Jun

14

2023

3 Reasons Why Therapists Need to Be Menopause Informed

In the realm of mental health care, we are typically equipped with the tools and understanding necessary to deal with a wide spectrum of issues, from anxiety disorders to traumatic experiences. However, one area that often slips under the radar is menopause, a natural biological phase that every woman experiences.

Menopause is frequently depicted in popular memes, with amusing photos and captions, with the menopausal women the butt of the joke.

And yet, for the 1 in 4 women who experience severe symptoms, often menopause is often no laughing matter.

The Need for Menopause Awareness: Statistics and Facts*

*Source: Menopause Support 

  • There are an estimated 13 million peri or post-menopausal women in the UK (equivalent to a third of the entire UK female population).
  • Perimenopause is when hormone levels begin to fluctuate and symptoms may appear, often in the early to mid forties
  • Menopause is the day after 12 consecutive months without a period. The average age is 51-52
  • Post menopause is the time after menopause
  • There are 30+ recognised symptoms of menopause
  • Symptoms last, on average, 4-8 years
  • 1 in 4 will experience very few symptoms
  • 3 in 4 will experience symptoms
  • 1 in 4 will experience debilitating symptoms

Menopause can be: 

  • Natural,
  • Surgical, occurring when both ovaries are removed
  • Induced, caused by some forms of medical treatment
  • Early, occurs under the age of 45
  • Premature, occurs under the age of 40

Furthermore:

  • 1 in 100 will experience menopause under the age of 40
  • 1 in 1000 will experience menopause under the age of 30
  • 1 in 10,000 will experience menopause under the age of 20
  • Transgender and non-binary people may also experience menopause
Why Therapists Need to Understand Menopause

As therapists, we are often called upon to help our clients navigate life transitions and cope with the associated challenges. Menopause is no exception. It is crucial that we understand menopause and its impact on our clients’ physical, emotional, and psychological well-being, as well as the impact on those they are in relationship with: partners, children and friends and work colleagues.

Menopause is a natural biological process of hormone fluctuation and change, that marks the end of a woman’s reproductive years. It is a significant life transition that affects nearly all women, and yet it is often overlooked in discussions about women’s health. This transition, starting with Perimenopause, can start in a woman’s late 30s and 40s, and often takes them by surprise. While some of the symptoms are physical, others are emotional and psychological, which is where counselling and talking therapy can have an important role.

Understanding Symptoms

Menopause is not a disease, but it is a significant life transition that affects nearly all women. Some women experience few symptoms or have mild symptoms, while others may experience more severe symptoms that affect their daily lives. The symptoms of menopause can vary widely and may include hot flashes, night sweats, mood changes, sleep disturbances, vaginal dryness, and changes in sexual function. 

Clients going through menopause may experience a range of symptoms that affect their mental health, such as anxiety, depression, and irritability. The Menopause Support website provides a downloadable Symptom Checker which could be a useful resource to share with clients.

3 Issues That Can Arise through a lack of Menopause Awareness

If therapists are not informed about menopause, there can be several issues and problems that arise.

Misdiagnosis: Menopause symptoms can overlap with symptoms of other conditions, such as depression or anxiety. If a therapist is not familiar with menopause, they may misdiagnose the symptoms and miss opportunities to provide the best support, including helping inform the client about menopause.

Clients Feeling Unsupported: Menopause can be a difficult and isolating experience, and clients may feel that their therapist does not understand what they are going through. This can lead to clients feeling like they cannot open up, hindering the therapeutic process.

Missed Opportunities for Client Education and Support: Clients going through menopause may have questions or concerns about their symptoms, treatment options, or lifestyle changes. Therapists who are informed about menopause can provide accurate information and support to their clients, which can help them better manage their symptoms and improve their quality of life. 

9 Ways that Therapists Can Support Clients Going Through Menopause

Therapists can play a crucial role in supporting clients going through menopause. Here are some ways that therapists can best support their clients during this time:

