How Menopause Shows Up in My Therapy Room
By the Willingness Team
As therapists and mental health professionals, we’re trained to listen to what is said—but sometimes, it’s what remains unsaid that matters most.
Over the years, I’ve noticed a pattern in some of the women I support. They arrive with symptoms that don’t always fit into a neat diagnostic box. Describe feeling “not like themselves.” They speak of anxiety that has crept in from nowhere, of irritability that surprises even them. They mention sleep disturbances, fatigue, forgetfulness, and sudden mood swings. Many assume it’s burnout, depression, or just the result of a stressful life stage.
But often, what they’re actually navigating is menopause—and they don’t even realise it.
More Than Just Hot Flashes
While physical symptoms like hot flashes and night sweats are more commonly associated with menopause, what we see in therapy is far more layered.
Clients may report:
- Feeling flat or emotionally detached
- A loss of motivation or meaning
- Increased anxiety or panic attacks
- Frustration with memory lapses or “brain fog”
- Relationship strain due to changes in libido or emotional responses
- A deep sense of grief, identity shift, or fear of ageing
Menopause can arrive like a slow tide or hit like a wave. And for many, the emotional experience is unexpected and isolating.
The Invisible Transition
What makes this period even more complex is that it’s often invisible—especially to those going through it. Many women aren’t told that these emotional shifts may be connected to hormonal changes. Some are met with dismissal by healthcare providers or even loved ones.
This lack of awareness means menopause often sneaks into therapy, disguised as something else. And if we, as professionals, aren’t attuned to it, we might miss an opportunity to validate, educate, and truly support.
Our Role as Mental Health Professionals
Menopause is not a disorder—but it is a life transition that carries psychological weight. Just like adolescence or parenthood, it can reshape self-concept, relationships, and wellbeing.
As professionals, our role isn’t to diagnose hormonal imbalances, but to:
- Hold space for the emotional turbulence that may come with menopause
- Normalize the experience without minimising the struggle
- Support identity work as clients navigate ageing, body changes, and new roles
- Refer to medical professionals when appropriate, especially if symptoms are severe
Creating a More Informed Space
The more we understand menopause, the better we can support our clients.
That’s why at Willingness, we’ve developed a new online course:
👉 Supporting Clients Going Through Menopause. The course is led by Ms. Helen McGillivray, a highly experienced CBT therapist and clinical supervisor with over 25 years of healthcare experience. Helen brings a specialised focus on the psychological impact of menopause and perimenopause, combining evidence-based approaches like ACT and CBT to empower both professionals and clients navigating this life stage.
It’s designed for therapists, counsellors, coaches, and health professionals who want to confidently support their clients through this transition. The course offers insights into the emotional, psychological, and social aspects of menopause—and practical tools you can apply immediately in your work.
Because when our clients whisper, “I just don’t feel like myself anymore,” we want to be ready to say:
“You’re not alone—and we can talk about this.”
