Menopause and PTSD Among Women in Service

As we navigate through life, certain phases bring about unique challenges that deeply impact our well-being. One such intersection that often remains unexplored is the connection between menopause and post-traumatic stress disorder (PTSD), especially in the context of servicing and veteran women, including first responders.

This blog article, delves into the complexities of this relationship and sheds light on how experiences in service to others intertwine to shape the journey of uniformed women. Further, this article will explore menopause literacy in the communities where serving and veteran women can feel better supported with tools that enforce awareness and education in the workforce.

Understanding the Journey

The journey of menopause is a natural phase that women go through, marked by significant hormonal changes. However, for women who have served in uniform - millitary or first responders - and have experienced trauma during their service, such as combat or sexual assault, the onset of menopause can amplify symptoms of PTSD. The hormonal fluctuations in estrogen and progesterone levels can intensify anxiety, depression, and mood swings, making it a particularly challenging time for these women. One of the important qualities of estrogen is its neuroprotective and antidepressant effects. Naturally, when it drops, there are adverse effects on mood and depressive symptoms. In fact, depressive episodes in women, in general, appear to be linked to hormone changes, according to a published in the The National Library of Medicine.

But understand, depressive symptoms during the menopausal transition are common and should not be negatively perceived. According to Mandy Stenehjem, for the Master of Physician Assistant Studies (MPAS) program, University of North Dakota, treatment guidelines strongly advise for early screening and starting a conversation about perimenopause and the associated mood symptoms. Only then can depression in perimenopausal be identified appropriately and a more individualized treatment plan be developed based on the client's severity.

Impact on Mental Health

The coexistence of menopause and PTSD can manifest in various ways, leading to heightened anxiety, irritability, difficulty sleeping, and triggering traumatic memories. The experience of vasomotor symptoms -hot flashes and night sweats - common of menopause, can further exacerbate existing PTSD symptoms, creating a cycle of emotional and psychological distress for these individuals. Research shows that women, let alone clients diagnosed with PTSD, are more vulnerable to depression during this time, with rates typically ranging from 20% to 40%. Factors such as a history of depression, early onset of menopause and vasomotor symptoms increase the risk of depression,a ccording to the MGH Center for Women's Mental Health.

To effectively navigate this intersection, it is essential for healthcare providers to recognize the unique needs of serving and veteran women experiencing menopause with their PTSD diagnosis. As mentioned, early screening and conversations lead to approprate treatment, however, many may go undiagnosed and untreated due to misconceptions about menopause. However, more accessible and educationregarding perimenopausal depression and tools for depression screening are critical so that this population of vulnerable women do not slip through the cracks. 

Seeking Support and Treatment

Psychotherapy, particularly cognitive behavioral therapy (CBT), can help develop coping skills to manage symptoms. The Centre for Women's Mental Health, defines CBT as a brief, goal-oriented psychotherapy approach that emphasizes developing skills and focuses on the interplay between thoughts, emotions, and actions. Its aim is to empower individuals by teaching them to adjust unhelpful behaviors and thought patterns that might be contributing to a specific issue.

Treatment can also include, particularly if the prevalence of severe depressive symptoms, stressful life events, and heightened mood fluctuation exists antidepressants as a first step (Stenehjem, 2023). However, antidpressants should mot be prescribed as a first line of treatment for menopausal women, in general. This form of treatment is nuanced and covered in a previous blog article but should always be discussed with a client's healthcare team.

Building Awareness and Support

Educating society about the intersection of menopause and PTSD is crucial in ensuring that women in this demographic receive the necessary support and resources to thrive during this phase of life. By destigmatizing conversations around menopause and PTSD within military and civilian communities, we can create a more supportive environment for serving and veteran women to seek help and healing.

The journey of menopause and PTSD in military women is a multifaceted one, filled with challenges and resilience. By raising awareness, advocating for comprehensive care, and fostering open conversations, including with the healthcare providers we can empower these women to navigate this intersection with strength and grace. Seeking help from healthcare professionals, support groups, or trusted individuals is a crucial step towards finding healing and reclaiming well-being.

Empowering Women Through Menopause Literacy

Remember, you are not alone in this journey. There is hope, there is help, and there is healing. Let's continue to support and uplift each other as we navigate through these phases of life.

Shining a light on the often overlooked intersection of menopause and PTSD in military women can pave wave for better support and resources for those suffering, often in silence and alone. By acknowledging and addressing the unique challenges faced by these individuals, we create a more compassionate and understanding environment for their healing journey be it in military, emergency services, policing, or the civilian workforce, as well as the broader community.

The demand for hormone health education is growing as women show increasing curiosity for understanding this significant stage in their lives. So, creating a community approach toward menopause literacy is essential everywhere, from healthcare settings to places of work, as well as throughout local communities. This is where a licensed menopause champion can come in to play.

Tools for change

Through workshops, webinars and coaching, The Menopause Expert Group (MEG) arms their licensees with tools to destigmatize menopause and foster open dialogue and empowerment within communities. If you are looking to host an event that addresses the needs of individuals going through menopause, hire a MEG Licensed Menopause Champion. Together, you can create an inclusive and supportive environment where individuals feel seen, heard, and empowered to embrace this stage of life. Consider a licensed Menopause Champion as your in-house expert to bring education, awareness and tools to help create a more supportive, includive workplace environment.

References

Nonacs, R. (2021, Nov 3). Essential Reads: Who is at Risk for Depression During the Perimenopause? Women's Mental Health: A Clinical and Research Blog. Retrieved from https://womensmentalhealth.org/posts/essential-reads-who-is-at-risk-for-depression-during-the-perimenopause/

Albert KM, Newhouse PA. Estrogen, Stress, and Depression: Cognitive and Biological Interactions. Annu Rev Clin Psychol. 2019 May 7;15:399-423. doi: 10.1146/annurev-clinpsy-050718-095557. Epub 2019 Feb 20. PMID: 30786242; PMCID: PMC9673602.

Stenehjem, Mandy, "Perimenopausal Depression Screening and Treatment Efficacy Between Antidepressants and/or Hormone Replacement Therapy" (2023). Physician Assistant Scholarly Project Papers. 174.
https://commons.und.edu/pas-grad-papers/174

Women's Mental Health. (2018, July 16). CBT for the Management of Perimenopausal Symptoms. Women's Mental Health. Retrieved from https://womensmentalhealth.org/posts/cbt-management-perimenopausal-symptoms/

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