POI can lead to menopause symptoms

Premature Ovarian Insufficiency (POI) can come as an unexpected and unpleasant shock, whatever age it occurs. It is the theme of this year’s World Menopause Day 2020 organised by the International Menopause Society to raise awareness of menopause issues.

POI and menopause before age 40 can give rise to feelings of loss and grief connected to loss of options to have children. As one woman, L, told me:

“My official diagnosis of menopause came on my 36^th birthday. I’d had one child. To me, this was like ‘game over’. I don’t have the option to have children any more. I felt like I’d been hit by a train. That was the hardest thing to come to terms with.”

The Information

The average age of menopause is 52 in the UK but POI can happen at any age after menstruation starts up to age 40, plunging the woman into menopause. It has been estimated that the condition affects approximately 1% of the population but that incidence may vary between countries. There are various causes which include:

• Genetic and chromosomal disorders
• Autoimmune disorders
• Chemotherapy and radiation therapy
• Viral infections

Doctors are not sure why this happens and may be slow or reluctant to diagnose it. The symptoms are the same as menopause such as hot flushes, night sweats, brain fog, sleep problems, changes to menstrual periods and anxiety.

L said:

“I’d had my child at 34 and eighteen months later I was having hot flushes, constant headaches, lethargic, really tired all the time. Also, my periods were all over the place. I joked with my husband that I was going through the menopause and I was going to see the GP. She laughed at me when I said it too. She thought it might be thyroid. But she did all the tests and when I went in for the follow-up she said ‘Actually your hormones are indicating menopause’.”

Taking Action

If you are diagnosed with POI you are likely to be offered hormone therapy (HT or HRT) to aid the symptoms and specifically to support bone health. You may also be advised to take calcium and vitamin D supplements to prevent bone density loss. Changes to nutrition, exercise and lifestyle are also recommended to reduce symptoms and enhance physical and mental wellbeing.

“I worked with a trainer who uses kettlebells which is a form of weight resistant exercise. She said this would be excellent for my bone density. I was having a bone density scan every year but four years ago they told me my bone density was growing so I don’t have to go every year now. I do my exercise outside because I do get hot.

She also suggested changes to my diet. I had put on an awful lot of weight. As In the end I lost about two stone. I am happy now and fit and healthy and strong.”

Top Tips

If you are under age 40 and you are experiencing symptoms such as hot flushes, poor sleep, irregular periods or lethargy, don’t ignore it:

• Visit your doctor and explain what you are experiencing
• Ask for hormone tests if they are not suggested
• Discuss your options for treatment.
• Talk to your doctor about possible side effects and risks
• Consider changes to your nutrition, exercise and lifestyle
• If you were hoping to get pregnant you may want to talk to a fertility specialist or counselor to understand your options.

If you want more information or to talk about what you are experiencing contact me today.

For more information about Premature Ovarian Insufficiency, the IMS have released a White Paper: Premature ovarian insufficiency: an International Menopause Society White Paper

After three months in lockdown you may be greeting the gradual easing out of restrictions with joy and celebration as you take back control. You can’t wait to head down the pub and see your friends. Or you might be feeling anxious. Is it too much too soon? Do you feel safe?

Understanding Control

Control During Lockdown

There is a Cognitive Hypnotherapy model I use with my clients called ‘Locus of Control’. Bear with the jargon because this can be very helpful. If you have an external locus of control (ELOC) you believe that control over situations lays outside of yourself.  That means that there is not much you can do to make any situation better. You feel powerless. It becomes very stressful.

If you have an internal locus of control (ILOC) you believe that there is always some action you can take in any situation. You understand what is within your control and what is outside and take action accordingly.

The first stage of lockdown was very ELOC. There were tight rules around what you could and couldn’t do. If you have an ILOC approach you understood the limits of your control. You could decide to stick to the rules, wash your hands regularly, stay indoors, keep your distance, exercise regularly and eat healthily. If you have an ELOC approach it might have felt like there was nothing you could do but worry and wait for things to get back to normal.

