Grief and menopause may arrive in their own demanding and inconvenient times, amid the chaos of midlife career and financial pressures, caring for children and aging parents, and finding time and energy for self-care and intimate connection. There’s never a good time for any of it, and you may wonder if there’s a cascade effect from these pressures.
Research has not addressed whether grief can bring on early menopause. However, studies have shown that there can be a correlation between stress and early menopause. These studies have not proven that stress causes early menopause, but they don’t rule it out, either.
Grief, stress, and menopause have a lot of overlapping symptoms, so it is easy to see how people might think that grief can cause premature menopause. It may be hard to tell where the effects of grief end and the symptoms of perimenopause begin.
What Is Grief?
Healthy grief is an active process that arises in response to a loss, often in 5 stages but not always. Usually, the death of a loved one is what triggers grief, but people can also grieve when life transitions are experienced as losses. This is not uncommon in cases of relocation, divorce, empty nesting, and career transitions.
The grief process is mainly private, so we don’t have prominent role models to follow. And finding the right resources may take more effort than a grieving person can muster.
Overwhelming grief can cross over into depression. Mental health elements of depression can include feelings of hopelessness, worthlessness, and suicidal thoughts. If the grieving person is too debilitated to seek help independently, friends and relatives may have to arrange for counseling, using depression resources, or seek out a lifeline.
In addition, grief can affect physical health.
How Grief and Stress Affect Our Physical Health
Grief is stressful – sometimes extremely stressful, which can affect your physical health. The stress hormones can also exacerbate existing conditions like heart disease and diabetes.
When our brains perceive a threat, the hypothalamus sets a hormonal reaction in motion. The adrenal glands pump out hormones including adrenaline and cortisol:
Adrenaline Effects:
- Increased heart rate
- Raised blood pressure
- Raised energy supply
Cortisol Effects:
- Reduces functions that are nonessential in emergencies
- Lowers immune system responses
- Suppresses digestive system
- Suppresses growth processes
- Suppresses reproductive system
In fight-or-flight situations, these dynamics work to promote our safety and then return to normal balances. But when chronic stress persists, as it often does in an extended grief process, the hormonal overdrive can lead to problems:
- Anxiety
- Depression
- Digestive problems, stomach pain, nausea, heartburn, changes in appetite
- Heart disease, raised risk of blood clots, shortness of breath (call your doctor)
- Chest pain (call 911)
- Can affect the heart muscle so much that “broken heart syndrome” results
- Insomnia and sleep disorders
- Fatigue, sluggishness
- Memory and concentration impairment
- Weight gain
- Headaches
- Dry mouth
- Depleted the immune system opening the door to infections and increased inflammation
If you think some of these symptoms look a lot like menopause, you’re not wrong.
Why Might People Think Grief and Stress Promote Early Menopause?
Stress and menopause have several very similar symptoms:
- Pain
- Irritability
- Reduced interest in sex
- Depression
- Insomnia
- Forgetfulness
- Mood swings
- Anxiety
These symptoms can blur the line between the effects of grief and perimenopause. If grief triggers symptoms from sustained stress, you may not know when perimenopause began until menopause is over.
Menopause itself may trigger grief, although this is not usually included in lists of symptoms. The end of the potential for pregnancy may be a profound loss for women who are expected to have more time. It may even be mourned by women whose pregnancy plans were behind them; fertility is a link to youth that they may not be ready to let go.
Uncertainty about their changing identity also unleashes unease. Some women may feel very much out of control of the process (because they are) as they peer ahead toward their imminent role of elder or wise woman: Ready or not, here it comes.
Other Symptoms of Menopause
The clinical and calendar-based definitions of menopause are one thing. The physical and emotional experiences of menopause are quite another. The changes to women’s bodies can be troublesome, inconvenient, annoying, and can have ramifications for sexual intimacy.
- Heavy bleeding
- Spotting
- Periods lasting longer than a week
- Longer stretches between periods
- Vaginal dryness
- Painful intercourse
- Hot flashes
- Night sweats
- Loss of bladder control; urinary urgency
- Breast tenderness
- Racing heart
- Headaches
- Joint and muscle aches and pains
- Weight gain
- Hair loss
- Facial hair growth
These symptoms may first arise in perimenopause. They may be in full swing during menopause and then take years to fade in postmenopause. But what exactly are these phases?
