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Mindset and Menopause

Mindfulness practices can improve women’s experiences and exercise motivation.

Flowers as female reproductive organs to represent mindset and menopause

There’s no arguing about the benefit and importance of physical activity for our health, especially during menopause. And that’s only the starting point: Women transitioning through menopause benefit from a comprehensive approach—one that addresses both body and mindset—so they can have the most positive experience possible. Studies have shown that attitude plays a big part in how women experience menopause. For example, women with a more positive attitude tend to have a more positive body image and less depression (Erbil 2018). What’s more, addressing the mental aspects of menopause can help boost a woman’s motivation to exercise (see “Menopause and Motivation,” below). Fortunately, attitude is something that fitness professionals can help their clients improve through an added focus on mindset and mindfulness during workout sessions.

Mindset and mindfulness both start with the mind but are quite different in definition. Still, they can be complementary in helping achieve a goal—in this case, improving a woman’s experience of menopause. Mindset can be described as a person’s way of thinking, while mindfulness refers to how people feel about their own thinking.

Mindset

Carol Dweck, PhD, professor of psychology at Stanford University in California, coined the two most-used terms about mindset in her book Mindset: The New Psychology of Success (Ballantine Books 2006). In it, she talks about two types of mindsets: growth mindset and fixed mindset. People with a growth mindset believe that change is possible, while those with a fixed mindset believe they cannot change anything about their situation or outcome.

For example, some women dread menopause, thinking it will be an awful experience and that there’s nothing they can do about it. Others keep a more open mind and believe that menopause may be challenging but that there are things they can do to minimize the effects.

Understanding and adapting to a situation is a significant component of a growth mindset. The underlying question is: What can I do to make the best of this situation?

A Matter of Perception

Thomas, Mitchell & Woods (2018) make an interesting and important distinction between the terms “challenges” and “stressors” when talking about menopause. According to them, the word challenge refers to experiences that require great physical and mental effort, while a stressor is a stimulus or threat that places real or perceived demands on the body, emotions, mind or spirit of an individual. This distinction is important because women may experience challenges but not perceive them as stressors. It highlights that the experience of menopause is greatly influenced by mindset and attitude and possibly less by symptomology.

Symptom Outcomes

Another aspect of mindset within menopause is that it can influence what a person expects the outcome to be. For example, suppose a woman believes menopause will be full of symptoms. She has a higher risk of experiencing symptoms, while women with a more positive attitude toward menopause report having fewer symptoms (Ghazanfarpour et al. 2015).

Another way to see this phenomenon is the placebo versus nocebo effect. “Placebo and nocebo effects are the effects of patients’ positive and negative expectations, respectively, concerning their state of health” (Colloca & Barsky 2020). The North American Menopause Society also highlights the fact that many of the changes that come with menopause are not avoidable, but how a woman experiences menopause has a lot to do with her mindset and attitude (NAMS 2022).

Psychological Rewards of Mindset in Menopause

Research on the impact of mindset and stress has shown that a stress-is-enhancing mindset mitigates the development of depression and anxiety symptoms (Huebschmann & Sheets 2020). A person with a stress-is-enhancing mindset tends to believe that stress can have positive outcomes versus a person with a stress-is-debilitating mindset who believes it will have negative consequences. Considering that the menopausal transition is considered a “window of vulnerability” for the development of depressive symptoms, developing the right mindset can have big rewards (Soares 2014).

Mindfulness

According to Kabet-Zinn (1994), “Mindfulness means paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally.” Research indicates that mindfulness can play a big role in alleviating and managing menopause symptoms, as well as increasing menopause-specific quality of life (Sung et al. 2020).

Mindfulness is a skill that can be learned. Many different types of mindfulness training have been shown to improve menopause symptoms. Examples include yoga, tai chi, breathing, meditation and mindfulness-based stress reduction (MBSR). The goal is to make a person more resilient and able to handle day-to-day stressors and challenges.

Mindfulness-Based Stress Reduction

Mindfulness-based stress reduction is based on the concept that a person can become better at recognizing thoughts, feelings and stressful sensations and having strategies in place to be aware of them but not react to them.

In a systematic review of the peer-reviewed literature regarding the effects of self-administered mind-body therapies on menopausal symptoms, MBSR significantly improved quality of life, anxiety, sleep and perceived stress among study subjects (Innes, Selfe & Vishnu 2010).

One important factor to mention is that MBSR may not be effective at reducing the occurrence of menopausal symptoms, but it improves the ability to cope with them, which is what results in an increase in quality of life (Carmody et al. 2011).

Besides the psychological and physiological benefits of MBSR highlighted in studies, two big advantages of MBSR are the costs (which are low to none) and the accessibility (it can be practiced anywhere without any specialized equipment).

