Mindfulness Eases Menopause Symptoms, Stress

Tara Haelle

October 11, 2018

SAN DIEGO — Women who are "mindful" — who can pay attention to the present moment and be nonjudgmental — have a lower burden of menopausal symptoms and experience less stress, results from a new study show.

And in women with higher stress levels, in general, "the magnitude of association between mindfulness and menopausal symptoms appeared more robust," said Richa Sood, MD, from the Mayo Clinic in Rochester, Minnesota.

Women experience a wide range of potentially stressful experiences as they move through midlife, including menopausal issues and general aging, Sood said here at the North American Menopause Society (NAMS) 2018 Annual Meeting.

It is often in midlife that children move out of the family home, leaving an "empty nest," and aging parents need care just as careers are reaching their peak. "Add menopausal symptoms to the mix and you have the perfect storm," said Sood.

"Stress can interfere with work relationships and can affect productivity" for people with mood issues, and "the symptoms of menopause can get amplified," reducing a woman's overall quality of life, she added.

Sood and her colleagues wanted to find out if mindfulness, which is believed "to mitigate stress by decreasing emotional reactivity and maladaptive, negative ruminative thinking," could help.

The team conducted a cross-sectional study of 1744 women, 40 to 65 years of age, who visited the Women's Health Clinic at the Rochester Mayo Clinic from January 2015 to December 2016. Nearly all the women were white (93%) and married (83%), and most had at least a 4-year college education (65%) and were employed (65%). Their average age was 53.4, and average body mass index was 26 kg/m2.

The women completed three assessments: the 11-item Menopause Rating Scale (MRS), the four-item Perceived Stress Scale-4 (PSS-4), and the 15-item Mindfulness Attention Awareness Scale (MAAS).

Greater mindfulness correlated with lower stress levels and a lower burden of menopausal symptoms. Each 1-point increase in a woman's mindfulness MAAS score translated to a 1.98-point decrease in her PSS-4 stress score and a 3.97-point drop in her MRS menopausal symptom score (P < 0.001).A higher burden of menopausal symptom was linked to greater stress, with each 1-point increase in the MRS score correlating to a 0.26-point increase in PSS-4.

For example, for a woman with a PSS-4 stress score of 4, a 1-point increase in her mindfulness score correlated with a 1.53 drop in her menopausal symptoms score. Women with higher baseline stress — PSS-4 values of 8, 12, and 16 — saw their MRS scores drop 1.9, 2.27, and 2.64 points, respectively, with each 1-point increase in their mindfulness score.

"Although additional studies are needed in more diverse settings to replicate our findings, this study provides a strong signal for the potential role of mindfulness in improving psychological symptoms, emotional response to menopausal symptoms, and stress in women during midlife," Sood and her colleagues write in their abstract.

Previous research has shown the positive effects of mindfulness on a woman's mental and physical health, quality of life, and sleep, said Sood. Most of that research, however, relied on interventions that taught mindfulness, whereas participants in this trial had no such training.

It appears that dispositional mindfulness is "protective against stress and symptoms in midlife women," she explained.

Sood suggested two potential mechanisms that could explain these findings.

"Since 'trained' attention can be deployed at will, more mindful women may be choosing to shift their attention to more pleasant aspects of life rather than their symptoms," she explained. And "more mindful women may be softening the impact of their symptoms by avoiding negative emotional responses to their symptoms and by decreasing ruminations about their implications."

More mindful women may be choosing to shift their attention to more pleasant aspects of life rather than their symptoms.

Previous research has shown that mindfulness reduces the impact of hot flashes, although it does not affect the frequency or intensity of those vasomotor symptoms, said JoAnn Pinkerton, MD, from the University of Virginia Health System in Charlottesville, who is executive director of NAMS. "These new findings add to that body of evidence."

This could be "an alternative nonmedication option for symptomatic menopausal women," she said. For women who do not take hormone therapy but struggle with anxiety, sleep disturbances, hot flashes, or other menopausal symptoms, clinicians might consider referring them to an 8-week course in mindfulness-based stress reduction.

"The goal is that instead of the brain spinning and worrying and feeling anxious, women can learn to relax themselves, calm themselves, and be more self-aware," Pinkerton told Medscape Medical News.

"Taking a deep calming breath slows your brain waves" and is something women can learn to do in classes or online, she said.

The research did not receive outside funding. Sood and Pinkerton have disclosed no relevant financial relationships.

North American Menopause Society (NAMS) 2018 Annual Meeting: Abstract S-11. Presented October 5, 2018.

Follow Medscape OBGYN on Twitter @MedscapeObGyn and Tara Haelle @TaraHaelle

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