Menopause
Work stress top trigger of perimenopause symptoms, says Health & Her report

The menopause support platform Health & Her has found that 80 per cent of women reported at least one trigger of perimenopause symptoms, including stress, caffeine, alcohol, and sugar.
The research conducted on 55,047 women going through perimenopause has shown that 54 per cent of participants reported stress at work as a major trigger. Examples of work stressors might be meeting a tight deadline, presenting in front of clients, attending performance reviews and taking part in social events.
“There are an estimated three million women currently going through perimenopause in the UK,” says Dr Rebeccah Tomlinson, GP menopause specialist at Health & Her.
“Although symptoms are primarily due to falling sex hormone levels, many of these women are unaware of the way mental health, lifestyle and diet choices can trigger the frequency and severity of their perimenopause symptoms.
“The reason stress at work is cited so frequently by women is because oestrogen helps maintain cortisol levels, so when oestrogen levels start to drop things go out of balance. It then becomes a vicious circle. The more you stress, the more you experience mind, mood, and sleep problems.”
Health & Her research found stress of this nature highly correlated to mind and mood symptoms of perimenopause including anxiety, low mood, poor concentration, brain fog and memory loss.
With more than four million perimenopausal or menopausal women currently in the workplace and one in ten leaving the workplace, finding ways to help them manage stress to minimise triggering symptoms is vital.
The research confirms a link between stressful events and worse menopause symptoms. However, according to the report, it is not necessarily the event that exacerbates symptoms but how a woman responds to that event.
Just under half (47 per cent) of the women surveyed reported this as trigger alongside anxiety, poor concentration, memory loss and heart palpitations.
Two in five women reported they started to experience more sensitivity to caffeine as they progressed through perimenopause.
Dr Rebeccah says this happens due to the caffeine found in tea, coffee and energy drinks that accelerates the nervous system, increases alertness, and interferes with the absorption of vitamins and minerals.
“Whilst it might seem like a good pick me up after a bad night’s sleep, caffeine can have a detrimental effect on sleep, causing insomnia which is one of the most common symptoms of perimenopause,” she adds.
Additionally, four in ten women found that they experienced an issue with alcohol tolerance.
Alcohol causes the blood vessels to dilate and raise the internal body temperature, leading to more hot flushes and night sweats, higher levels of cortisol, disrupted sleep, mood swings and increased dehydration.
Sugar posed a moderate issue for one third of the women. Sugary snacks are known to cause rapid high spikes in blood sugar levels.
High blood sugar, insulin resistance and metabolic syndrome are linked to hot flushes in perimenopausal women while dips in blood sugar can impact energy and mood levels. These spikes and dips can lead to a cycle of snacking on quick fix foods that can exacerbate menopausal weight gain and other symptoms such as bloating, digestive issues and memory loss, the researchers say.
Kate Bache, co-founder at Health & Her, says: “Seeing stress featuring twice in the top five triggers, it’s no wonder 15 per cent of women experiencing perimenopausal women have called in sick due to their symptoms.
“Women are struggling to perform at their job, due to the severity of their symptoms and lack of support.
“Almost a quarter of perimenopausal women surveyed admitted to making mistakes at work, while six per cent had to skip meetings to deal with their symptoms.”
Bache’s Health & Her aims to support perimenopausal and menopausal women through its Employer Menopause Support Plan.
The package offers clinic access to menopause-specialist GPs, advice, managerial and employee training, digital tools and webinars to help women track and manage menopause symptoms and support the employees who work with them.
“Businesses need to learn to adapt, create a space and culture that supports perimenopausal women to retain them in the workplace,” says Bache.
“These women are at a point in their lives where they have the experience, talent, and skills to positively contribute to the workforce. By offering the right help and developing the right plan around they will be able to continue to progress in their careers, rather leaving due to their symptoms.”
Menopause
Osteoporosis significantly increases risk of death in menopause, study suggests

Osteoporosis may raise the risk of death in postmenopausal women by up to 47 per cent, a new study suggests.
The findings point to an inverse relationship between femoral bone mineral density and mortality risk, especially within certain ranges.
Femoral bone mineral density is the amount of mineral in the thigh bone, which is often measured to assess bone strength and osteoporosis risk.
Dr Monica Christmas is associate medical director for The Menopause Society.
She said: “Osteoporosis often remains a silent threat after menopause, despite its profound effect on women’s lives—from loss of height, poor balance, and reduced mobility to disfigurement, pain, and even premature death.
“Early screening and preventive measures, including a calcium-rich diet (preferably from food sources), regular weight-bearing exercise, and hormone therapy when appropriate, can significantly improve bone health and reduce risks not only of fractures but also cardiovascular disease, certain cancers, and dementia.
“It’s time we bring this conversation to the forefront.”
In the study involving nearly 3,000 postmenopausal women, bone mineral density at four femoral sites was assessed using dual-energy x-ray absorptiometry, a scan commonly used to measure bone strength and fracture risk.
The analysis found that mortality risk was significantly higher when femoral bone mineral density reached the osteoporotic threshold or when osteoporotic fractures were present.
After full adjustment, osteoporosis was associated with a 47 per cent increased risk of mortality.
A stronger inverse association between increased bone mineral density and mortality risk was seen within specific ranges, suggesting bone mineral density could serve as a prognostic marker of wider health.
The relationship appeared especially notable within the range of 0.46 to 0.71 g/cm² for total femur bone mineral density.
Previous research has shown that postmenopausal women face a significantly higher risk of death within one year of hip or vertebral fractures.
News
Study seeks to understand why women’s hearts become more vulnerable after menopause

