silly", then odds on are you WILL cry. It is much better to say, "I am okay, if I cry so what, I am just being human and it doesn't make me a weak person, it means I am a feeling person", then you actually feel better about yourself and you are less likely to cry. You may also find you are less likely to cry if you get your emotions out in other ways like writing, talking or even exercising. Reduce stress, get as much sleep as you can, be kind to yourself, sit down and have a cup of tea for half an hour, put breaks in your day for time out so you don't get so overwhelmed by everything.

Q. I have had postnatal depression after 2nd child's birth 2003. I am now going through premature menopause (I am 36) what impact can that have? What should I look for?

Premature menopause seems to have more of an impact on mood.

1. Hormonal changes with premature menopause can make you more susceptible to depression and anxiety and if you have also had postnatal depression this might be something to look out for. So please seek help if you find the symptoms of your depression returning.

2. Experiencing menopause outside the ‘normal' time also means there is less understanding from friends and family and this can make it difficult. It can be hard on relationships and symptoms can make sex painful. The best thing is to seek help with physical changes and treat any changes to mood if this does happen. You could also look on the Jean Hailes website for our fact sheets on premature/early menopause.

 Early Menopause Fact Sheet (66.45 KB)

Early Menopause Website (http://www.earlymenopause.org.au/)

Q. Are there any groups that I could join to have further exchanges of ideas and discuss some of the issues brought up here? Especially the emotional side that Mandy covered.

I can’t think of any formal groups that discuss emotional wellbeing at midlife. It might be a good idea to contact your local community health centre to see if they have any groups running and if not maybe you could volunteer to start one. I find a lot of my clients are starting to join book clubs so that they can discuss matters of emotional wellbeing through the books that they study. Local libraries and community centres often have information on book clubs in your area so maybe this might be a place to start.

Content Updated April 23, 2008