Hot Flushes, Anger, Irritability and the Menopause
We know that hot flushes and night sweats are common in the perimenopause, but why do so many women experience hot tempered emotional symptoms such as anger, rage and irritability at this stage of life?
Women who perhaps considered themselves calm and level-headed suddenly experience surges of emotion, and are as much surprised by these outbursts as these people who get caught in the crossfire.
This is not a trivial matter; it can affect a woman’s relationships at work and at home. These angry outbursts can feel out of our control and are often followed by apologies and embarrassment. Anger and verbal aggression in women is an uncomfortable emotion in our culture.
It is a fascinating area of menopause that isn’t widely discussed, but we’re going to talk about it in this week’s Menopause Yoga (Pitta) class, on Wednesday 1-2.30pm.
These emotional surges are caused by a combination of hormone imbalance and mid-life stress, but there are good reasons why these emotions are bubbling to the surface, and that releasing these emotions is healthy and necessary to help us transition through menopause to the next stage in life.
Biologically, we know that hot flushes and mood swings are caused by fluctuations in a woman’s hormone levels in perimenopause when her ovaries are trying to compensate for the loss of oestrogen. There are oestrogen receptors all over our bodies, including the body's thermostat (hypothalamus) in the brain, which becomes more sensitive to slight changes in body temperature. When the hypothalamus thinks your body is too warm, it starts a chain of events — a hot flash — to cool you down.
But menopausal women know that it is more than just our hormones; we can trigger a hot flush simply with our thoughts and emotions. Stressful or anxious situations and thoughts are expressed in our bodies as muscle tension, physical pain, clenched jaws, shallow breathing - and if we leave these thoughts unprocessed, they will come out later, as a panic attack, or wake us up in the night. Some of us experience these hot stressful thoughts as night sweats. This stress can also express itself as anger.
Some physical signs of anger include:
· Clenching your jaws or grinding your teeth.
· Stomach ache.
· Rapid heart rate.
· Feeling hot in the neck/face.
· Shaking, trembling or dizziness.
· [do these symptoms sound familiar?]
According to MIND – the mental health charity - stress, financial issues, abuse, poor social or familial situations, and overwhelming requirements on your time and energy can all contribute to the formation of anger in men and women. Women who are juggling work, family life, maybe elderly parents needing care, teenage children with their own raging hormones, or an empty nest as they leave home.
In perimenopause, the biological quick answer is that the hormone fluctuations that a woman normally experiences for a day or two just before the start of her monthly period (Pre-Menstrual Tension) become more frequent and more dramatic, with hormone peaks and troughs occurring every week and every day. In post menopause, if you’re not taking HRT, the permanent loss of oestrogen can bring on a menopause low mood that at best can be described a feeling flat, and at worse can feel like a trough of depression.
The cognitive impairment associated with low oestrogen in menopause causes a hormonal brain fog, temporary memory loss, a sense of feeling overwhelmed. No wonder we feel irritable!
But menopause anger, rage, irritability are so much more than just hormonal fluctuations. It’s a slightly taboo subject as women can feel a sense of shame or embarrassment, as if expressing anger and aggression somehow made them less feminine, less caring or nurturing, more masculine, out of control. This is particularly poignant in western cultures where our definition of what it is to be female are often proscribed for us. And this, my friends, is where it gets interesting.
What is anger?
Anger is unexpressed pain. Take a pause to think about that….
To understand and manage angry feelings and aggressive behaviour, we need to recognise that must anger comes from hurt, which can be physical or emotional pain. Aggression is the behavioural response to hurt and anger. Anger can be an expression of feeling vulnerable. Anger can be an expression of feeling unloved, rejected or shame.
It is a Secondary Emotion. Underneath anger is usually a primary emotion, such as fear or sadness. Fear includes emotions such as anxiety and sadness and comes from our experience of loss, grief, disappointment or discouragement.
So what is causing women in menopause to feel fear, sadness, a sense of loss or grief, disappointment, rejections, unloved or under-valued?
You might feel a sense of grief at the loss of your hormones, your fertility and – in our western culture that idolises youth – there can be a loss of identity as a sexually desirable woman.
In the workplace, there can be a sense that we no longer belong, and if you’ve taken a work break to look after children, or worked part-time, there can be a sense of loss of your career – not being able to reach your potential.
Opportunity for self growth
Midlife is naturally a time of reflection, looking back on your life lived and a wondering what lies in store.
And here again, the western cultural taboo against talking about menopause has left women in the dark… and when we face the unknown we start to experience primitive feelings of fear, vulnerability, stress and our stress response (Fight ort Flight) kicks in to defend us.
Simple Self Help Solutions:
So, clearly the remedy for menopausal anger, rage, irritability, and aggression is:
a. Speak out: To talk about menopause and emotions such as anger, so they become less taboo. Menopausal women’s voices need to be heard.
b. Community: reate women’s circles or menopause meet ups where women can share experiences, laugh and take away the fear of the unknown.
c. Breathe: Practice a cooling style of breathing that calms the nervous system and taps into our parasympathetic nervous system;
d. Yoga: Practice a yoga sequence that releases emotional pent up tension, anger and aggression through deep yoga stretches, and switches you from the Fight & Flight mode into a Rest & Digest mode. In Menopause Yoga these poses specifically focus on our jaw and hips.
e. Eliminate or reduce caffeinated drinks and foods, and alcohol that are high in sugar and carbo
Hydrates that give you steep highs and lows.
f. Write a Journal to track your moods and link these to triggers, such as foods, drinks, medications, work, activities, exercise and, most importantly, your thoughts.
g. Practice Meditation and Mindfulness to reconnect with the stillness and peaceful state deep below the surface of your raging emotions. Learning how to tap into this inner state of peace can be liberating and take away the fear of your emotions.
h. Consider counselling and anger management strategies to understand the underlying causes. Remember: Anger is often unprocessed pain, grief, or fear. Seek support to help you process those old emotions that have bubbled to the surface.
i. Practice loving kindness towards yourself, be your best friend and give yourself a physical and emotional hug. Menopause is a transition and the emotional imbalance you are experiencing now will not last forever.
j. Gratitude: find at least 1 thing in your life to be grateful for every day – including your raging emotions. These emotions may be shining a bright spotlight on something you need to notice. Use them to learn more about yourself and the root causes for your emotions could reveal lightbulb moment insights that could be personally empowering.