Finding your PMZ - Post Menopausal Zest for life
Sally Earlam FMAR, BSc, PGCE, (retired RGN)
For those approaching their 50's and 60's there are going to be plenty of new challenges coming their way which may affect both physical and emotional health. This is a time when children may be leaving home, there may be thoughts of marrying the wrong person (1), concerns of how they will cope with retirement, possibly the loss of friends and health issues may begin to arise- throw this in with reducing hormone levels and this then certainly becomes a time when clients could do with a little extra help!
According to the Office of National Statistics more women are now working than ever before, and many will have to work well into their 60's. Alongside work, women frequently hold responsibility for running the home, family life, budgeting etc. It is therefore little surprise that women often have times when pressures may feel excessive - throw all of that in with our changing hormone levels associated with peri-menopause and menopause and no wonder that this is a time when we could all do with a little extra help.
The Mental Health Organisation Health Statistics (1) report that women in the UK are more likely to have an anxiety disorder and this is most common between the ages of 45 to 54 - but why? And what can we do to protest our own emotional health?
This is a time when many things can be happening in our lives, there may be children leaving home, worry about getting work and also dealing with the peri-menopause and menopause. Hormones are essential for women's health and changing levels can affect us both physically and emotionally. As we approach the menopause, our oestrogen levels drop; oestrogen has many functions, including a direct impact on the stress hormone Cortisol. As oestrogen levels drop, Cortisol levels can rise which means that Adrenalin (our primary stress hormone) can easily be triggered in the body leaving us feeing anxious and stressed. On top of dealing with our changing hormones we also have to tackle the bad press that Western society tends to place on the menopause where our youth-obsessed cultures emphasise "loss" of fertility, rather than transition and the gain of wisdom and freedom. The medical or "disease" model of menopause seems to be dominant (2).
It is surely now time to challenge this attitude; menopause is not an illness, but is rather a natural gradual process whereby a woman's body moves out of childbearing years and aims to head into a liberated and more relaxed phase of life and healthy ageing. Maud Mead (anthropologist) describes her own positive experience of giving up PMS for PMZ (post- menopausal zest). However, we cannot ignore the fact that women can experience some common physical and emotional symptoms associated with peri-menopause and the menopause, but women should be able to feel empowered to look for support to help them deal with symptoms they experience and not feel they are 'ill' or are less valued in society.
How could Reflexology help?
Three common symptoms that women can experience in peri-menopause and menopause are hot flushes, poor sleep and anxiety. A study has been completed in Iran, looking at the effect of Reflexology on menopausal women and showed a reduction in hot flushes and an improvement in sleep (3). Reflexology has also been shown to significantly reduce anxiety state associated with 'an increased feeling of ease and a reduction in anxiety' (4).
Looking at lifestyle is also key for wellbeing and healthy ageing including diet and nutrition, exercise, relaxation, sleep and ensuring you have a sense of purpose. This is a time for women to decide who they want to be for the rest of their lives and make an action plan as to how they can get there!
3. Geraldine Giles. Association of Reflexologists Reflexions magazine. September 2014.
4. Maryam Asltoghiria and Zahra Ghodsi. Procedia - Social behaviour and sciences (iran). The effects of Reflexology on sleep disorder in menopausal women
5. Evaluation of anxiety, salivary cortisol and melatonin secretion following reflexology treatment: A pilot study in healthy individuals A.J. Mc Vicar, C.R. Greenwood, F. Fewell, V. D'Arcy, S. Chandrasekharan and L.C. Alldridge. Complementary Therapies in Clinical Practice, 2007 VOL 13; NUMBER 3, page(s) 137-145
Baby Brains - changes that occur in pregnancy
Sally Earlam FMAR. BSc. PGCE. (retired RGN)
Working as a Maternity Reflexologist has brought me some of my most precious moments of my working life. However I do believe that you need to really want to work with pregnant women - and this may not be for everyone. I am going to look at some of the changes that occur in the brain during pregnancy which explains some of the behaviours we see in maternity.
For this article I will refer to the foetus as the 'baby'.
A lot of things change when a woman becomes pregnant with some of the most marked changes being the emotional ones. Scientists have now identified that these are largely driven by neurological alterations that occur in the brain that can make a woman obsess and worry about their new little creation. (1)
Under the influence of increasing hormones there are many changes that occur in the brain including in the prefrontal cortex, midbrain, parietal lobes and grey matter becomes more concentrated. These discoveries begin to explain some of the behavioural changes that commonly occur in pregnancy and up to 2 years after the birth of the baby.