Moving towards ILOC

Now we are in a stage where individual control is being handed back to us. We are being asked to be more ILOC and make decisions about what we are prepared to do and not do. That may feel comfortable or very uncomfortable.

Control Post-Lockdown

A risk management approach can help you to get worries about the future into perspective.  If you find yourself worrying about a future event, think about the benefits associated with the event and then the risks associated with it.  For example: meeting your friend at the pub.

Assess the likelihood of the risk you are worrying about happening. For example: Is the risk of you catching the virus by meeting your friend low, medium or high?

Assess the impact of the risk happening. For example: would the impact be low, medium or high?

If both your responses are in the medium to high range it’s time to assess the benefits of what you are considering. For example: Would you rate the benefits from meeting your friend low, medium or high?

If the benefits are medium or high and you want to go ahead, what can you do reduce the impact or likelihood of the risk occurring? For example: could you wear a face mask, sit at least 2 metres apart, sit in the pub garden, go at a time when it won’t be busy?

Finally, you can decide whether the benefits outweigh the remaining risks.

If you need more help taking back control and managing your risks, talk to me.

This week, 18 – 24 May, is National Mental Health Awareness Week, an opportunity to understand more about how to maintain good mental health.

The theme this year is Kindness because research has shown that kindness is connected mental health. When you are kind, your brain rewards you by releasing hormones into your system that make you feel good.

5 Top Tips for maintaining good mental health.

Mental Health Awareness Week

We are in the ninth week of lockdown and it can be very challenging. Most of us are spending more time online and on social media. That can be a dangerous place if you are feeling emotionally fragile. It is easy to become over-exposed to news bulletins that raise your levels of stress and anxiety.

#Tip 1 Limit your exposure to news programmes. Cancel your daily newspaper. Stop watching news bulletins after 6pm so that your system can be relaxed at bedtime.

Another problem with social media is that it can lead you to comparing yourself with other people and how they are living their lives. You might see friends who are coping really well with lockdown and even seem to be having a good time cooking and home-schooling their children. Or you might see people who are sharing how bad they feel.

It is important to recognise that what you are seeing is what others choose to share and it is just a glimpse of what they are experiencing. Don’t judge them or yourself. Your experience is unique to you and you need to acknowledge what you are feeling, positive or negative.

#Tip 2 Stop comparing yourself to other people. You and your experience are unique

If you are following the activities of friends and connections on line you may be thinking that there are things you ‘should’ be doing. You may be seeing people fundraising or making face masks or running online courses and feel bad that you are not doing something similar.

‘Should’ is a word that is loaded with guilt. There is nothing you should be doing if you don’t want to do it. Follow your bliss and do the things you enjoy doing. Maintaining your own good mental health is the best thing that you can do for other people.

#Tip 3 Let go of the ‘shoulds’.

Once you are aware of your feelings, don’t try to push them down or ignore them. Those feelings are sending you a signal that there is something in your life that needs attention. There is a saying that ‘what you resist persists’.  If you bury your emotions they will find another way to pop up.

#Tip 4 acknowledge your feelings.

If a negative feeling stays with you, find somebody to talk to about it. It’s not a sign of weakness. We all have times when we get tired or overwhelmed. Family and friends can be good, supportive listeners. You may need to find support outside your social circle such as from a counsellor or therapist.

# Tip 5 Seek help and support from people you trust.

I wrote this poem a couple of weeks ago to express how I was feeling that day and to encourage readers to recognise and admit to how they were feeling too.

Today is a day for crying

Today is a day for crying

I don’t know why

It just is.

The sun rose as usual

In a blue sky with fluffy white clouds.

Spring is progressing

The flowers are blooming to their inner schedule.

The trees are shedding their blossoms

and filling out their new bright green leaves

My home is still safe and comfortable

The village and fields a delight.

