Menopause and life change issues 

 

Life changes and sense of identity

 

Life is full of changes, some inevitable and some unexpected. When you go through any life change, your sense of self has to adapt. Your idea of what it means to be you has to encompass new information and experiences. Some changes, such as illness or bereavement, are clearly difficult and disruptive. Other life changes, such as becoming a parent, moving house, starting a new job or relationship might be generally positive, but they can still trigger anxiety, doubts, insecurities or questions about meaning, purpose and identity.  Whatever changes you’re going through, talking to a therapist can help you make sense of your feelings and face your situation with more clarity.

 

Menopause

 

Menopause is a natural and inevitable life change, but for many women it’s a time of physical and emotional upheaval. Changes in mood, energy levels, sleep, libido and concentration can be disorientating, alongside physical symptoms ranging from hot flushes to joint pains and heart palpitations. And all of this happens at a time in life when you are most likely to be stretched in every direction, managing your own personal combination of family demands, relationships, work, health issues and ageing.  

 

Perhaps you’re bringing up children or facing an empty nest; maintaining or reassessing a long-term relationship or navigating being single; looking after ageing parents or facing bereavement; feeling overwhelmed by the needs of others or feeling alone and isolated; navigating career, return to work, loss of work or retirement. Whatever your circumstances, the transition from childbearing years to menopause is an existential turning point, stirring complex feelings about ageing, mortality, meaning and purpose.

 

How therapy can help

 

Talking to a therapist who understands all of these changes and pressures can help you to make sense of what is happening. A therapist can help you to navigate the physical and emotional changes with more agency and insight, and provide a supportive space to help you move through this time of transition with a renewed sense of purpose and energy.

 

When you’re struggling and under pressure it can seem as though the only option is to speed up or just keep going and avoid facing difficult issues. This may be useful in the short-term, but over time things tend to get worse if they are left unresolved, and trying to push through and ignore physical symptoms or difficult feelings can lead to burnout. Therapy provides space and support to address whatever you’re struggling with during menopause, without judgement or pressure. Even for women who have not found menopause particularly difficult it’s nevertheless a time when you’re likely to take stock of your life and to think about how you want to live the next chapter. With support, information and insight, menopause is a time to prioritise taking care of your health and wellbeing, to connect with your needs, desires, hopes and fears, and to emerge with new clarity about who you are and new possibilities for living life to the full.

 

Therapy can help you to:

 

• Understand your feelings and symptoms in the context of your life and history

• Manage anxiety and low mood

• Explore feelings about ageing

• See yourself and your relationships more clearly

• Grieve for losses

• Reconnect with your values and interests

• Identify new possibilities

 

What’s going on in your body during menopause, and why does this affect mood?

 

Menopause starts one year after your last menstrual period, and perimenopause is the time leading up to this (either months or several years) during which hormone levels are fluctuating and decreasing. A decrease in oestrogen, progesterone and (less recognised and discussed) testosterone can cause a range of symptoms including hot flushes, vaginal dryness, joint stiffness, irregular heartbeat, decline in libido, changes in memory and concentration (brain fog) and insomnia.  80-90% of women will have some symptoms.  For some these are mild and short-lived, but for many the impact can be devastating and affect a woman’s health, emotional wellbeing, work and relationships. Decreasing hormone levels not only cause physical symptoms, they also have a significant impact on mood. Oestrogen levels in the body influence levels of other hormones including serotonin which are responsible for regulating mood and sleep. When oestrogen levels fall during menopause, serotonin levels also drop, which can cause depression, anxiety and insomnia. Things which used to be easy can suddenly become overwhelming, leading to a loss of confidence and self-esteem. For some women these symptoms may be new and alarming, and for others menopause can trigger a flare-up of issues from the past which are unresolved or ongoing.

 

Whilst it’s a positive development that awareness of menopause is increasing, some of the narratives around menopause can be unhelpful. Reducing it to a purely negative picture of loss and of hormone deficiency which must be treated or corrected can increase fears and stigma, and conflicting advice and information about hormone replacement therapy (HRT) can amplify anxiety. It’s important to take your time to sift through the advice and information available, ask questions, and to do what feels right for you. It might take some patience and trial and error to find what works best for you.

 

Self-care and support

 

Life can feel out of control when your body is going through major changes. Focusing on some thoughtful self-care and working out what makes you feel better (or what makes you feel worse) enables you to regain a sense of agency. Here are a few things which can help:

 

• Talk to friends

 

The symptoms of menopause can be shrouded in confusion and embarrassment, and the best way to counter that is through talking to trusted friends and loved ones about what you’re going through. Sharing your experience and comparing notes can be empowering and a huge relief to find that you’re not alone.

 

• Eat well

 

Support your body and mind through menopause by eating well and paying attention to the relationship between what you eat and drink and how you feel.

 

• Move your body

 

Find what feels good – this might mean continuing to do what you already do, or trying out a new form of exercise or movement that suits you. Listen to your body.

 

• Slow down

 

Try to make space during the week to slow down and rest, even for a short time – whether that’s meditation, reading, listening to music, taking a power nap or just pausing - whatever works best for you

 

• Support your sleep routine

 

If your sleep is disrupted, go back to basics. Cut down on caffeine and alcohol; try reading instead of screen time in the time leading up to bedtime; keep the bedroom cool and dark at night and have layers of bedding that can be easily added or taken off.  Try not to problem-solve if you’re lying awake – instead try to shift your thoughts to things which are not personal or emotionally charged.

 

Information and resources

 

• British Menopause Society
  
  What is the Menopause?

 

• Menopause Matters
  
  Website created by women’s health professionals with helpful library of information on a wide range of menopause and women’s health issues.
  
  www.menopausematters.co.uk

 

Fern Dickson has particular experience of working menopause, midlife and life changes. Have a look at her biography to see if her approach might work for what you are struggling with.

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Keywords:

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Menopause support, psychotherapy for menopause, managing life changes, anxiety relief, emotional wellbeing, hormone changes, self-identity, ageing and mental health, menopause symptoms, therapy for women, personal transitions, career changes, relationship support, bereavement counselling, self-care, menopause anxiety, cognitive function, mental health support

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