There is also increased activity in the amygdala, part of the limbic system, which essentially drives our emotional reactions such as fear, anxiety, motivation, affection, empathy etc, and it is this enhanced amygdala that makes new mums hypersensitive to her baby's needs, especially just after the birth.
All of these neurological changes lead to maternal feelings of overwhelming love, fierce protectiveness and worry and as a result most pregnant women and new mums want to talk baby and need the space to be able to talk baby. This brings an important consideration for those therapists that want to work in Maternity Reflexology; we need to be in a place where we are able to and want to listen to their baby talk.
It is these emotional and behavioural changes that can affect many, if not all key relationships:
Impact of Baby Brain on the couple
During pregnancy and the first year after the birth, 40-70% of couples report some decline in relationships (2) with the key issues described as:
• Less positive communication - both partners report feeling isolated and less supported.
• Tiredness and exhaustion
• Increased conflict e.g. household chores
Of course the same level of neurological changes do not occur in the partner's brain, so you have women who may want to constantly talk baby and feel the partner is not interested in the baby (they are, but not to the same level) and the partner who feels their relationship is being neglected.
Tips for Reflexologists
If these types of concerns are raised by your client, then reassure her it is normal. Encourage her to talk to, and listen to her partner and maybe suggest she shares her hopes and dreams and encourages her partner to share theirs as this may help initiate some two-way positive communication. But perhaps best of all suggest she tries to arrange some quality time for them together, doing something they both enjoy, as a reminder of why they fell in love in the first place.
Impact of Baby Brain on friends and family
This can be a trying time for many of those longstanding relationships that have previously been a key part of your client's support network and two possible scenarios are that family or friends can:
• Start to withdraw from the relationship as they may feel excluded or jealous as they are at a different stage in their lives and don't want to listen to 'baby talk'. It could even be that they have had issues with conception and it is too painful for them.
Tips for Reflexologists
Reassure your client that friendships can sometimes adapt or come back later in life and new friendships will be made. You could suggest she looks for antenatal classes in her local area to meet with other mums-to-be.
• Offer unwanted advice or criticism. Pregnancy seems to bring with it plenty of 'advice' from others whether asked for or not.
Tips for Reflexologists
Reassure her that it is OK to say that some decisions need to be made by her and her partner and they will decide what is right for them.
Impact of Baby Brains on themselves
All of the swirling hormones and changes in the brain leads to many unfamiliar feelings for the woman - they can be on an emotional rollercoaster and find it hard to comprehend how they can be laughing one minute and crying the next. How they see themselves as a worker, a friend, a partner, a mother to be is changing and can also bring up memories of how they were parented - and these can be good or bad.
Tips for Reflexologists
Remember this is a time when anxiety is more common, you can reassure them this is normal to have worries but if you have concerns that their anxiety is affecting their everyday life encourage them to talk to their midwife or GP. It is also possible to refer yourself for counselling without seeing a GP if you live in England through the NHS website (4)
Build the relationship with their baby
This is a time where your client is developing a completely new relationship and the changes that occur in the brain are similar to the changes that occur when you fall in love - only this time thoughts are dominated by the baby not the partner. Of course in all of this the mother has one very willing audience who will never tire of the baby talk - and that is the baby. Babies are thought to recognise the mother's voice from around 26 weeks and the sound of her voice will calm the baby - unborn babies clearly respond to different vibrations and sounds with changes in their heart rate and movement patterns, and are particularly responsive to the sound of their mother's voice (3).
Tips for Reflexologists
Encourage the mother to talk to their baby. Talking and singing to their bump can be a lovely way to start building a relationship with their unborn baby and can benefit them as well as their baby
1. Swain JE, Lorberbaum JP, Kose S, Strathearn L.. Brain basis of early parent-infant interactions: psychology, physiology, and in vivo functional neuroimaging studies.. J Child Psychol Psychiatry. 2007 Mar-Apr;48(3-4):262-87.
2. Shapiro, A.F. and Gottman, J.M., 2005. Effects on Marriage of a Psycho- Communicative-Educational Intervention With Couples Undergoing the Transition to Parenthood, Evaluation at 1-Year Post Intervention. Journal of Family Communication 5, 1-24.
3. Voegtline KM et al. Near-term fetal response to maternal spoken voice. Infant Behav Dev 2013;36:526-33.