The cupboards are stocked,

the freezer is full

and the bathroom has toilet rolls.

My loved ones are well

I am healthy and fit

My heart and lungs are strong.

My friends are okay and staying indoors,

just getting older, one lock-down day at a time.

I’ve counted my blessings

Been grateful every day

I know that all will be well.

I’m finding the positives

I’ve meditated and journaled.

I’ve baked and gardened and painted

I’ve posted pictures of it all.

But today is a day for crying.

I don’t know why

It just is.

Some days are just like that

And it is alright if you feel that too.

There are more resources and suggestions available on the Mental Health Foundation website

If you would like to talk about what you are experiencing or need some support, you can contact me for a free 30 minute consultation.

I was recently asked to be part of a radio discussion about social media addiction. There has been so much in the news recently about social media, particularly Facebook, and people trying to decide whether to delete their accounts and whether they feel they can do without that contact. How easy is it to stop the habit of checking your Facebook account or is it an addiction?

Pat Duckworth with Chris Mann, BBC Radio Cambs

We use the word addiction a bit too freely. It is a serious medical condition that can ruin lives.  It’s often used in a way that demonises the behaviour of young people. When I was young, parents were worried that kids would be addicted to television. Now they are worried about social media.

So what does it mean to be addicted? You can become addicted to anything that affects the reward circuitry in the brain. It’s not about the substance or the behaviour, it’s about the way the brain responds through changing structure and releasing hormones such as dopamine and endorphin. A person experiencing an addiction carries on repeating the habit or behaviour regardless of the negative consequences.

Someone with a social media addiction would feel compelled to check their social media sites frequently and be unable to control the amount of time they spend online. This is likely to be accompanied by feelings of anxiety. The negative impacts could include:

• Losing track of time
• Procrastination
• Stress
• Need for instant gratification
• Reduced self-esteem
• Feelings of guilt
• Being emotionally unavailable

Stopping the behaviour for a short period of time may be quite easy. The challenge is not going back to it or taking up a new addiction to replace it.

If you recognise any of this in yourself or someone you know, the first step to recovery is to admit that you have a problem and that you need help. Don’t let it ruin your life.

If you think you have just developed a habit that is wasting your time there are some steps you can take to break the habit:

• Leave mobile devices outside the bedroom so they do not disturb your sleep.
• Turn off message alerts
• Limit your exposure. Decide how much time you are going to look at the website and stick to it
• Delete sites from mobile devices so you don’t get tempted. Or make them password protected to make it harder for you to access the sites quickly

If you need help, don’t put it off, contact me now

If you have resolved to lose weight this year, the chances are that you have been looking at diet books and weight loss clubs and wondering what will keep you motivated and whether you can keep weight off in the long term.  So many people lose weight on a diet only to put on more when they start to eat ‘normally’ again.

In a new book published this month*, Dr Deborah Cohen sets out two forces that are driving obesity in the modern world.  One is the availability of cheap food, large portion sizes and food advertising.   The second major force is our human nature, the fundamental limits to our self-control and the unconscious ways that we are hard-wired to eat.

Dr Cohen says, “Because our moods and desires change throughout the day, many people claim their weight problem is the result of emotional eating.  They say they eat when they are stressed, lonely or anxious  – whenever they are not at their best.  Yet others claim they eat too much when they are happy’.

When I work with clients who want to lose weight we talk about establishing a different relationship to food.  I always start by asking them to eat slowly so that they really notice what they are eating and can recognise the signal that their body has had sufficient and is satisfied.  I also help them to discover techniques for recognising emotional hunger and dealing with it.

If you really want to lose weight in the long term you need to change your mind first.  It is the only way to long-lasting change.

*’A Big Fat Crisis; The hidden forces behind the obesity epidemic and how we can end it. ‘ by Deborah A Cohen, MD., Nation Books,  Jan 2014