  1. Normalising Menopause: Many women feel shame or embarrassment about menopause, as if it is a sign of aging or weakness. Therapists can help their clients reframe menopause as a natural and normal life transition, rather than a medical deficiency or illness. By doing so, clients can feel less alone and more empowered to manage their symptoms and embrace this new phase of their lives.
  2. Provide education and information: Many women going through menopause feel confused and overwhelmed by the changes they are experiencing. Therapists can provide education and information about the physical and emotional symptoms of menopause, as well as strategies for managing them. This can help clients feel more empowered and in control.
  3. Validate their emotional experiences: Menopause is a significant life transition, and clients may feel a range of emotions during this time. Therapists can provide validation and empathy for the feelings that arise, within a safe space. They can also help them process and cope with the changes they are experiencing, perhaps also exploring  strategies to cope with mood changes.
  4. Address body image concerns: Menopause can be accompanied by changes in body shape and weight, which can be challenging for some clients. Therapists can work with clients to address body image concerns and help them develop a positive relationship with their body during this time.
  5. Support self-care: As therapists we may be able to help our clients manage physical symptoms of menopause by discussing lifestyle changes and offering coping strategies. Self-care is crucial during menopause, and therapists can encourage clients to prioritise self-care practices such as exercise, healthy eating, and stress management.
  6. Address relationship issues: Menopause can put strain on relationships, and clients may need support in navigating these changes. Therapists can help clients address relationship issues that may arise during menopause and develop strategies for maintaining healthy relationships.
  7. Address Sexual Changes: Menopause can bring changes to sexual function, which can be extremely distressing for some women, and also put pressure on intimate relationships. Therapists can help by discussing sex and the impact on sexual relationships.
  8. Consider hormone therapy: Hormone therapy can be an effective treatment for menopause symptoms, and therapists can work with clients to weigh the pros and cons of hormone therapy, decide if it is something they want to explore or not, and make informed decisions about their treatment options.
  9. Encourage communication with healthcare providers: Therapists can encourage clients to communicate openly with their healthcare providers about their menopause symptoms and treatment options. They can also help clients advocate for themselves and ensure that their healthcare needs are being met.
What this might look like in practice

The following client scenarios show how this awareness and understanding might be used in practice:

1. A woman experiencing depression, unaware she is perimenopausal:

“Martha” has been in therapy for the past six months, and initially presents with symptoms of depression and heightened anxiety. She feels overwhelmed, emotionally volatile, and has noticed an uncharacteristic lack of focus. Her sleep is disrupted, and she reports feeling excessively tired during the day. She attributes these changes to stress at work, personal life issues, or possibly to the onset of a mid-life crisis.

A menopause-informed approach in therapy has the possibility of guiding Martha to a potentially broader understanding of her situation. By exploring the possibility that she could be experiencing perimenopause, Martha might decided to consult her healthcare provider for a hormone level check. This, in combination with the therapy sessions, could help Martha better understand the changes happening in her body, reduce the sense of unpredictability, and enable a more holistic plan that addresses both her emotional and physical health.

2. A man whose wife no longer wants to have sex, impacting their marriage:

“John” is struggling with his wife’s sudden lack of interest in intimacy. He’s confused and feels rejected, which is causing strain in their marriage. With a menopause-informed approach, John could be helped to understand that his wife’s decreased libido might be linked to menopause, which can cause physical discomfort during sex, hormonal fluctuations leading to mood swings, and an overall decrease in sexual desire. By understanding the physiological changes his wife may be experiencing, John can develop greater empathy and patience. This understanding could encourage more open conversations between them about their sexual life, help relieve feelings of rejection, and create opportunities for them to explore other forms of intimacy, or seek medical advice for physical discomfort if necessary.

3. A same sex couple in different stages of menopause:

“Karen” and “Laura,” have been together for several years. Karen, who is perimenopausal, is experiencing mood swings, fatigue, and a general decrease in activity level. In stark contrast, Laura, having transitioned into post-menopause, is filled with renewed energy and wants to travel and embark on new adventures. This dynamic is creating conflict in their relationship. A menopause-informed approach could help both Karen and Laura understand that they’re each in a different physiological phase, with its own challenges and strengths. For Karen, this might mean exploring ways to manage her perimenopause symptoms, while for Laura, it’s about recognising Karen’s current needs and limitations. This understanding can help them communicate their needs and feelings more effectively, and hopefully find a balanced approach to their life together – one that embraces Laura’s newfound energy while accommodating Karen’s need for a slower pace.

Menopause Education as the key

Whatever the scenario, the number one thing that therapists can do to better help their clients going through menopause, is to educate themselves about the menopause. This can include reading books, attending workshops, or taking courses specifically focused on menopause.

This article from BTP: Menopause: A Resource List for Therapists could be a good place to start.

You can also join us for our upcoming seminar Working with the Menopause in Therapy with Diane Danzebrink the original menopause activist via Zoom on Monday 10th July 6pm – 9pm GMT. 

This three hour session is the ideal introduction to understanding what menopause is, when it happens, why it happens and what those who will experience menopause directly can do to help manage the transition. As well as how you, as a therapist, can support those you are working with, and how you can consider your own self care if it will happen to you too.

This workshop is suitable for therapists of any gender who might be working with individuals or couples, and who are curious about how best to support their clients during this important life transition. See the full event details here.

 

 

 

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