The Wisdom of Menopause

by Christiane Northrup

  14

  Living with Heart, Passion, and Joy:

  How to Listen to and Love Your

  Midlife Heart

  The years around menopause are the time when women’s risk for heart disease, hypertension, and stroke rise significantly as our hearts and the network of blood vessels that carries nourishment to every cell in our bodies call out to us more loudly than ever, demanding that we listen well and allow ourselves to feel the exquisite joy of life more fully than ever. Because heart disease in all its guises claims more lives than any other illness, midlife is a time when a change of heart may save your life.

  Despite the fact that five times more women die of heart disease than breast cancer, failure to diagnose heart disease in a timely manner is rarely the subject of lawsuits, whereas suits for failure to diagnose breast cancer are very common. Statistics (which need not apply to you) show that one in two women will eventually die of some kind of heart disease—either a heart attack or a stroke (a stroke is just a “heart attack” of the brain)! In contrast, one woman in twenty-five will die of breast cancer.

  Many women never realize that they have a heart problem until the disease is well established. Breast cancer, on the other hand, is seen as an invader from outside ourselves, so we tend to take a fighting stance toward it, for better or for worse.

  When it comes to your heart, however, you can’t fight it—you must instead follow its dictates if you are to achieve the vibrant cardiovascular health that will nourish and rejuvenate every organ in your body for the rest of your life. Indeed, the latest research shows that keeping your cardiovascular system healthy also leads to healthier brain function—no kidding!1 The heart teaches us directly and persistently. And it is quite forgiving if we will simply heed its messages.

  THE HEART HAS ITS SAY AT MENOPAUSE:

  MY PERSONAL STORY

  In chapter 3 I wrote about my first experience of the “empty nest”: how I had picked up my younger daughter at camp, taken her to Dartmouth for a college tour, driven the three long hours home with her sound asleep in the car—and then found myself face-to-face with the realization that her physical presence wouldn’t heal my emptiness. There is a sequel to that story. The next morning I went for a walk. About halfway through I began to experience an ache in my throat that radiated up into my jaw. No matter what I did, I couldn’t make the pain go away. It felt as though a fist were squeezing my esophagus. I kept walking, wondering what this symptom was all about. When I got home the pain was still there and impossible to ignore. So I called a physician friend well versed in mind-body medicine, who came right over. (She would have called an ambulance or driven me to the ER immediately if she had felt that I was having a heart attack.)

  The throat is in the fifth emotional center, which has to do with communication, so I wondered if there was something I needed to say. But my friend reminded me that I’ve never had any trouble expressing myself. Instead, my family legacy of stoicism and heart disease pointed to challenges in the fourth emotional center.

  Together we sat down and took out the Motherpeace tarot cards to try to get some clarity. My intuition, which was reflected in the cards, suggested that my throat and jaw pain had in fact originated in my heart. I was also reminded that the classic symptoms of heart attack in women are often located in the neck, jaw, and upper chest. As I reviewed the events of the prior twenty-four hours, I came to see that my literal “heartache” stemmed from my disappointment and grief over my reunion with my daughter—a reunion in which my own needs for partnership and companionship had not materialized at all. That same pain has recurred a couple of times since then, despite the fact that I do not have any evidence of cardiovascular disease. Each time, the message has been the same: feel your grief (or your fear) and open your heart to yourself. The pain, I am sure, has been the direct result of constricted blood vessels in the heart, a result of constricted feelings that need to be released in order to live in a more openhearted way.

  Setting Myself Up for Heartache

  Looking back, I see now how I had set myself up for heartache. For several days before going to pick up my daughter, I had fantasized about how loving and warm our reunion would be. I anticipated her every emotional and physical need as I prepared for the trip. I thought that her return would help me heal from the heartache of my divorce. In retrospect, I see that by trying to truly be there for her, I was actually treating her the way I wished someone would treat me. In addition to the drive together, I had hoped that she’d want to spend some time shopping and having a meal with me. I didn’t ask for this outright. I’ve never wanted to be the kind of mother who manipulates her children into taking care of her needs by staging after-all-I’ve-done-for-you-at-least-you-could-have-dinner-with-me kinds of scenes. Knowing that this approach confuses love with guilt and obligation, I went to the opposite extreme. It never occurred to me, for instance, that it was okay to ask my daughters to spend an evening or a day with me now and then. Instead, I had led my daughters—and myself—to believe that I didn’t have any needs that I couldn’t fulfill on my own. No wonder my heart was forced to speak up! And it’s still forced to speak up if I slide into that old pattern of overgiving and underreceiving.

  The Stoic Heart: My Legacy

  By asking for so little, I was unconsciously carrying on a legacy I had inherited from my stoic maternal line, a legacy that is a setup for heart disease: if you don’t ask for much, you won’t be disappointed. Instead, you can earn love by providing service. And if you become strong enough and capable enough to meet your needs for yourself, you’ll never have to feel vulnerable, never have to face possible rejection.