A new study will investigate why women’s hearts may be affected differently by type 2 diabetes before and after menopause.
The researchers are among a cohort of leading mid-career scientists to receive a total of almost €6m, about £5.2m, through a partnership between the British Heart Foundation, the Dutch Heart Foundation, the German Centre for Cardiovascular Research and the Lefoulon-Delalande Foundation to support international research collaborations over four years.
The menopause project will be led by Dr Lisa Heather, from the University of Oxford, Dr Miranda Nabben, from Maastricht University and Dr Annie Turkieh, from the Pasteur Institute.
Professor Metin Avkiran is director of international partnerships and special programmes at the British Heart Foundation.
Avkiran said: “We’re delighted to be supporting these ambitious research programmes alongside our European partners, and to welcome CNIC and CIBER-CV to this pioneering partnership,” said
“By joining together, we can make the money donated by BHF’s generous supporters go further to drive more lifesaving research.
“By placing mid-career researchers at the heart of this scheme, we’re backing emerging leaders in cardiovascular science.
“These partnerships are designed to last well beyond the lifetime of the awards and help address the biggest unmet needs in cardiovascular research.”
Before menopause, women are largely protected from diabetic cardiomyopathy, a type of heart muscle damage linked to diabetes, yet after menopause they become more vulnerable than men and more susceptible to heart failure.
Researchers do not yet fully understand why this happens, but believe changing hormone levels after menopause may disrupt cell signals sent out by fat tissue.
This may lead to diabetic cardiomyopathy and trigger damage to the heart.
The study will examine how the hearts and fat tissue of women with type 2 diabetes differ before and after menopause, using animal models, human cells, computer modelling and patient data.
The team says this could lead to a blood test for earlier diagnosis and better treatments for women living with type 2 diabetes.
Menopause
CBT shows promise for menopause insomnia and hot flashes

Cognitive behavioural therapy (CBT) may offer short-term relief for menopause insomnia and night-time hot flushes, a pilot study suggests.
CBT is a structured, short-term talking treatment that helps people change thoughts and behaviours that can worsen sleep problems.
Researchers found the intervention was linked to meaningful short-term improvements in insomnia severity, hot flush interference, sleep self-efficacy, or confidence around sleep, and depressive symptoms.
The Menopause Society said insomnia affects an estimated 20 to 60 per cent of perimenopausal and postmenopausal women in the US.
Ongoing research is focusing on effective treatments because insomnia can have serious physical and psychological effects.
Dr Monica Christmas, associate medical director for The Menopause Society, said: “Nocturnal hot flushes (night sweats) and sleep disruption can have a significant effect on the quality of life with many women claiming extreme impairment due to symptoms that often start in early perimenopause and last 10 or more years.”
“Sleep disturbances can persist even in those using pharmacological therapy to manage hot flushes.
“The study’s findings highlight the utility of cognitive-behavioural therapy as a standalone treatment for insomnia and hot flushes, offering women an alternative or adjunct to pharmacological treatments.”
Insomnia is defined as disturbed sleep associated with distress or impaired daily functioning and is one of the most common complaints in perimenopause and postmenopause.
It can reduce quality of life and is linked to higher healthcare use and costs, disability, depression and cardiovascular disease.
Hot flushes occur in 60 to 80 per cent of women during the menopause transition and can persist for four to five years on average.
Night-time hot flushes are linked to sleep disruption, and women may respond by napping or spending longer in bed, which can help keep insomnia going.
Previous studies have shown that cognitive behavioural therapy is an effective treatment for insomnia and may also help women cope with hot flushes and other menopause symptoms.
However, few trials have looked at both insomnia and hot flushes together.
Insomnia during and after the menopause transition is complex and can have many causes, including ageing, hormone fluctuation, hot flushes, other sleep disorders, psychiatric and medical conditions and psychosocial stressors.
Because women with acute and sustained insomnia can experience greater negative health effects, effective treatment is important.
The pilot study concluded that CBT was feasible and may be a promising approach for menopause-related insomnia and nocturnal hot flushes, although the benefits appeared to lessen after three months.
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