Understanding and adapting to a situation is a significant component of a growth mindset. The underlying question is: What can I do to make the best out of this situation?

Physical Activity and Mindset

The role of physical activity in health and quality of life is well-established in the research literature. Physical activity positively impacts menopausal symptoms and psychological health and results in lower general menopausal symptom reporting (Daley et al. 2007; McAndrew et al. 2009). Shorey, Ang & Lau state that, “Exercise-based interventions and mind-body therapies suggest effectiveness on quality of life, menopausal symptoms and depression.”

See also: The Best Exercises for Menopause and Postmenopause.

Barriers to Exercise in Menopause

Although physical activity has been correlated to improved menopause health, women often lack the motivation to exercise, which can be in part due to menopause symptoms such as lack of energy, fatigue, insomnia, depression, anxiety, etc. (Ali, Ahmed & Smail 2020).

See also: Body Image During Menopause.

Additionally, a woman’s mindset toward the effectiveness of physical activity in helping with menopause symptoms might pose a hurdle. Research indicates that a person’s mindset about how well their level of physical activity corresponds to their desired health outcome—and the uncertainty around what it means to get the adequate and correct type of physical activity—can inhibit motivation to engage in such activity (Zahrt & Crum 2020).

Women are inundated with conflicting information about what type of exercise is the best, with some studies indicating that low- to moderate-intensity exercise is the best. In contrast, others say that high-intensity training is the most beneficial approach. The inconsistency in recommendations leaves women confused and often paralyzed to start a physical activity routine.

Physical Benefits of an Adaptive Mindset in Menopause

Zahrt & Crum indicate that promoting a growth mindset, which they refer to as an adaptive mindset, is most likely to increase well-being in menopausal women. Their support for adaptive mindsets go hand in hand with research that indicates that having a mindset of more flexibility is more beneficial in long-term and sustainable health behaviors (Ng 2018).

In her TEDx Talk “Why We Fail and How We Stand Up Afterwards,” Katherine Milkman, PhD, mentions that when people make concrete plans, such as setting a specific time and sequence to work out (e.g., every day at 5 a.m.), they are more likely to follow that routine but are less likely to complete their workout if they miss their predetermined time. People who learn to be more flexible can be more successful at long-lasting habits, because learning to adapt to sudden changes can make it easier to complete the goal regardless of time or day.

See also: Women in Menopause Benefit From Physical Activity.

With an adaptive mindset, women feel the freedom to make physical activity decisions based on how they feel on each given day rather than a preplanned and rigid routine. For example, if the plan is to work out at 5 a.m. but, as a perimenopausal woman, insomnia kept you up all night, it’s okay to prioritize sleep and not get up—but then still work out later in the day.

Build Mental Muscle—and Motivation for Mindset in Menopause

Symptoms experienced during menopause can greatly impact a woman’s motivation, energy and overall quality of life. Research indicates that the menopausal experience is influenced by a woman’s mindset and her attitude toward menopause, so providing female clients with help in improving or changing their mindset can be a powerful tool in keeping them motivated to continue their fitness and wellness journey.

Mindset and Mindfulness Tips for Menopausal Clients

To help your clients navigate the unique challenges of menopause—and improve their motivation to engage in beneficial physical activity—work with them on these exercises as a part of each training session.

  • Discuss and explore the rewards of menopause, not just the challenges.
  • Recommend ways to add mindfulness and movement to every day.
  • Help them focus on what they can do with what they have and where they are.
  • Encourage them to be open to learning new things about their body and mind.
  • Explain how to find credible resources on menopause, and encourage them to seek experts to answer their questions.
  • Remind them that menopause is a transition and will soon be in their rearview mirror.
  • Encourage those who have found successful strategies to share their insights with others in this phase of life.

Menopause and Motivation

There are numerous factors that affect how a woman views and transitions through menopause—and whether she is able to embrace the physical movement that can improve outcomes.

Symptoms. The constantly changing hormonal profile during menopause can result in various physical, psychological and sexual symptoms that often go untreated but profoundly affect women’s bodies, psyches and fitness habits. For example, fatigue and lack of energy—common symptoms of menopause—can inhibit motivation and adherence to exercise. In fact, 43.9%–64.7% of women in this stage of life report a lack of energy and fatigue (Ali, Ahmed & Smail 2020).

Stressors. Ali, Ahmed & Smail state that psychological distress is widespread among menopausal women and is a crucial link to negative attitudes toward menopause. This may be attributed to the multitude of responsibilities and experiences, including balancing family, work and eldercare, while also possibly experiencing losses such as the death of a loved one, children leaving the house or relationships coming to an end (Thomas, Mitchell & Woods 2018). Additionally, Sood et al. (2019) state that “psychological symptoms, rather than the vasomotor symptoms, affected women’s view of menopause negatively.” These circumstances can also get in the way of scheduling regular workouts.

