Beyond the Physical: Menopause, Mental Health, and Relationships
As World Menopause Day approaches on 18 October 2026, thankfully conversations surrounding women’s health and the menopause have grown over recent years. The menopause isn’t just about hot flushes and night sweats. Whilst this might be the case for many women, in reality, there are over 30 symptoms, which can impact women psychologically, emotionally, mentally, and cognitively. They have wide-ranging impact on women, their confidence, self-esteem, relationships and work.
What is World Menopause Day and why is it important?
World Menopause Day is observed globally each year, and it’s purpose is to help raise awareness and encourage open conversations. So many women, particularly in the past, have suffered in silence. In recent years we’ve seen a rise in celebrities like Davina McCall, talking more openly about the menopause, which helps break the stigma surrounding it and advocates women’s health in general. The awareness day also helps to highlight support options available for women and the people in their lives. We don’t just wake up one morning knowing we are perimenopausal. Certainly, that wasn’t my personal experience, it gradually builds and develops over time, even years. Therefore, education and awareness can help women recognise this period of their life and the options available to them. It’s also important to continue to educate partners, family members, employers, and healthcare providers so that women no longer have to navigate perimenopause and menopause in isolation.
What is the perimenopause and menopause?
The Perimenopause is the term given to the phase leading up to menopause. During this stage, our ovaries gradually begin to produce less oestrogen and progesterone. The perimenopause can begin several years, often up to 10 years before a woman's final menstrual period. On a personal level, looking back, I can see now that I began experiencing some symptoms in my early 40’s, yet I had no idea at that time it was due to my hormones. Our levels of oestrogen during this phase become very erratic, daily up and downs, which is what triggers the erratic nature of physical, cognitive, and psychological symptoms.
The Menopause is a specific date in time in which a woman has not had a menstrual period for 12 consecutive months. At this stage, the ovaries stop releasing eggs and oestrogen production drops significantly.
Who does the menopause affect?
The perimenopause and menopause will affect all women and people assigned female at birth, and it typically occurs naturally between the ages of 45 and 55. In the UK, the average age is 51. However, whilst women experience the symptoms and changes to their body, awareness days like this help to continue to educate how the menopause can impact everyone. For example, indirectly, it can have a significant impact the lives of partners, families, children, and colleagues who share homes and workplaces with those going through the transition.
What are the symptoms?
We often think of hot flushes and night sweats associated to the menopause. Whilst these are symptoms, there are actually over 30 symptoms:
Psychological & Emotional symptoms: During this period, women can experience anxiety, panic attacks, low mood, depression, lack of energy and motivation and rapid mood swings, even if they haven’t typically experienced these symptoms in the past. This can be a frightening time for many women. Many women I see in my practice speak of experiencing sudden onset of anger and rage.
Cognitive & Sleep: Many women can experience severe brain fog, memory loss, concentration difficulties, and severe insomnia. This can impact a women’s self-esteem and confidence, impacting them day to day and in the workplace. For example, suddenly forgetting a colleague’s name or what you were about to say. This may seem insignificant but can have a profound effect on a woman and their confidence. I have known women who have seen their GP because they were so concerned about their memory loss, believing it could be onset dementia.
Physical: These are wide and far ranging for example, hot flushes, night sweats, heart palpitations, fatigue, joint pain, muscle stiffness, hair loss, dry skin, migraines, stress incontinence, abnormal periods, increase in allergies and weakening bones which can lead to other problems such as osteoporosis.
How can it affect women and their relationships?
The menopause doesn’t just happen in isolation; it can also have a significant impact on relationships and careers. In terms of the impact on partners, the British Menopause Society (BMS) research says that 75% of women stated the menopause had a direct impact causing them to make changes to their lives.
In my practice, many of my clients often report not being seen, heard or understood by their partner and family. They are so confused and struggling with such debilitating symptoms, often holding down a demanding career, whilst also managing a home and caring responsibilities. This can be a psychological confusing and difficult time for women, who are often trying to make sense and come to terms with this phase of their life and identity. During this period, it is common for women to experience some significant changes to their emotions and mood. When we look at the research from the British Menopause Society (BMS), over half of women report that menopause symptoms negatively impacted their overall lives, with 28% of partners noting frequent arguments stemmed from a lack of understanding.
This phase is not just about the physical, emotional and cognitive symptoms, but the decline in oestrogen can also have a profound effect of a women’s libido and intimacy. Due to the falling levels of oestrogen, it can cause physical discomfort such as vaginal atrophy and dryness. Many women even find wearing jeans uncomfortable, all of which can impact their body confidence, resulting in the lack of sexual intimacy or painful sex. The BMS research highlights that over half of women report changes in their sex lives, which can leave many partners feeling helpless and about how best to offer support.
Due to the fluctuation of hormones, emotions can be heightened for what might appear as no reason. With low energy and motivation, combined with exhaustion and insomnia, it can leave women often depleted with little energy for their day to day demands of family life and work. Therefore, with all this happening, for what could be years, this can create difficulties and distance in relationships when our partners and family members don't understand that our symptoms are primarily hormonally driven.
Another significant aspect of the menopause that is often not spoken about, is that it brings the natural end of fertility and reproduction. For many women, this can be hugely complex and often brings up feelings of immense grief and loss. Not just the loss of further children, but it can be a time when a woman questions their age, identity and self-worth.
What is the mental health impact?
The menopause can bring significant mental health implications for women. When we look at the data from the Office for National Statistics (ONS) they report women of menopause age experience the highest rates of completed suicide among all females aged 50 to 54 in the UK. It cites mental health, mood disturbances, sexual problems, and relationship issues as key factors. In a further study, it highlights that up to 10% of women experience suicide thoughts as a direct result of their symptoms. (If you’re in crisis, call The Samaritans on 116 123).
This clearly shows that this can be a vulnerable time for women. Managing this phase of life, combined with career demands, empty nest, caring responsibilities can really highlight how women need support during this period, not just from partners, family but professional support from GP’s and healthcare professionals.
How can counselling help?
As I said before, the menopause is not just about symptoms, it can have a significant impact on their life, relationships and career. Counselling can help provide that space for women to process their emotions and changes to their identity, and help rebuild their sense of self. In fact, the National Institute for Health and Care Excellence (NICE) updated their guidance in 2024 to include the consideration of CBT counselling alongside prescribing HRT for treatment of specific menopause symptoms.
Many women I see in my practice are so confused. They need to feel seen, heard and understood. Therapy can help provide the space where they can explore their emotions and needs, feeling empowered and able to communicate these effectively. It can be really effective for women to help discover themselves and build greater self-compassionate.
If you or someone you love is struggling with the emotional or relational impact of menopause, Sophie offers counselling through held in Haywards Heath. Read more about Sophie or book a free 20-minute introductory call.
Researched References & Professional Resources
British Menopause Society (BMS) / Women’s Health Concern: A Woman's Relationship with the Menopause (National Survey Data).
National Institute for Health and Care Excellence (NICE): Menopause: Identification and Management Guidelines (including CBT recommendations).
Office for National Statistics (ONS): UK Suicide Registrations by Age Demographic.
Chartered Institute of Personnel and Development (CIPD): Menopause in the Workplace Report.
International Menopause Society (IMS): World Menopause Day Educational Guidelines.