  My frenzied redecorating in the three weeks prior to my younger daughter’s return was not motivated purely by the desire to create a living space that was pleasing to me, though that was part of it. It was also meant to please and delight my daughters. I had envisioned the newly decorated family room as a space in which they could stay up late and watch movies with friends with no fear of keeping me awake. I wanted their approval.

  After my daughter and I arrived home, I eagerly showed her the new rooms, anticipating oohs, ahhs, and praise. She looked around briefly, said she liked it, wondered why I had chosen those particular couch cushions, and then settled down to phone the six friends who had left messages for her.

  As I unpacked the car to the background of her enthusiastic conversations, I felt as though I had just provided a very nurturing taxi service. When my children were little, providing a warm, safe place for them to grow up was enough. Now I wanted more. But I didn’t know that yet. I was simply aware of vague discontent within me. After all, my daughter’s behavior was completely normal for a healthy sixteen-year-old with a burgeoning social life.

  Why was I so heartsick? Why did I get chest pain the next morning? My daughter certainly wasn’t responsible for that. What was my heart trying to tell me? Over the next few days I began to unearth and let go of a big heartache-inducing legacy that was now obsolete.

  Keeping the Peace at Any Price

  Is a Big Pain in the Heart

  Like my mother before me, I had been brought up to believe that it was my job to keep the peace in the family and make a comfortable home for my husband and children. I did this—mostly single handedly—for most of my marriage. After my husband and I separated, I characteristically plowed ahead, believing that my good-natured efforts would make it okay for the children. The truth is that I was heartsick about putting them through the pain of my divorce and also about stepping down from my position as cheerful emotional buffer for the family. In all this I had neglected the fact that I, too, had emotional needs and that I, too, was hurting and grieving over the loss of my marriage.

  In trying to protect my children from their own inevitable pain, I had been doing everything in my power to maintain the illusion that our lives hadn’t changed. I shielded them from the reality of bills to be paid and a household to be maintained, and never asked for their help. But my h
eart was giving me the painful message that this coping style wasn’t working.

  Intellectually I knew that staying healthy on all levels was far and away the biggest help and support I could provide for my daughters during this difficult time. My chest pain was a sign that I needed to tend to the needs and desires of my own heart if I was going to accomplish this. As soon as I began this process my upper chest and neck pain went away completely—and on the rare occasions when this pain has returned, I immediately know that my heart is talking to me.

  At midlife I came face-to-face with an unconscious, deeply buried sense of unworthiness that had, for as long as I could remember, motivated me to prove myself to others through service. In the case of my family, this giving was laced with unconscious guilt for having and loving my career while simultaneously thinking that maybe I really should be spending more time as a stay-at-home mom. I made up for the time I spent on the job—or at least I told myself I did—by becoming as efficient and cheerful as possible, my nurturing providing steady background music in the lives of those closest to me. It was simply expected.

  Part of my legacy of stoicism and unworthiness was that I had almost no “receptor sites” in my own body and psyche for the experience of someone actually anticipating and making space for my personal emotional needs. In other words, even if someone had wanted to be there for me in the way I was there for my children and husband, I would not have been open to attracting or even recognizing it. The music may have been playing, but my personal radio dial was always set on another station.

  My divorce awakened me to the presence of those friends who had always been there for me—and who always would be. But I first had to open my heart and feel vulnerable and needy enough to allow myself to ask for help and then accept it when it was offered. This didn’t come naturally or easily. But it was preferable to the old pattern, and with practice, opening my heart to myself and accepting help and support has become much easier.

  Over the years I’ve observed that many women use pleasing behaviors to make themselves acceptable to others. One of my friends told me that whenever she feels that she doesn’t belong or fit in, she does what she did in her family of origin to relieve the tension: she cleans, she buys food, and she makes meals for others.

  When we first recognize the patterns within us that shut down the energy of our hearts, our tendency is to beat ourselves up for them—which simply closes our hearts further. The first step we each must take is to acknowledge that the patterns that are causing us heartache in adulthood began as successful adaptations to difficult childhood circumstances. They worked for us then, and they have allowed us to become who we are. So the first thing we want to do when we recognize these patterns is to congratulate ourselves. Now, in retrospect, I can’t imagine living a life in which I put my desires on the back burner. Now I know that my desires are an important part of my inner guidance and that ignoring them is a health risk.

  Yearning for Connection: Needing to Be Free

  I’m not suggesting that at midlife we need to give up serving others. Participating in true service—where you’re not in it for love and approval—is good for the heart. Most women, however, don’t get to true service until we learn to balance our need for connection with our need to be free. Like the parasympathetic and sympathetic aspects of our autonomic nervous system, which so exquisitely control the minute-to-minute caliber of our blood vessels, we need both freedom and connection. Nanna Aida Svendsen, a writer and teacher originally from Denmark, eloquently articulates this balance.