What Are Perimenopause, Menopause, and Postmenopause?
It might be helpful to define some terms:
- Perimenopause: Ovaries reduce their hormonal output. Levels of estrogen and progesterone fluctuate. Hot flashes and other menopausal symptoms may begin. Menstrual cycles may become irregular.
- Menopause: The first 12 consecutive months with no menstrual period. Ovaries are not releasing eggs. Estrogen levels are very low. During this time, because women cannot be absolutely sure they have had their final periods, they can only suspect they are in menopause. They won’t know for certain until it is confirmed in retrospect.
- Postmenopause: The phase after the year of menopause is completed. Menopausal symptoms start to fade but may recur for ten years or more.
While some women experience grief triggered by menopause, others are relieved to leave their reproductive years behind. The reaction might be affected by the age of menopause:
- Premature menopause is completed before age 40
- Early menopause is completed before age 45
- Average age that menopause occurs is 51 in the USA. Between 40-58 is considered normal. Most begin between 45 and 55
Correlation But No Causation
Researchers have a hard time differentiating between these dynamics:
- Stress caused by life challenges or grief, leading to menstrual cycle irregularities: When stress causes our adrenal glands to secrete more of the hormone cortisol, that can disrupt the normal cyclical balances of estrogen and progesterone, which results in irregular periods.
- Stress caused by perimenopause itself: The hormonal, emotional, and physical changes in perimenopause are often frustrating, inconvenient and exhausting. Perimenopause also results in irregular periods.
These hormonal dynamics and symptoms may occur together, but there may not be enough evidence that stress alone can cause early menopause. This study shows a correlation between stress and early onset of menopause but was not able to demonstrate a specific causal relationship.
Causes of Early Menopause
While grief may be a suspect, many confirmed factors may promote early menopause:
Genetics (when your mother started menopause)
- Chromosomal defects
- Autoimmune conditions
- thyroid disease
- rheumatoid arthritis
- HIV
- AIDS
- Epilepsy
- Chemotherapy
- Surgery: removal of ovaries
Lifestyle factors
- Smoking
- Thinness
- Anorexia
- Bulimia
- Elite athlete
- Alcoholism
- Vegetarian diet
- Lack of exercise
- Lack of lifetime sun exposure
- Economic hardship
Women living with economic hardship are 80% more likely to undergo early menopause, but this is not enough to prove causality because additional factors may be associated. Menopause begins about 8 years earlier in developing countries.
Early menopause means that there is less lifetime exposure to the levels of estrogen present during the years of menstrual cycles. This has mixed ramifications for long term health. Those comparatively high estrogen levels help to:
- boost HDL cholesterol (the good one)
- reduce LDL cholesterol (the bad one)
- relax blood vessels
- preserve bone strength
When estrogen drops during menopause, these benefits drop as well. This can make you more vulnerable to:
- Osteoporosis
- Mood disorders
- Depression
- Dementia
- Heart disease
- Stroke
- Premature death
For these reasons, estrogen replacement therapy may be advised.
On the other hand, early menopause can also reduce your risk of breast cancer and other estrogen-sensitive cancers; to support that risk reduction, estrogen replacement therapy may be discouraged.
Concurrent Grief and Menopause
Midlife is already an emotional balancing act for many women with career and family responsibilities. Being in the sandwich generation also has inherent stresses.
When grief over the loss of a spouse, parent, or other cherished person moves in, coping is a huge challenge. Stress is multiplied when that loss also triggers a change in role, a relocation, or another significant disruption.
To make things worse, it is very common for menopause to overlap with grief over the loss of parents. Here are links to articles on the co-existence of grief and menopause and books that explore the loss of a mother.
It can all feel like too much. If you are looking for ways to navigate this confluence of grief, stress, and midlife hormonal changes, there are pathways to help you move forward:
- Grief support groups
- Coping with the physical effects of grief
- Coping with menopausal symptoms: here and here.
Finally, be kind to yourself and know that you are in very good company.
