Anshu Bahanda: This is Anshu Bahanda on Wellness Curated. Thanks for joining me on this podcast. My mission is to empower you with health and wellness so that you can then go and empower others. We have someone very special today. We have Katrine Cakuls, who’s a manual therapist and a Canadian qualified physio and osteopath. She’s worked internationally in Canada, England, Australia, and the US. She’s addressed all levels of fitness and health, and her work has been featured on national television. She’s been quoted in books. She works with a network of practitioners, including medical consultants, psychotherapists, acupuncturists, homoeopaths and movement specialists. Here’s something that really stayed with me.
Welcome to the chat, Katrine. So tell me, how are stress and menopause related?
Katrine Cakuls: Menopause is a big transition in a woman’s life. It’s a natural transition in her hormonal life, but it does bring on big changes, and the brain doesn’t like changes. Going away from the familiar is really difficult for the brain because the brain is always looking for familiar patterns to take us back to. That’s not what’s happening in menopause, things are changing. This can be very stressful. On top of the fact that most women going through menopause are between the ages of 45 to 55, when there are many other stressful factors, such as dealing with ageing parents, such as dealing with maintaining a household, raising children, dealing with spousal relationships, and all on top of this, trying to hold down a job.
KC: Taking care of all of this on top of having hormones that are shifting, which is the change that’s going on in menopause, can make for a very bumpy and difficult ride, if the stress of the life isn’t well managed.
AB: What is the stress response to menopause? Everyone talks about being stressed during menopause, but explain that to us a little more.
KC: So let’s start with the stress response in general, because the stress response is generic, whether you’re in menopause or not. The stress response is an emotion in relation to something that is not in balance with what we’re feeling internally. So, for instance, we have a fear of going for a job interview or going on a first date. So it could be a mental picture, or it can be something really physical. We’re standing in front of an angry tiger. In both cases, whether the stressor is imagined or whether it’s actually real, you get the same response. And that’s a very key point to remember in what I’m going to say. And the stress response is very set. It acts very quickly, and it always acts in the same way. You get this rush of biochemicals flowing through your body that do a couple of things. Number one, they get you into action because it’s a survival response. So the first thing that it does is it takes blood away from your digestion and away from reproduction because if you’re standing in front of a tiger you don’t have time to digest, you don’t have time to reproduce. So it pumps blood instead to the heart and our large muscles. So we get increased heart rate, increased breathing. We start to sweat and we’re ready to go into action. All of our senses are heightened. One of the glands that’s activated during the stress response is called the adrenal gland. It sits down sort of by our waist just above the kidney on both sides. Adrenal glands do, besides being part of the response unit, the stress response in menopause they actually make secondary hormones-oestrogen and progesterone to help to balance out the hormonal shifts of menopause. Now, if you’re constantly under stress and the adrenals are busy taking care of the tiger again, real or not, then they won’t be able to kick in and help you to even out menopause and the shifts of the hormones.
AB: What are the main symptoms that happen to women during menopause? So I know it’s different for everyone, but what do you see as the main symptoms?
KC: So if you’re asking me directly the fluctuation in oestrogen and progesterone that happen at menopause cause a lot of different symptoms. But some of the main ones are fatigue or low energy, insomnia, weight gain, changes in libido usually a lowering of libido, some poor concentration like brain fog and some bladder issues and sometimes some joint aches and pains. And so if you want to relate that to what neuroscientists have found to explain that I’ve got a very interesting quote here by Dr Lisa Mosconi, she’s written an excellent book that I like, The XX Brain. She’s also written Brain Food and she describes that what some people might not realise is that in your brain there are little receptors. So these are these little areas that oestrogen goes into and sort of makes an action happen. But during menopause, because there’s a lowering of oestrogen, those areas of the brain change their function. And she’s very specific because she does a lot of research on the brain, particularly women’s brains which I think is an overlooked area. And she describes, for instance, very specifically that there’s this part of the brain called the hypothalamus. If the oestrogen is low, it doesn’t activate the hypothalamus, so the hypothalamus is involved in regulating body temperature. So the hot flashes that you get, that’s the hypothalamus. So sometimes it’s just good, I feel, to really know that there’s something concrete going on in the body.
