Anxiety is the number one reason why women in menopause are seeking therapy, according to our Mindometer survey

Detrimental impact

The survey, which provides an in-depth look at what our members have experienced in their practice over the past year, showed that almost three in five (58%) therapists say their clients in menopause are seeking support for anxiety. And nearly two thirds (65%) stated that menopause-related issues are having a detrimental impact on their clients’ mental health.

Mood changes

Mood changes and relationship issues, sex, and intimacy were also amongst the top reasons why women in menopause are seeking therapy. Around half (53%) of the therapists who help clients in menopause saw women seek support for mood changes, and just under half (47%) for relationship issues, sex, and intimacy.  

The survey also revealed that, over the past year, over half (55%) of the therapists said their clients had not realised they were experiencing symptoms of menopause.

Anxiety and depression

“Menopause, and more specifically perimenopause, is a time of great change for a woman,” shares Brieanne Doyle, a registered therapist who specialises in helping women. “It often coincides with a number of other significant life events too - such as teenage children, children leaving home (empty nest), ageing parents, more responsibility at work, and a changing body - which can amplify the emotional experience.

“Many women going through menopause arrive in my therapy room experiencing anxiety, often for the first time in their lives. It can present as feelings of inadequacy, and a failure or inability to complete tasks previously done with ease. It might also look like they are disinterested in things they previously enjoyed, or they sometimes have a feeling of heaviness as they go about their day. Both anxiety and depression are common features of menopause but are rarely discussed.”

The perfect storm

Lina Mookerjee, a senior accredited therapist who is studying menopause for her PHD as well as having lived experience herself, agrees with this. She also says that hormonal fluctuations during menopause is often a major reason why anxiety is present during menopause.

“Oestrogen is like a women’s buffer and emollient to lots of things including stress and pain. And as this declines in menopause, the balance gets tipped and causes anxiety,” explains Lina. 

“For many women in heterosexual partnerships it can also be a time when it seems as if their partners are really hitting their stride, enjoying the greater freedom that life affords many men in their middle age,” adds Brieanne.

“All of these factors combine with the very real biological process that is perimenopause and the significant hormonal changes to create what many women describe as a 'perfect storm.' Menopause is also often a time when a woman begins to take stock of her own life, perhaps questioning what she would like from the next phase?”

Suffering on many levels

Lina says that menopause is also a time where women begin to feel invisible.

“Menopause is a time where many women can feel abandoned through invisibility, invalidated, rejected and shamed because of family, cultural, or society’s deference to youth, and getting old is something to be avoided. As a consequence of the lack of societal structures in place to offer patience, valuing of, understanding and respect for menopause as a natural life changing process, women suffer on many levels,” she explains.

Top tips for anxiety in menopause 

To mark World Menopause Day, here are Brieanne and Lina’s top tips to help keep anxiety at bay if you’re are experiencing menopausal symptoms:

1. Be aware of your body’s natural response

“It all starts with awareness,” says Lina. “Get to know the signs you’re anxious. Do you get sweaty hands? Does your heart beat faster? Do you lose concentration? Or talk faster or slower when you’re anxious? Paying attention to your body’s natural response when you’re anxious is the first step in understanding what’s going on.”  

2. Regulate your nervous system

Once you’re aware of how anxiety presents in your body, Lina suggests using your breath to help regulate your nervous system.

“When you’re feeling anxious, try slowing down the time you take to inhale. Take a deeper breath in and slow your breath even more as you exhale. Give yourself five minutes to focus on this exercise and it will help to change not only your heart rhythm but blood chemistry too.” 

“Trying to outthink anxiety is very difficult, but helping the body to calm can reduce the feelings of worry and panic,” adds Brieanne.

3. Pause and reflect

Brieanne also recommends that if you find yourself catastrophising (imagining the worst outcome), it’s worth taking a moment to pause and reflect.

“Consider how likely this terrible thing is this to happen, and what is more likely to happen. It’s also important to address that if it did happen, would you still be ok?”.

4. Create a good morning and evening routine

Brieanne suggests that having a good routine is key if you’re experiencing anxiety and menopause.

“Brain fog is a common symptom in perimenopause and leads many women to feeling they are literally losing their minds. Building good morning and evening routines can be helpful for establishing a predictable daily rhythm. As part of this I encourage clients to do a 'brain dump' where they spend a few minutes morning and evening writing down what needs to be done during the day,” explains Brieanne.

5. Build healthy habits to lower adrenaline levels

Lina says that as anxiety and menopause both create extra adrenaline in our bodies, she recommends creating a few healthy habits to help lower your levels.

“Walking and moving more is a great way to remove any excess adrenaline from our bodies, shares Lina. “Drinking lots of water also helps to get rid of adrenaline too as it leaves our body when we go to the toilet. Cutting down on stimulants – such as sugar, alcohol, high processed food, coffee, tea and social media – will also help lower adrenaline levels.”   

6. Don’t suffer in silence

Despite the survey revealing that 30% of therapists reported an increase in the amount of enquiries and referrals from people experiencing menopause-related issues and concerns, almost a third (32%) of therapists still say there is a stigma around seeking therapy for menopause-related issues.

“There is no need to suffer in silence,” shares Brieanne. “Approach your GP and consider HRT - the role of oestrogen should not be underestimated when it comes to anxiety and depression in perimenopause. Also consider finding a therapist who is educated on the experience of menopause can offer deeper tools and techniques to help you.

Menopause and therapy

“Therapy can be helpful in that it allows women the space to process what is happening - physically and emotionally. Holding space for the changes that are occurring and reflecting on past experiences can be hugely helpful in that women feel heard, seen and acknowledged. It can normalise the experiences she may be having and a therapist with specialist knowledge can offer helpful awareness and context for what the client is experiencing, which is so much more than hot flushes. 

“For example, insomnia can be excruciating during menopause. But if you find yourself really struggling it is worth investigating Cognitive Behavioural Therapy which can be transformative for many women in menopause.”