  The heart, it seems, yearns for connection. A great grief arises when connection to others seems to come at the cost of connection to ourselves. I notice how dead I become inside, even if only subtly, when I try to conform to other people’s idea of who and how I should be and forgo my own feelings—my connection to myself. When the natural generosity, compassion, and caring of the heart becomes distorted or usurped, then all sense of aliveness, generosity, creativity, and true self-expression seems to go and I am left feeling empty and drained. It takes a great deal of energy to shape oneself to fit someone else’s needs and expectations, to conform to their demands, to be codependent. And no matter how tempting it is in the hope of gaining love, or of being kept safe, it always costs. Just as it always costs to demand conformity to our needs by others—to be in a hierarchy when the heart is yearning for partnership. You can see that cost in the faces of so many couples. You can see the suppressed anger or the deadness that resides there. Though the heart may long for connection and love, it also, it appears, longs to be free.2

  CARDIOVASCULAR DISEASE:

  WHEN THE FLOW OF LIFE IS BLOCKED

  Cardiovascular disease results, in part, from an accumulation of oxidized fat in blood vessels that calcifies and eventually causes blood vessel and heart damage. Strokes, which kill 90,000 women per year, can be likened to a heart attack in the head. Both heart attacks and strokes are caused by clogged vessels; what differs is their location. In addition to arteriosclerotic plaque deposits, emotions such as depression, anxiety, panic, and grief have been shown to cause constriction in blood vessels, thereby impeding the free flow of blood.3

  Your heart beats 100,000 times per day and 36 million times per year. Anything that causes constriction in your blood vessels makes your heart and your vessels have to work harder to do their job. Clearly both emotional and physical factors are involved in creating or maintaining heart health. Over my years in practice I’ve seen happy, joyful women with high cholesterol counts live healthy lives into their eighties and even nineties, while much younger women whose lives were characterized by depression, anxiety, or hostility might have their first heart disease symptoms in their early fifties despite normal cholesterol levels. (Fully 50 percent of all heart attacks occur in people with normal cholesterol levels.)4

  Cardiovascular disease in any one area means that it is also present throughout your entire body. Though most of us wait until midlife to take steps to prevent or treat it, heart disease actually begins in utero. It is well documented, for example, that low-birth weight babies have a significantly greater risk for heart disease decades later, perhaps because stresses in the womb have contributed to underdeveloped cardiovascular systems.5 In the famous Bogalusa Heart Study, for example, the beginnings of heart disease were discovered in children as young as age nine.6

  Regardless of any overt risks we may have for heart disease (such as poor diet or lack of exercise), the seeds for potentially developing heart disease later on are sown the minute we learn to start shutting down our hearts to avoid feeling disappointment and loss. Whether or not heart disease eventually results has a lot to do with how well we learn how to feel and express our emotions fully and name the needs they signify. This is especially true given the inevitable disappointments and losses of life.

  At midlife our hearts ask us to wake up and live our personal truth so that there is a seamless connection between what we say we believe and how we actually live our day-to-day lives. As astrologer Barbara Hand Clow writes: “The heart does not open if one is lying to oneself or others, is manipulating or controlling others, or is separated from other people.” She goes on to explain, “The heart chakra is experienced very physically, and it is possible to actually feel the heart opening at mid-life as the kundalini energy flows in: Many of my clients, for example, report a burning in their heart areas.” If we don’t follow our body’s lead and fuel our hearts and lives with the energy of full emotional expression, full partnership, and heeding our desire for more pleasure in our lives, then heart attack, hypertension, stroke, and dementia are more likely to result.

  When we have the courage to open our hearts at midlife, however, we are opening ourselves up to the possibility of living more fully and joyfully than we have since we were young children—only now we have the skills and power of an adult with which to direct our openhearted energy. Clow writes, “The heart chakra opening is the signal of ‘radical embodiment’—the soul totally in th
e body—which is the most exquisite experience available on Earth. The integrity of a person with an open heart is always astounding.”7

  HEART DISEASE FACTS

  ~ Heart disease actually begins in childhood but often doesn’t manifest until around menopause.

  ~ Heart disease (including hypertension and stroke) is the most frequent cause of death in women over the age of 65.8

  ~ Heart attack, though usually occurring later in life, is twice as deadly in women as in men.9

  ~ One in two women will eventually die of coronary artery disease or stroke.

  ~ One in thirty women dies from breast cancer, while one in six dies from cardiovascular disease.10

  PALPITATIONS: YOUR HEART’S WAKE-UP CALL

  There’s no question that heart palpitations at menopause are related to changing hormones. However, my experience has been that in many midlife women heart palpitations are primarily from increasing heart energy trying to get in and be embodied in a woman’s life. At midlife our hearts and bodies often become increasingly sensitive to those things that don’t serve us, including caffeine, refined carbohydrates, aspartame, alcohol, or monosodium glutamate, all of which may overstimulate our hearts. You also might need to avoid scary, violent, or emotionally draining news, movies, books, or individuals.