AB: Wow. That is fascinating.
KC: Another change in the brain that happens because the little receptors aren’t getting the oestrogen and that is in charge of sleep and wakefulness. Oestrogen doesn’t activate the brain stem correctly, we have trouble sleeping, so again you can say it’s due to a million different reasons, that this is one big reason. If you look at stress making secondary oestrogen and progesterone, you want that to kick in to help with sleeping. The last part of the brain, two parts- there’s the amygdala, which is the emotional centre of the brain, close to another centre. That’s the memory centre called the hippocampus, so again, when oestrogen levels start to shift in these areas, you get mood swings and you forget things. Now, what’s interesting is that if you look at stress causes in terms of changes, you are going to get low energy, you are going to gain weight, you are going to get difficulties with sleep, you’re going to get muscle joint aches and pains. You won’t be able to think as clearly if you look at that. It’s almost a mirror to the menopausal symptoms.
AB: So the important thing to remember in life, during menopause specifically, is decreased stress and the menopausal symptoms will go down. Now, I know you talk quite a lot about intelligent stress management during menopause. Can you explain to us what you mean by that?
KC: I really wanted to find an approach for menopausal women that was scientifically evidence-based, because there are all kinds of fancy things we can do where we need to go to a spa and sit there for a while. Those are great, by all means I support them. But I like the intelligence of having something scientifically back that we can grab onto when we’re in the bus, when we’re dealing with our kids. One of the key points that I want to start with is that this approach teaches how you can decrease the intensity of the stress response in the moment it happens because we don’t realise how many stressors we engage on a daily basis. You’ve forgotten your money when you go to buy your lunch, whatever it is. There are small stressors that keep accumulating during the day. And the interesting thing is that every time there’s a stressor activates the stress response right away. So if you’re constantly turning on the stress response like this, you stay at a high stress level and you’re taxing the adrenal gland. Again, that’s supposed to be helping with menopause. So by the end of the day, you go to the gym and you think you’re going to take care of it, but you’re exhausted and you’re hungry and you go and buy a donut instead, then you go home and you’re irritable. Being able to have a tool where you can immediately take down that intensity of the stress response, for me, is really key. It stops the energy drain that the stress response brings on, so it’s revitalising. You’ll have a little extra energy at the end of the day, maybe you will go to the gym instead of having the donut or do both, whatever you like. The other thing that it does is that it improves your performance. When you’re stressed, it’s survival. You’ve got to act really quickly, you’ve got to think really quickly. It’s not the time to reflect, to sort of think deeply and make longer term decisions or really go back into deep memory and try to pull something forward. So let’s say that you’re in a meeting and somebody’s asking you difficult questions and you’re stressed. Do something quickly to take down the stress response. You’ll be able to analyse, pull out all those things that you remember and present them and improve your performance. With the stress response too, you don’t have as good access to your intuition. Take down the intensity, you’re in that meeting, you’re not sure what thing to choose. You choose better with your intuition when the intensity of stress is less.
KC: Also, it’ll give you a way to better respond to things. So for instance, if you respond like that *snaps*really quickly and snap into something, you may think, oh, I wish I didn’t say that. Taking down the stress response gives you that second to reflect and make a better choice in responding. So this allows you to put your best foot forward and to feel better about yourself. So this is the first really important point in the intelligent stress management. The second point I’d like to make has to do with becoming self aware of your emotions. So this approach teaches you about your emotions and your emotional patterns. Dr. Candace Kurt, who was an incredible neuroscientist and pharmacologist and wrote a wonderful book called “The Molecules of Emotion”, so I’m going to quote from her- “our physical body can be changed by the emotions we experience.” And in fact she goes to the point of saying that there is no body and no mind, she calls it the body mind. And so just to go through this a little bit more- every emotion you feel and every thought you think creates a cascade of electrochemical signals that go everywhere in your body. Negative thoughts like hate, fear, jealousy, loathing create signals that actually shut down self function. Whereas positive emotions like joy, gratitude, hope, do the exact opposite and improve self function. This has also been spoken about a lot by Dr. Bruce Lipton who is a cell biologist and wrote the book “The Biology of Belief”. And so he looked at the fact that if you put cells in a petri dish and if you put them in a different substance, it’ll change how the cells function. So again, negative thoughts, negative emotions really can change your health for the better or for the worse.