Culture. It is interesting to note that culture can also influence the attitude toward menopause. For example, a woman’s attitude toward menopause can be dependent on whether “menopause is seen as a medical condition or a natural phenomenon, or whether mid-life represents positive or negative social changes and/or values within a society” (Ayers, Forshaw & Hunter 2010). Understanding the roots of a woman’s views of menopause may help fitness professionals provide targeted support and help her positively transition through this part of life.

References

Ali, A.M., Ahmed, A.H., & Smail, L. 2020. Psychological climacteric symptoms and attitudes toward menopause among Emirati women. International Journal of Environmental Research and Public Health, 17 (14), 5028.

Ayers, B., Forshaw, M., & Hunter, M.S. 2010. The impact of attitudes towards the menopause on women’s symptom experience: A systematic review. Maturitas, 65 (1), 28–36.

Carmody, J.F., et al. 2011. Mindfulness training for coping with hot flashes: Results of a randomized trial. Menopause, 18 (6), 611–20.

Colloca, L., & Barsky, A.J. 2020. Placebo and nocebo effects. The New England Journal of Medicine, 382 (6), 554–61. Daley, A., et al. 2007. Exercise participation, body mass index, and health-related quality of life in women of menopausal age. British Journal of General Practice, 57 (535), 130–35.

Dweck, C.S. 2006. Mindset: The New Psychology of Success. New York: Ballantine Books.

Erbil, N. 2018. Attitudes towards menopause and depression, body image of women during menopause. Alexandria Journal of Medicine, 54 (3), 241–46.

Ghazanfarpour, M., et al. 2015. The relationship between women’s attitude towards menopause and menopausal symptoms among postmenopausal women. Gynecological Endocrinology, 31 (11), 860–65.

Huebschmann, N.A., & Sheets, E.S. 2020. The right mindset: Stress mindset moderates the association between perceived stress and depressive symptoms. Anxiety, Stress, and Coping, 33 (3), 248–55.

Innes, K.E., Selfe, T.K., & Vishnu, A. 2010. Mind-body therapies for menopausal symptoms: A systematic review. Maturitas, 66 (2), 135–49. Kabat-Zinn, J. 1994. Wherever You Go, There You Are. New York: Hatchette Books.

McAndrew, L.M., et al. 2009. When, why and for whom there is a relationship between physical activity and menopause symptoms. Maturitas, 64 (2), 119–25.

Milkman, K. 2017. Why We Fail and How We Stand Up Afterwards. YouTube. TEDx Talks. Accessed Nov. 14, 2022: youtube.com/watch?v=zaf3yQ4OLdw.

NAMS (North American Menopause Society). 2022. Make your menopause a positive experience. Accessed Nov. 14, 2022: menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/make-your-menopause-a-positive-experience.

Ng, B. 2018. The neuroscience of growth mindset and intrinsic motivation. Brain Sciences, 8 (2), 20.

Shorey, S., Ang, L., & Lau, Y. 2020. Efficacy of mind-body therapies and exercise-based interventions on menopausal-related outcomes among Asian perimenopause women: A systematic review, meta-analysis, and synthesis without a meta-analysis. Journal of Advanced Nursing, 76 (5), 1098–110.

Soares, C.N. 2014. Mood disorders in midlife women: Understanding the critical window and its clinical implications. Menopause, 21 (2), 198–206.

Sood, R., et al. 2019. Association of mindfulness and stress with menopausal symptoms in midlife women. Climacteric: The Journal of the International Menopause Society, 22 (4), 377–82.

Sung, M-K., et al. 2020. A potential association of meditation with menopausal symptoms and blood chemistry in healthy women: A pilot cross-sectional study. Medicine, 99 (36), e22048.

Thomas, A.J., Mitchell, E.S., & Woods, N.F. 2018. The challenges of midlife women: Themes from the Seattle Midlife Women’s Health Study. Women’s Midlife Health, 4 (8).

Zahrt, O.H., & Crum, A.J. 2020. Effects of physical activity recommendations on mindset, behavior and perceived health. Preventive Medicine Reports, 17, 101027.


Maria Luque, PhD, MS, CHES

Maria Luque, PhD, is a health educator, fitness expert, presenter, writer and USAF veteran. She created Fitness in Menopause, a company dedicated to helping women navigate the challenges and rewards of menopause. Her course “Menopausal Fitness: Training the Menopausal Client” is NASM-, AFAA- and ACE- accredited. She holds graduate and postgraduate degrees in health sciences and teaches at the College of Health and Human Services at Trident University International.

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