Menopause

Perimenopause and menopause are among the most significant biological and psychological transitions in a woman’s life, and among the least well supported. The hormonal changes involved affect sleep, mood, cognition, concentration, and energy in ways that are frequently more disruptive than expected, and often more invisible to the people around you than the experience warrants.

Many women describe managing the gap between how they appear on the outside and how destabilised they feel on the inside largely alone. There can be a pressure, professional, relational, or internal, to continue functioning at the same level while absorbing changes that are genuinely significant. That pressure has its own cost.

This page is for women who are finding the psychological and emotional dimensions of this transition difficult, and who are looking for a space to make sense of what’s happening beyond symptom management.

The Psychological Dimensions of Menopause

The physical symptoms of menopause are well documented. What receives less attention is the psychological and relational impact of the transition, and this is often where the most significant difficulty sits.

Menopause can bring a quiet but disorienting shift in identity. The sense of who you are, how you inhabit your body, what roles you occupy, and what you want from the next chapter of your life, can all become uncertain in ways that are difficult to articulate. For some women this surface uncertainty connects to something deeper: earlier experiences of loss or trauma that the transition has brought closer to the surface, or longstanding questions about self-worth and self-permission that the hormonal upheaval has made harder to suppress.

Common psychological experiences during menopause include:

Anxiety, including new or intensified anxiety that feels disproportionate to current circumstances
Low mood or depression, sometimes arriving without obvious cause
Irritability or emotional dysregulation that feels out of character
Cognitive changes including difficulty concentrating, memory lapses, and a sense of mental fog
Sleep disruption, and the cumulative effects of sustained poor sleep on mood, resilience, and functioning
A diminished sense of self or a feeling of losing your grip on who you are
Grief, including grief about ageing, about fertility, about roles that are changing, and about aspects of life that feel like they are closing
Difficulty in close relationships, including changes in libido, shifts in relational dynamics, and a reduced tolerance for situations or relationships that are no longer sustainable

Early and Surgical Menopause

Early menopause, including premature ovarian insufficiency and surgically induced menopause, brings its own particular dimensions. The loss of fertility, often sudden and without the gradual preparation that natural menopause allows, can involve profound grief alongside the physical transition. This may include grief about the loss of possible motherhood, about a future that has changed shape without warning, and about a body that has behaved in ways that feel unfamiliar or unwelcome.

These losses deserve careful attention rather than the practical management focus that medical consultations often necessarily prioritise.

Menopause and Trauma

For women with a history of trauma, particularly relational or developmental trauma, menopause can be a period of heightened difficulty. Hormonal changes affect the nervous system’s capacity to regulate, which can make previously managed trauma responses harder to contain. Dissociation, anxiety, emotional dysregulation, and relational difficulties that may have been partially managed can intensify during this transition.

Addressing both the menopause and the underlying trauma together, rather than treating them as separate concerns, is usually the more effective approach.

How I Work With Menopause

I bring a particular interest in the psychological and relational dimensions of menopause to my clinical work. My approach is relational and psychodynamic, which means I’m interested in what this transition means for you specifically, in its connections to your history, and in what it would take to move through it with more support and more self-understanding than the culture typically offers.

Alongside individual therapy I have experience of facilitating therapeutic writing groups for women navigating menopause, and I draw on expressive writing as a tool within individual work when it’s a useful addition.

I work with women at all stages of the menopausal transition, including those experiencing perimenopause, those well into postmenopause, and those navigating early or surgical menopause.

If you’d like to explore whether working together might help, get in touch at samanthamerry.co.uk/contacts.