KC: For me, it’s very important to become aware of our emotions and our emotional patterns. One of the things that’s really important in this that I’ve added into the intelligent stress management is hands on treatment. So through my Osteopathic training, I work on people that come in for a variety of things, they might have sprained their ankle on the way to the audition of their life. I can work on their ankle. And they burst out into tears saying “I missed my audition”, that those thoughts, memories, are stored in tissues. And so what I found for decades, I’ve been practising over 30 years, is that when I treat people, they could have come in for a sprained thumb, burst out saying, “I hate my boss”. And then they say, “oh my God, where did that come from?” So the body stores memories. And so one of the things that I do with menopausal women, when I’m using this approach is I do hands-on work. They’ll come in, we’ll work on relieving tension in their body. There might be specific issues, there might not be. But in working on them to relieve those tensions, to relieve the specific issues, sometimes emotions come up. Sometimes I feel emotions that may be stuck. And so becoming aware of emotions allows us to work with repatterning our emotions. And this again takes me to another quote by another researcher that I really like, Joe Dispenza. But the one I’m going to quote here is breaking the habit of being yourself. So tying this all back into change and into menopause. Menopause is a great time of change. So if you want to go with the flow, go with the change. You may need to shift who you are, in relation to how your body’s acting, in relation to how your mind may be working, in relation to when you turn inwards and look at your emotions, maybe patterns that you no longer want. And what Joe Dispenza very clearly says is “our routine thoughts and feelings perpetuate the same reality”. So if we’re constantly thinking and feeling a certain way, we maintain our reality. You need to think, feel, act in different ways, be different in order to change your reality.
AB: If you can give us some practical tools that we can take away, that would be great,So you said a woman could be sitting on a bus and she can help herself, right? Or something that people can build into their lives which will help them.
KC: So let’s start with something that Professor Andrew Kuberman speaks about. He’s another neuroscientist at Stanford, and I like the way that he presented this. And this is a technique that will immediately take down the intensity of the stress response, it’s called the physiological sigh ,S-I-G-H. The idea behind this is that it’s a breathing technique. The breathing here is that the exhalation phase is longer than the inhalation phase. So some people term it rather than the physiological side. They call it exhalation dominant breathing. So what I want to just point out here is it’s not two breaths, it’s sort of one long breath and then just a little extra breath and then a really long exhale.
AB: So you breathe in twice and then you exhale. You do a long exhale.
KC: You take in as much breath as you can and a little bit more and then you let out the long breath. Just to let you know that you can do one of these, you can do two of them, you can do three in a row, take a little break and then do a couple of cycles of that, see how you feel. What Dr. Huberman points out is that naturally we sometimes do this anyway, in response to let’s say you’ve been sobbing out of control. You do that kind of a thing at the end. But this is something that you can control yourself. And this is really important in menopause as well because menopause can seem like it’s out of control. So these are techniques that can help to put you into control. You have these tools that you can pull out anywhere. The Sigh, as I presented it initially, might be a little overwhelming to use in certain situations and people might think “what are you doing?” And so what I’m saying is you can tone it down.
AB: So you’re saying you can make it very subtle and quiet, but the technique is the same where you breathe in twice and then you breathe out for a longer exhalation.
