Navigating the Change: 5 Ways Counseling for Menopause Works


Counseling for menopause - Dr. Sarah Allen

Menopause is a natural biological process that marks the end of menstrual cycles in a woman’s life, typically occurring between 45 and 55 years of age. However, beyond this clinical definition, there is a multitude of experiences—some women embark on this transition smoothly, while others find themselves struggling with symptoms that can impact their quality of life.

People often forget it is during the perimenopause stage, which can last up to 5 years before menopause, that negative symptoms begin and the hormonal fluctuations during that time can cause a host of physical symptoms. Perimenopause and menopause can also profoundly affect emotional well-being. It’s a transition that can feel isolating and overwhelming for many, but counseling, especially cognitive behavioral therapy (CBT), has been shown to offer effective relief.

Understanding Menopause and Its Challenges

Before we delve into the role of counseling, let’s understand what menopause entails. Menopause typically occurs between the ages of 45 and 55 and is diagnosed after a woman goes 12 months without a menstrual period. Beyond the hallmark sign of ending periods, hormonal fluctuations trigger a host of symptoms that can affect quality of life. Hot flashes, night sweats, vaginal dryness, weight gain, thinning hair, and sleep problems are just the tip of the iceberg. 

Emotionally, the fluctuation of hormones can cause irritability, feelings of sadness, and even depression. This emotional rollercoaster, combined with the physical discomforts, can be a lot to handle. That’s where counseling, particularly Cognitive Behavioral Therapy also known as CBT, can help.

The Role of Cognitive Behavioral Therapy (CBT) in Managing Menopause

CBT is a form of psychotherapy that is effective for a range of problems including depression, anxiety disorders, and stress-related issues — all of which can be exacerbated by menopause. According to the American Psychological Association, CBT helps women entering menopause cope more effectively with difficult symptoms (APA Monitor).

CBT for menopause is typically involves identifying negative thought patterns and behaviors associated with menopause symptoms, then learning practical strategies to manage these thoughts and reduce or mitigate symptoms. 

Practical CBT Tips and Exercises

The focus of therapy of course varies according to what a woman is experiencing but often we will focus on these different strategies:

1. Identify and Challenge Negative Thoughts

CBT emphasizes the role of thought processes in how we feel and act. For peri/menopausal women, negative thoughts about aging, body image, weight changes and personal capabilities can exacerbate stress and anxiety. A practical exercise is to keep a thought journal. When a negative thought arises, write it down and consider evidence that challenges this thought. By doing so consistently, it becomes easier to replace these thoughts with more balanced, positive ones. 

We can also develop coping strategies for sleep, mood issues and anger/frustration. We identify their negative self-talk i.e. “I am not as pretty as I used to be” or “my partner isn’t going to find me as attractive” and comparative thinking “other women my age look younger, slimmer, prettier …. than me” that leads to self-criticism. We then challenge the negative thoughts and replace them with more reasonable ones including self compassion and focus on the positives about their body i.e. the strength and resilience your body has carried you through.

2. Mindfulness and Relaxation Techniques

Mindfulness helps focus the mind on the present moment, reducing the stress of menopausal symptoms. Techniques such as deep breathing, progressive muscle relaxation, or guided imagery can be practiced daily to cultivate mindfulness and diminish the impact of stress.

3. Behavioral Activation

With menopause related depression, there can be a tendency to withdraw from activities that used to bring joy due to low energy levels or mood. Behavioral activation involves creating a plan to reengage in these activities, regardless of mood, to stimulate positivity and fulfillment. This is sort of along the principle of “fake it until you make it” but I am sure you have noticed that when your mood is low and it’s hard to get going, you usually feel a little better once you have got out of the house. Start with small, enjoyable tasks, and gradually build up to more complex or social activities.

4. Engage in Physical Activities You Enjoy

Engaging in physical activities that make you feel good can help shift the focus away from appearance and towards overall well-being. Choose activities that promote strength, flexibility, and a positive body-mind connection. Perhaps re-visit ways of exercising that you used to enjoy but got too busy for. Or try a completely new exercise class, you don’t know what you like until you try it. 

Body movement helps you cognitively as well as physically. If you can’t get to a class, dance around at home to your favorite music. Music, especially upbeat music that you liked in your youth, is especially potent in increasing positive feelings.

5. Sleep Hygiene

Sleep disturbances are common during menopause, and CBT for insomnia (CBT-I) techniques can be particularly helpful. Creating a calming bedtime routine and maintaining a regular sleep schedule can lead to improved sleep. This routine may include winding down for 30 minutes before bed, reducing screen time, and ensuring the bedroom environment is conducive to sleep. 

The Importance of Professional Help

While practicing CBT techniques at home can be beneficial, working with a therapist trained in CBT provides the support and structure for women to explore the thoughts that are contributing to anxiety or mood swings and learn and apply these skills effectively. A therapist who is experienced in CBT methods can tailor the therapy to each individual’s specific needs, providing a level of personalization that is the key to successful treatment. Therapy doesn’t need to be long-term. CBT research has shown it to be an effective, short-term solution. 

In conclusion, counseling for perimenopause and menopause, specifically through CBT, offers vital support for women as they navigate the complexities of this life stage. The approach works not just to alleviate the often unsettling symptoms but also empowers women to approach this transitional period with confidence and optimism. Remember, every woman’s experience is different, and what works for one may not work for another. It’s important to seek out options and find what resonates with you, such as counseling for menopause. The journey through menopause doesn’t have to be navigated alone – help is available, and it can truly transform your experience.


If you are thinking about getting counseling and you’d like to talk to someone about the things that are troubling you, I am happy to help.