We chatted to Vhi Clinical Psychologist, Dr Aoife Dáibhis, about the impact of perimenopause and menopause on body image and what can cause negative body image. We delve into why some women feel more confidence and freedom than ever before during perimenopause and menopause, and how to reframe how you feel about your body during times of change.

Disclaimer: This blog discusses themes of a sensitive nature, including disordered eating, which may be triggering for some people. For resources regarding the topics discussed, please skip to the bottom of the page. 

What is body image?

Body image refers to the thoughts, feelings and attitudes we have about our bodies and how we look. It encompasses our beliefs about our appearance as it is now, our desired appearance, and how we think the body should look. Our body image is influenced by biological factors (such as age and sex), psychological factors (such as anxiety or low self-esteem) and socio-cultural factors (including driven ideals of beauty).

Why can perimenopause and menopause impact body image?

Body image can vary over time and is something that anyone can struggle with. Women may find that they particularly struggle with their body image during certain stages of life, especially times associated with significant change, such as puberty, pregnancy, perimenopause and menopause. Dr Dáibhis explains the changes in women’s bodies during perimenopause and menopause, which are normal and expected, may nevertheless be difficult to adjust to. Changes to weight or hair during perimenopause and menopause can have a big impact on how you feel about your body.

Dr Dáibhis highlights that body image and mood are linked. A negative body image is likely to negatively influence mood, and vice versa. With the hormone and mood fluctuations that occur during perimenopause and menopause it’s easy to understand why those periods can be a risk factor for negative body image.

What are common triggers for feelings of negative body image?

There are lots of triggers for negative body image, and they can vary from person to person, but some common ones include:

• Appearance talk, whether negative or positive, may contribute to a negative body image. Even paying someone else a compliment about their appearance can have a negative impact on your body image, and that of those around you. Appearance comments invite comparison and draw focus to the evaluation of another’s appearance. Compliments about someone’s qualities (e.g. “that was very kind of you”) or behaviours (“you handled that well”) for example, are more helpful. 
• Negative self-talk. If you speak to yourself in a critical or demeaning way, this is a risk factor for negative body image. 
• Physical changes during perimenopause and menopause can trigger feelings of negative body image. Changes that nobody else can see or notice can still influence our body image.
• A negative perception of ageing may be a triggering factor for negative body image as you go through perimenopause and menopause.
• Social media. The saying “comparison is the thief of joy” is well-known for good reason. It’s difficult to scroll on social media and not compare our lives and appearance to that of others, which can lead to feeling inadequate or unhappy.

Can following body-positive accounts on social media be helpful?

Generally, body- and appearance-focused content on social media is unhelpful when it comes to body image. Dr Dáibhis refers to something known as “toxic wellness”, which is content on social media that appears to focus on health and wellness but in fact, promotes unrealistic standards and goals, and is generally based on a questionable, if any, evidence-base. When you consume this kind of content, sit and think about how it has made you feel. Consider whether you feel disillusioned or dissatisfied with your body or appearance, or if you feel you need to make ‘big’ changes. It’s a good idea to limit your consumption of this kind of content online as much as possible. Instead, focus on health and wellness habits and routines that feel good for you, and are not influenced by what others are doing online.

How can women reframe how they feel about their body image during perimenopause and menopause?

First and foremost, Dr Dáibhis reminds women that it’s understandable to experience feelings of negative body image during a time of change like perimenopause and menopause. Some of the ways Dr Dáibhis recommends for women to improve their mindset about body image include:

• Exercise is highly effective; it releases endorphins and makes us feel more powerful. It improves mood and increases positive thinking, which in turn can improve how you feel each day.
• Starting to value your body and thinking of it in terms of more than how it looks. When you exercise for instance, try to approach it with thoughts like “I want to feel stronger. I want to run faster. I want to improve my cardiac health.” Think of exercise from a health perspective, not a physical appearance perspective.
• Think of what your body does for you every single day, such as carrying you to and from work and hugging our loved ones. Your body digests your food and converts it to energy and nutrients. It uses your immune system to protect you from illness. These are amazing functions! Pay attention to the role your body plays for you in your life each day.
•  Interrupt appearance talk and be as kind as you can when it comes to thinking and talking about your own body. The impact of talking negatively about your body is linked to feeling negative about your body; even when doing so in a bit of a joking way in a group of friends. It can often be a type of bonding for women in groups to discuss the things they are unhappy about when it comes to their bodies, but this is an unhelpful habit that may negatively impact your body image.

Do some women feel increased body confidence during perimenopause and menopause?

For some women, perimenopause and menopause can herald a time for increased body confidence. It’s an opportunity to revaluate and realise you have a good opportunity to engage in activities and health behaviours you might not have had time for previously. It’s the perfect time to focus more on self-care, which can positively impact how you feel about yourself. Dr Dáibhis explains how some women can feel a “release of pressure” from years of feeling like they need to fit into an externally-driven standard of beauty - this new stage in their lives allows them to feel more freedom and contentment with their bodies and appearance.

Can libido be impacted by negative body image?

Dr Dáibhis agrees that libido can be negatively impacted by body image - if you have negative body image, you may not feel as desirable, or want to engage in sexual intimacy. Perimenopause and menopause symptoms can also impact our libido directly, so the two can go hand-in-hand. Treating your symptoms of perimenopause or menopause and focusing on improving your mind-set around your body image can positively influence your libido.

How can women try to accept the physical changes that may come with perimenopause and menopause and how it makes them feel about their body image?

Body image is part of everyone’s self-worth and identity, so taking care of it is important for us all. However, if you find that appearance and body-image outweigh all else when it comes to your self-worth, Dr Dáibhis says it’s worth addressing this and seeking professional help.

When it comes to acceptance of the physical changes that occur in perimenopause and menopause, Dr Dáibhis suggests:

1. Preparing and educating yourself as much as possible about the changes that may happen to your body. Understand that it’s completely normal to see changes in your body during perimenopause and menopause, some of which will be temporary, some of which won’t be temporary.
2. Engaging in healthy behaviours, both mentally and physically, such as exercise, good nutrition and self-care.
3. Changing your self-talk if it’s critical or often putting yourself down. Try to make efforts to change that.
4. Being aware of what you’re engaging in on a day-to-day basis; are you constantly on social media or reading magazines? Are you consuming content that will negatively impact how you feel about yourself and the stage of life you’re in?
5. Trying to influence or move away from conversations about appearance.
6. Don’t be in isolation with your emotions and feelings about the changes you’re seeing in your body. Speaking to other women in perimenopause and menopause in particular can be helpful for accepting the changes you’re experiencing.

When should women seek help from a healthcare provider when they’re experiencing negative body image during perimenopause and menopause?

If you have tried to make healthy changes and behaviours such as those mentioned by Dr Dáibhis above, but you’re still feeling distressed about your body image, or your behaviour has been impacted - not socialising, excessive dieting, dressing in a way that makes you unhappy - it’s important at this point to speak to someone and get help. 

This guidance has hopefully helped you understand why your body image may have been impacted by perimenopause or menopause, and how totally normal this is. Be sure to speak to your healthcare provider immediately if you’re struggling with negative body image or feel you’re dealing with disordered eating or an eating disorder. Remember, there are lots of supports available to help you during this time of change in your life, and help is always there when you need it.

This content is for information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment. Always seek advice from your GP or an appropriate medical professional if you have concerns about your health, or before commencing a new healthcare regime. If you believe that you are experiencing a medical emergency call 999 / 112 or seek emergency assistance immediately.

Resources:

1.       The Eating Disorders Association of Ireland (Bodywhys)

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