Menopause is defined as after menstrual periods have stopped for 12 months. Perimenopause is the phase before the final menstrual period when the body's sex hormones are fluctuating in an unpredictable manner. The surging and ebbing of hormones is responsible, at least in part, for many of the troubling symptoms that women experience, including hot flashes, night sweats, brain fog, and sleep disruption. Studies also show that perimenopausal women are much more likely to experience anxiety and depression, as well as worsening of existing mental illnesses.
In one particular study of women age 45-55 in Brazil, as many as 52% and 68% of the perimenopausal women were diagnosed with anxiety and depression, respectively. Multiple causes may explain the increase, including erratic estrogen levels, loss of sleep due to night sweats, worry about the onset of menopause, and/or increased stress from children leaving home for college or from taking care of aging parents.
Although there are medical options for treatment of anxiety and depression (anti-depressant/anti-anxiety drugs, MHT, and pyschotherapy), many patients fail to seek treatment, often because of practical limitations, such as cost, undesirable side effects, or lack of access to providers. A 2023 report from Stanford University published in Cell found that daily 5-min breathwork exercises produce a significant improvement in mood and a reduction in respiratory rate. A 2022 meta-analysis published in Scientific Reports describes a significant effect of breathwork on self-reported/subjective stress, anxiety, and depression compared to non-breathwork control conditions. Breathwork is easy to learn and doesn't have any of the limitations listed above.
As an OBGYN who specializes in helping women navigate menopause, I have been recommending a simple but elegant breathing device that my patients can keep with them at all times to help keep their stress under control. The Komuso Shift is a device that can be worn around the neck as a necklace or on the wrist as a bracelet. It functions by increasing the time of your exhale, which signals your body to "shift" out of a fight-or-flight mode into a more relaxed state. To use the Shift, you should take a deep inhale to fill your belly with air, pause, then place your mouth completely around the end of the Shift, and release the air from your belly as a normal exhale. Don't blow or push - just gently release the air. The 8-10 second exhale necessitated by the shape of the Shift tells your body to reduce your heightened state into a lower, less activated one. Repeat the breathing exercise 5x, ideally every hour.
The Shift is an effective way to reduce stress, and having the device available at all times during the day makes it more likely that you'll use it. I have one and bought another one for my teenage son. I find it helpful to use before public speaking, after arguing with my teenager, and before important meetings. He tells me he uses it before big tests, when social situations start to be overwhelming, and to help him speak up in class. I confess that I don't follow my own "use once per hour" advice, but I do find myself reaching for it as I notice my shoulders and jaw getting tense. It's comforting that I know I can settle myself whenever I need. You can get 15% of the Shift at https://www.komusodesign.com/purely15
See your doctor immediately if you are having thoughts of harming yourself or others. If you experience frequent, severe feelings of anxiety or panic attacks and/or the breathwork techniques are not working for you, contact a medical professional.
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