KC: The key to this technique is that the exhalation, the breathing out has to be much longer than the breathing in. And then what I was going to say, if still that doesn’t feel comfortable to you, turn to a technique by heart map-the relationship between the heart and the brain and their communication. Heart and brain are constantly in communication. They talk about heart focused breathing where you bring your attention into the area of the heart. And sometimes if I’m on the telephone and I really can’t focus on that if I’m too stressed, I’ll put my hand in the area of the heart, just hold my hand there. And you can either just imagine your breath flowing in and out of that area or what the heart math suggests is that you can breathe in for 5 seconds and breathe out for 5 seconds. And this, according to heart math, regulates heartbeat rhythms. Your heartbeat is in a sine wave-like rhythm. The more your body functions harmoniously, to shift into this very healthy, coherent and harmonious state in the body. It’s really important for us to feel a positive emotion. As if we’re sitting and we’re imagining the breath flowing in and out of our heart area, we’re either doing the sniff-sniff out or doing the 5 seconds in, 5 seconds out.
Heart Math suggests you make a sincere attempt to feel a positive emotion. So if you start to maybe think about the dog, you love or imagine that you’re sitting in the favourite place you have for vacation, or you feel so grateful that you’ve got the place on the bus during the strike. Whatever it is, whatever that positive emotion is that you have warm, comfortable shoes on, whatever it is, going into a positive and feeling a positive emotion creates a cascade of electrochemicals that are sent to your cells, but more importantly also because they’re electrochemical signals, they emanate from your body, that electromagnetic field influences those in your environment. So another thing that people can choose to do is if you’re going into a meeting with a spouse, a child, where you think there might be some confrontation or at work, go into a more coherent state, go into your heart, focus on breathing, feel a positive emotion and sit there for 5 minutes. Your heartbeat will regularise and you will emanate a more coherent electromagnetic field which will affect those that you’re going to interact with. And this will help you in menopause as well because again, irritability, anxiety, low mood, all be neutralised by these techniques.
AB: So what I wanted to ask you was-how has this intelligent stress management system, as you called it, how has it helped you or any of your clients? Have there been examples, concrete examples that you’ve had?
KC: Tons of concrete examples. I like to try things out before I teach them. So I’ve been working with transforming my thoughts, which then transform my emotions, my emotional patterns have been very focused for a good three years and I find my flight is cancelled, I don’t freak out as much, I choose a better thought, I always arrive on time or my journeys are always smooth and I prepare myself when I go to places and I find I get better results. So that’s one thing. The other thing is that what I’ve seen with patients is that again, patients may come in that are menopausal, they might come in for a strained ankle. That when we start to use this approach, they’ll say oh my God, my urination is better. Last week, a woman said I’ve really noticed that I get less hot flashes because I find myself being less angry. I’m able to step away from the situation, do some of the techniques that we’ve worked on or prepare to go into a situation. The other thing is that I sometimes work with a woman and then they ask their family to come in and do a session together either on Zoom or here in the clinic. And what they found is that they have an easier time relating to one another. And it started because when the mother was using these techniques and these approaches to prepare her responses to her family, she started to teach them to members of her family, and they would do things like what I call do an inner weather report, maybe cloudy, maybe a little sun, and that really helped the harmony of their family. And in fact, the woman told me last week again that her child went to school and told one of her friends, now her little group of friends practise that, which I think is really nice. So it has a knock on effect. It helps other people. And just even if you do it, it’s like when you go to a party, you’re not going to be attracted to the person who has bad vibes.
KC: Tell me, Katrine, do you have any other advice? Take time out for yourself. Menopause is a transition from a fertile time to time to turn inwards for your needs, looking at what your body, your mind, your soul needs, where you’re at. So, number one, take time for yourself. Whether it’s on the bus, focusing on yourself instead of reading 20 million things. Take the time to get a treatment, to allow your body to relax, to hold up, to let go of those held up emotions. And give yourself some time to practise things. Things take time to practise, even if it’s twice a day for 30 seconds, that you practise some of the techniques, or maybe a time you feel stressed, just choose one time during the day and it’ll become a routine. And that’s what Joe Dispenza said, that you need to practise things and rewire your brain so that it becomes a habit.
AB: Thank you, Katrine. That was so wonderful. Thanks for joining us. Hope you enjoyed the Wellness Curated podcast. Please subscribe and tell your friends and family about it. And here’s to you, leading your best life.