Counselling for Menopause and Perimenopause

Menopause and perimenopause (the years leading up to menopause) are natural stages of life. While some women transition with little difficulty, others experience severe physical and emotional symptoms that can impact their mental and physical health. It’s estimated that 20% of women will experience little or no difficulty, 20% will experience a lot of difficulty and the other 60% will fall somewhere in between. But for those severely affected there can be serious issues, for example according to Menopause Charity, 10% of women leave their job due to menopause symptoms.

Perimenopause is the transition phase into menopause and typically begins in the 40s (though it can be earlier) – it can go on for up to a decade before menopause, and during this time, symptoms can fluctuate in severity. You are officially in menopause when you haven’t had a period for 12 months.

Maureen (not a real client) is a 48-year-old teacher who always prides herself on her calm demeanour and energy. Over the past year, she began experiencing intense hot flushes during meetings, waking up drenched in sweat at night, and feeling unusually irritable with her family. On top of that, her confidence had taken a hit and she felt anxious doing things that previously she would have handled with ease. She had a noticeable drop in her concentration at work and at home often forgetting things. Maureen felt like she was “losing herself” and often blamed herself for not being able to “handle it better.” These feelings of frustration and isolation left her unsure of where to turn for help.

Signs and symptoms of menopause and perimenopause

Hot flushes
Night Sweats
Anxiety
Mood changes
Sexual problems
Vaginal dryness
Body aches
Weight gain
Brain fog

These symptoms are caused by a decline in the body’s hormone levels, particularly Oestrogen, progesterone, and, to a lesser extent, testosterone. As well as the changes in hormone levels, often menopause happens at the age where women need to take care of parents or their children become more independent and leave home. This means that there are changes in life roles which can cause feelings of grief and loss on top of these physical changes.

For many women, these symptoms are not only uncomfortable but can also feel embarrassing or taboo. This can lead to feelings of shame, isolation, and reluctance to seek help. As well as this often the changes are gradual so many women don’t realise they struggling until they hit rock bottom.

How can counselling help women through menopause and perimenopause?

Many women find counselling helpful when going through perimenopause and menopause. Here are some of the main issues it can help with.

Understanding and Managing Emotions:
Menopause can bring a whirlwind of emotions, from anxiety to irritability. Counselling offers a supportive space to process these feelings and develop effective coping methods.
Building Healthy Coping Mechanisms:
Techniques like mindfulness, deep breathing, and cognitive-behavioral therapy (CBT) can help reduce stress and ease the physical and emotional symptoms of menopause.
Addressing Sexuality and Intimacy Concerns:
Changes in sex drive and intimacy are common during menopause. I provide a non-judgmental environment where we can explore these concerns, identify strategies for enhancing intimacy, and improve communication with our partners.
Empowering You Through the Transition:
Counselling is about helping you feel confident, empowered, and in control. Together, we’ll navigate this life stage, address any challenges, and focus on building resilience and self-compassion.

The main approaches I use are CBT (Cognitive Behavioural Therapy), ACT (Acceptance and Commitment Therapy and Self Compassion – here’s a little about how each approach can help.

CBT (Cognitive Behavioural Therapy)

Cognitive Behavioral Therapy (CBT) offers evidence-based techniques for managing anxiety and depression associated with menopause. It is one of the therapies recommended by the NHS for managing both emotional and physical symptoms of menopause

Challenging Negative Thoughts

Hormonal changes during menopause can lead to irrational fears or catastrophic thinking, such as, “I’m not myself anymore” or “I’ll never feel normal again.” CBT helps you reframe these thoughts into more balanced ones, such as, “I’m going through a challenging phase, but I can learn to manage it.”

Behavioral Activation

Depression during menopause can lead to withdrawal and inactivity. CBT encourages small, meaningful actions, such as engaging in hobbies, exercising, or socializing, which can improve mood.

Managing Sleep Disturbances

CBT for insomnia (CBT-I) can help address sleep disruptions, such as hot flashes or night sweats, by promoting better sleep hygiene and relaxation techniques.

ACT Therapy

Acceptance and Commitment Therapy (ACT) is particularly effective for managing the unique challenges of menopause. Instead of trying to “fix” difficult emotions, ACT focuses on accepting them and committing to actions aligned with your values.

Acceptance of Emotional Fluctuations

ACT encourages you to accept menopausal mood swings as a natural response to hormonal changes rather than resisting or judging them.
For example, instead of thinking, “I shouldn’t feel this anxious,” ACT helps you acknowledge, “This is a part of menopause and it will pass.”

Mindful Presence

ACT’s mindfulness techniques teach you to stay present and grounded, even during moments of intense anxiety or irritability. Simple practices like deep breathing or grounding exercises can help you weather emotional storms.

Clarifying Your Values

Menopause can be a time of self-reflection. ACT helps you identify what truly matters—whether it’s health, relationships, or personal growth—and guides you to take actions that align with these values, even when facing emotional distress.

Defusion from Negative Thoughts

Hormonal fluctuations can amplify thoughts like, “I’m losing control” or “I’ll never feel like myself again.” ACT helps you distance yourself from these thoughts, recognizing them as temporary mental events rather than facts.

The Role of Self-Compassion

Self-compassion is vital during menopause, a phase that often brings both physical and emotional challenges.

Normalize the Experience

Remind yourself that what you’re experiencing is common. Menopause affects all women, and it’s okay to feel vulnerable or emotional.

Be Kind to Yourself

Instead of criticizing yourself for feeling anxious or irritable, treat yourself with the same kindness you would offer a friend. Say, “This is hard, but I’m doing my best.”

Use Compassion to Build Resilience

Self-compassion can help you recover more quickly from emotional setbacks, making it easier to cope with recurring challenges.

Practical Tips for Navigating Menopause

Track Your Symptoms

Understanding patterns in your mood, sleep, and energy levels can help you identify triggers and prepare for difficult days.

Prioritise Self-Care

Engage in activities that support your mental health, such as yoga, meditation, or spending time outdoors.

Seek Support

Talk a professional such as a therapist trained in CBT or ACT or your GP for tailored strategies to manage menopausal anxiety and depression.

Maintain Social Connections

Menopause can feel isolating, but staying connected with friends, family, or support groups can provide a sense of belonging and understanding.

Adopt Healthy Habits

Eat a balanced diet, exercise regularly, and avoid excessive caffeine or alcohol, which can exacerbate symptoms.

Counseling as Part of a Holistic Approach

Counseling can complement Hormone Replacement Therapy (HRT) or other medical treatments. You don’t need a doctor’s referral to begin counseling, and it can be tailored to fit your unique needs.

want to know more?

If you’re going through menopause and finding it difficult to cope, click book now to schedule a face-to-face session in Birkenhead, Wirral or online.

If you would like, you can click here to contact me in confidence with any questions you may have.

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