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Section 4
Track #4 - Three Techniques for Managing Menopausal Stress

CEU Question 4 | CE Test | Table of Contents | Geriatric & Aging
Social Worker CEUs, Counselor CEUs, Psychologist CEs, MFT CEUs

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On the last track, we discussed three effects of fear of a decrease in sexual drive due to menopause.  These three effects of fear of a decrease in sexual drive due to menopause included:  low self-esteem; loss of sexual identity; and actual loss of sexual desire.

On this track, we will examine three concepts related to menopausal stress.  These three menopausal stress concepts include:  adrenal exhaustion; sleep-deprived stress; and managing stress through diet and nutrients.

3 Menopausal Stressors

#1 Adrenal Exhaustion
The first menopausal stress concept is adrenal exhaustion.  As you are already aware, there are three levels of stress that the body can experience:

-- Stress Level 1 - The first is fight or flight.  In this level, the adrenals pump out extra amounts of hormones, triggering the release of blood glucose to provide extra energy for the emergency situation.  When the crisis is over, the adrenals quiet down. 
-- Stress Level 2 - The body enters the second stage after a prolonged period of adrenal stimulation, usually lasting for weeks, months, or even years. This is known as the resistance stage when the adrenals adapt to this prolonged stress by increasing in size, which requires a greater amount of nutrients. 
-- Stress Level 3 - The third stage is adrenal exhaustion, in which adrenal function slows until the natural antistress responses of the body kick in slowly, if at all.  Reserves of both nutrients and energy are used up.  This last stage is extremely damaging to health, especially for a female client entering menopause.  If a woman enters menopause in a state of adrenal exhaustion, she can be caught in a downward cycle of progesterone deficiency, resulting in estrogen dominance and related symptoms, as well as exhaustion.  Characteristic signs of this depletion are weakness, fatigue, irritability, and mental sluggishness.

Hilene, age 50, had carved out a successful career as a high-profile corporation attorney.  Obviously, this job is extremely high stress, and Hilene was at a constant level of resistance and even adrenal exhaustion during the trial periods of certain cases.  Once she started menopause, Hilene noticed severe symptoms such as fatigue that she had never experienced before.  She stated, "I have always been able to handle stress in my job.  I've never needed a nap in the day.  I was never snippy.  But now, everything irritates me!  I can't concentrate and everything just flies out of my head in an instant!" 

Because Hilene had entered menopause, I believed that her adrenals have been in a state of exhaustion and this has increased her menopausal symptoms.  To help reduce Hilene's stress, I suggested she might try and reduce her work load.  For instance, handing off her less important cases to make time for her higher-profile cases.  At first, Hilene did not want to lose her reputation as a hard working lawyer in her firm. 

She stated, "So everyone is going to know that I've become weaker in my old age, and I just can't handle it!  How will that affect my reputation?"  I replied, "But wouldn't it be a better solution to hand off the little cases, and win the big cases instead of risking losing all of them because of your difficulties concentrating?"  Think of your Hilene.  Does she need to lighten the work load to decrease her adrenal exhaustion?

#2 Sleep-Deprived Stress
The second menopausal stress concept is sleep-deprived stress.  It is a very common and well-known occurrence for clients to experience night sweats as they progress through menopause.  Although these night sweats are never a direct threat to health, their result is.  When a client has a night sweat, she constantly awakens in the middle of the night, commonly during essential REM sleep, to sweat-soaked sheets and pajamas which she then needs to change. 

As a result, the client loses a great deal of sleep and further stresses her adrenals.  These sleep interruptions can cause the more serious psychological problems associated with menopause.  Women who, to the general public, seem to "go crazy" during menopause may simply be suffering from sleep deprivation. 

Donna, age 51, was continually being awoken by her night sweats.  As a result, she became more irritated during the day and less able to concentrate.  She stated, "I haven't had a good night's sleep in four months!  I wake up, and my pajama tops are soaked with sweat!  Then I have to get up and change them and then try to go back to sleep, which is made harder by my soaked sheets!  I just can't win!" 

To help Donna, I made some sleep suggestions that had worked for other clients of mine.  I suggested sleeping in a bra so that the damp, heavy pajama top would not be so apparent.  Also, other clients have slept with a fan by their beds, which helped evaporate the sweat when a hot flash did occur.  Although none of these techniques are fool proof, I have found that they have helped many of my clients get a fuller night's rest.  Think of your Donna.  Could he or she benefit from some sleep suggestions?

#3 Managing Stress through Diet and Nutrients
In addition to adrenal exhaustion and sleep-deprived stress, the third menopausal stress concept is managing stress through diet and nutrients.  Because adrenal function is so closely related to stress, I have found it beneficial for stressed-out clients beginning menopause to change to a diet rich in nutrients in order to facilitate adrenal performance.  The most important foods to adrenal function include vitamin A, B complex, and vitamin C.  Foods that contain a wealth of these vitamins include sweet potatoes, mushrooms, avocado, lobster, and chicken. 

However, I feel it is almost more important to find out if clients are consuming substances that stress rather than aid the adrenal glands.  For instance, refined white sugar depletes the body of thiamin, riboflavin, niacin, and pantothenic acid.  High consumption of sugar can burden the adrenals by competing for available vitamins and robbing the adrenals of the supply they need for proper functioning.  Obviously, caffeine increases the body's stress levels to a much higher degree than normal functioning.  However, clients who experience lack of sleep will supplement with caffeine, so the cycle continues. 

Deana, age 51, was a self-proclaimed caffeine addict.  Lately, though, she had been having trouble concentrating on simple tasks and experienced feelings of exhaustion during the day.  She stated, "I feel really anxious lately, and can't sleep.  I've been drinking more coffee, but that doesn't help very much.  I've upped it to about five cups a day."  I stated to Deana, "One of the reasons why you are so jittery is the fact that your adrenals are being overworked by the caffeine you are taking in.  If you would like to decrease your anxious feelings and increase your overall energy, you might want to consider that you cut back on your coffee if not quit it altogether." 

Think of your Deana.  Is there a certain substance in her diet that is negatively affecting her stress levels?

On this track, we discussed three concepts related to menopausal stress.  These three menopausal stress concepts include:  adrenal exhaustion; sleep-deprived stress; and managing stress through diet and nutrients.

On the next track, we will examine three emotional symptoms found in menopausal clients.  These three emotional symptoms include:  anger; anxiety; and mood swings.

Depression during the Transition to Menopause:
A Guide for Patients and Families

- Kahn. D. A., Moline. M. L., Ross, R. W., Altshuler, L. L., and Cohen, L. S. Depression During the Transition to Menopause: A Guide for Patients and Families.

Online Continuing Education QUESTION 4
What are three concepts related to menopausal stress? To select and enter your answer go to CE Test.

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