Treating menopausal patients: menopause, mood and the mirror

‍World Menopause Day is held each year on 18 October. In this guest article, Kimberley Cairns, psychologist and psycho-aesthetic consultant, explores the less discussed side effects of this hot topic, and how menopause affects body image and subsequent patient motivations for treatment.

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The menopausal transition: mood

Menopause is the time when periods stop due to lower hormone levels. The menopausal transition most often begins between ages 45 and 55. It usually lasts about seven years, but for some it can be as long as 14 years. Symptoms of menopause can have a huge impact on someone's life, including relationships and work, and may be compounded by other factors that are often present during this stage of life, including caring for ageing parents or relatives, suffering bereavement, and supporting children as they move into adulthood. These factors are well established in regards to their impact on mental health.

For some women a sense of relief may come with the menopause, when they no longer need to worry about painful periods or getting pregnant. At any stage of the menopausal transition, common physiological and emotional changes can occur. This includes but is not limited to fatigue, hot flashes, disturbed sleep, difficulties with memory, pain during sex, dryness, increased irritability, and depression.

During perimenopause, the body's production of oestrogen and progesterone hormones varies greatly. The body begins to use energy differently, fat cells change, and as a consequence weight gain can happen more easily. There can be changes in bone and heart health and cognitive function, hair may go grey, skin becomes dry and tone becomes uneven. Hormonal changes associated with menopause can also have wide-ranging impacts on cardiovascular health – the theme for World Menopause Day 2023.

Menopause and body image: mirror

It has been reported that women with higher self-esteem and positive attitudes toward menopause experienced fewer negative symptoms, whereas women with negative attitudes toward menopause experienced higher levels of shame about their bodies, and lower bodily esteem. The influence of menopause on body image is a growing area of research and according to the Mental Health Foundation, people in later life report feeling dissatisfied with their bodies and having misconceptions of their body size and shape. The Mental Health Foundation reported that, around one in five adults aged 55+ felt anxious (20%) or depressed (23%) specifically because of their body image, demonstrating that body image continues to affect our mental health into later life.

Women with low levels of oestrogen may experience weight gain in the abdomen, while women with high levels of oestrogen may experience weight gain in the hips and thighs. This may lead to an increased insecurity about weight gain which may be due in part to not matching media and societal ideals of body shape and weight, and experiences of appearance-related shaming or stigma. Stigma is a contributing factor to emotional distress which can cause social isolation and avoidance of situations where discrimination may occur. This can even include participation in health-promoting activities.

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Seeking an aesthetic provider: motivation

A desire to change physical appearance by way of cosmetic fillers and toxin is well reported in literature by those that report poor perceptions of body image. The culmination of physical, emotional, social and psychological factors associated with the menopause could underpin a clear motivation or catalyst to seek aesthetic or non-surgical cosmetic intervention in an attempt to relieve unwanted symptoms and help improve body image. It is important to be realistic with any patient and consider them as a whole and much more than their presenting symptoms through a detailed consultation exploring a broad scope of motivational factors for managing expectations and improved patient selection.

Common considerations:

Hot flashes and heavy sweating may be a clear motivation to seek anti-sweat treatments
Dry skin, uneven skin tone and blotchy skin may have been brought on by menopause
Intimate health and bladder control treatments may be of particular interest to the peri-menopausal population
‘Looking tired’ is often reported when requesting tear trough treatments making this an attractive treatment for those suffering with poor sleep
Intravenous vitamin treatments, and supplements may be attractive to those suffering from ‘brain fog’, and also those looking to restore energy and balance to mood changes and irritability
Body and face filler can ease the dissatisfaction with the body changing shape unexpectedly
Those experiencing fatigue may be attracted to toxin for targeting headache relief
Weight loss and sculpting services to manage the discomfort with changes of the body shape and weight.
Treatment for menopause is a regulated activity that requires CQC registration

Treating symptoms in isolation will limit treatment outcomes. Other factors such as genetics, lifestyle, and social influences also play a role. Unmanaged, early or misdiagnosed menopause can affect body image in various ways and it’s important to be aware that not only those who identify as women will experience menopause. Some transgender men, non-binary people and intersex people or those with variations in sex characteristics may also experience menopause. A specialist psycho-aesthetic approach can assist the complexities of body image and elective aesthetic intervention. It is important to remember that every experience of menopause is unique and that there are many ways to improve one’s body image during this time. Any consultation should provide non-aesthetic alternatives to make sure the right people get the right support at the right time.