How can counselling help during perimenopause?

Natural menopause happens at around 51 years old. This is when people assigned female at birth have not had a period for over a year. However, there is a transitional phase prior to menopause, called perimenopause.


Perimenopause can affect people in many different ways, and not just in the physical symptoms they experience. Although perimenopause is most commonly associated with women, people with different gender identities, including transgender men and non-binary folk, go through this phase of life and they may experience different challenges to cis-gendered women (people who were assigned female at birth and identify as women).

Symptoms and effects of perimenopause

Fluctuations in hormones during perimenopause can cause a variety of different physical and emotional symptoms. Some of these symptoms can include mood changes, sleep problems, hot flushes, brain fog, and fatigue, but there are many other less recognised ones.

Because people can enter perimenopause anywhere from a few months to several years prior to entering menopause, these symptoms can be confusing. Perimenopause symptoms may even be mistaken as symptoms of other problems, such as thyroid disorders, depression and anxiety, or chronic fatigue syndrome. This can leave those experiencing perimenopause symptoms with questions and feeling unsure about what they can do to improve how they feel, or who they can turn to for help.

Reading this, you may be someone struggling greatly with perimenopause symptoms, which can include anxiety and low mood. You may be feeling isolated, embarrassed, or that you have to manage how you are feeling on your own. You might be experiencing intimacy problems within your relationship with your partner because of changes to your libido. You might be having problems with your family or in other relationships because of mood fluctuations. At work, you might not feel as confident as you used to be because of brain fog and fatigue, or you might have started questioning your identity because of changes to the way you feel. These are just some examples of the wide-reaching impact perimenopause can have.

Challenges during perimenopause

When seeking medical help for perimenopause symptoms it can be difficult to get the appropriate support because the NICE guidelines state doctors should only offer those who are 45 years old and over Hormone Replacement Therapy (HRT), without having blood tests first. With GP appointments limited to five or 10 minutes, it can also be hard to discuss symptoms in full or to feel heard and supported.

Although awareness is improving with television programmes about HRT, and many companies introducing policies to support those in perimenopause and menopause at work, there is still a stigma attached to perimenopause and menopause that can lead to many people feeling unable to talk openly about the struggles they are experiencing.

How counselling can help during perimenopause

Speaking to a counsellor when you are struggling during perimenopause can help in a number of ways:

1. Counselling can give you time and a safe, confidential space to share your own experience of perimenopause – including how this is impacting you and different areas of your life – with an empathetic and non-judgemental therapist.

2. Talking to a counsellor can help you to feel heard, and have your thoughts and emotions validated. Perimenopause is a natural process, and speaking to a counsellor who has an interest in perimenopause and menopause can help you to recognise that you are not alone and that your experience is normal.

3. Counselling can help you to reflect on different areas of your life, and to discuss self-care, strategies to reduce your stress levels, and improve your resilience by recognising the resources you already have.

4. You may want to use this period of change as an opportunity to reflect on your hopes for the future and invest in yourself, and counselling can offer you a safe place to explore this.

5. Counselling can be part of a holistic approach to managing perimenopause symptoms by improving your emotional well-being. You could begin counselling in addition to taking HRT, exploring natural ways of improving your symptoms, adopting lifestyle changes (such as a healthier diet and exercise), and introducing good sleep hygiene.

Every person’s experience will be different and your counsellor will work with you on what is important to you, your needs, and your preferences. Your counsellor may also signpost helpful reading and resources to support you in addition to counselling sessions.

Finding a counsellor

It can be daunting reaching out to a counsellor, especially if you have not experienced counselling before. It is a good idea to look for a counsellor who has an interest in, or has experience of, working with the problem you are seeking help for, and it is always okay to speak to different counsellors to find one you feel comfortable with before beginning your counselling journey.

If you would like to speak to me about beginning counselling, please get in touch.

The views expressed in this article are those of the author. All articles published on Counselling Directory are reviewed by our editorial team.

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