“To be yourself in a world that is constantly trying to make you something else is the greatest accomplishment.”
— Ralph Waldo Emerson
When people talk about menopause, the conversation often centres around the physical symptoms. Hot flushes, night sweats, and changes in skin or hair texture are well known and visible. What is spoken about less often is the quiet emotional shift that many women experience. These changes are not always visible, but they can be deeply felt and unsettling. The sense of feeling “not quite myself” is something I hear often in my work.
Menopause is not just a biological process; it is a psychological and emotional transition. It asks a woman to adapt to new rhythms, to her body changing, and to the subtle but profound ways that hormones influence mood, confidence, and connection. For many women, this transition can stir feelings of vulnerability, self-doubt, and at times, grief for the person they used to feel they were.
The mind and body connection
Oestrogen, progesterone, and testosterone play a much larger role in mental health than many people realise. These hormones do more than regulate reproduction; they interact with the brain’s neurotransmitters that influence mood, focus, and energy.
Studies have shown that changes in oestrogen levels throughout perimenopause, menopause, and post-menopause can affect serotonin and dopamine, both of which are linked to emotional balance. When oestrogen falls, serotonin can drop too, which is why anxiety or low mood can feel heightened even when nothing specific has happened to cause it. Other research has found that while emotional symptoms can arise at any stage of midlife, the fluctuating hormones can make this period particularly vulnerable to depression and anxiety. These are not character flaws or weaknesses; they are chemical changes happening within the body.
As oestrogen declines, progesterone also falls. This hormone has a calming effect on the brain, so when it lowers, sleep quality can change, and many women describe feeling more alert or restless at night. Testosterone also declines with age and plays a quiet but important role in motivation, energy, and intimacy. For some women, restoring balance involves more than oestrogen and progesterone alone; carefully considered testosterone can support mood, energy, and overall wellbeing.
For those with digestive sensitivities, using progesterone vaginally can be a gentler and more effective option, as it bypasses the gut and often reduces side effects such as bloating or drowsiness.
Sleep disturbance can add to this. Oestrogen supports the regulation of temperature and REM sleep. When levels fluctuate, women may wake frequently or find their sleep more shallow. The next day, energy and mood are affected, and the cycle continues. I often remind clients that what feels emotional is also physical. The two cannot be separated.
A shift in identity and purpose
Beyond the biochemical, there is a deeper layer to the menopausal experience. For many women, this time of life brings questions of identity, purpose, and self-worth. Children may have grown up, careers might feel settled but less stimulating, and relationships sometimes begin to reveal long-standing imbalances.
Menopause can be a mirror, reflecting back not only what is changing physically but also what has been overlooked emotionally. Many women tell me they begin to reassess who they are and what truly matters. Old roles or expectations start to feel tight, like clothes that no longer fit. For some, this brings freedom and clarity; for others, it brings uncertainty.
In therapy, I see menopause as a threshold rather than an ending. It can be a time to pause, to reconnect with parts of ourselves that may have been quieted by years of caring for others or managing endless responsibilities. This is where self-compassion becomes vital. When women can meet themselves with understanding instead of judgment, the experience of menopause begins to soften.
Relationships and emotional connection
Changes in mood, energy, and libido can quietly ripple through relationships. What was once easy communication can sometimes feel strained. A partner might not understand why emotions feel closer to the surface, or why touch is less comfortable. This is not about the relationship failing; it is about the body and mind adjusting.
Studies have shown that relationship satisfaction can dip during the menopausal transition. Researchers suggest this is not because love or commitment fade, but because partners often do not have the language or knowledge to understand the changes taking place. When women feel emotionally supported and heard, the challenges of menopause become easier to navigate.
I encourage couples to approach this stage with curiosity. Honest conversation about emotional needs, energy, and intimacy can strengthen connection. It is a time to learn new ways of relating, rooted in empathy and patience.
The impact on men and partners
These changes do not affect only women. Men can also feel the impact of shifting hormones within their relationships. They may sense their partner’s distress but feel unsure how to help. They might misinterpret withdrawal or fatigue as rejection or experience their own sadness about a loss of closeness.
It is also worth remembering that hormonal change does not affect only older men. Even younger men, including those in their twenties, can sometimes experience low testosterone. I see this in my clinical work, and it can influence mood, motivation, and how emotionally available they feel within relationships.
It helps when both partners understand that these changes are rarely personal. They are physiological and emotional adjustments taking place within a complex, finely tuned system. When men are included in the conversation and learn about the role of hormones and the emotional turbulence that can accompany menopause, relationships often grow stronger. Compassion and communication make a very real difference.
The physical and emotional loop
The body and mind constantly communicate. Digestive health, movement, and breath all influence mood. When oestrogen levels shift, it can alter gut motility and even the balance of beneficial bacteria, which in turn affects neurotransmitter production. It is another reminder that these feelings are not imagined; they are part of a whole-body experience.
Simple routines can help. Regular movement, nourishing foods, gentle breathwork, and consistent sleep all support the nervous system. HRT can also provide important support by restoring a more balanced hormonal environment. For many women, this steadies mood, improves concentration, and brings back a sense of vitality that had quietly faded.
The silence that surrounds menopause
Despite greater awareness, menopause still carries a certain quietness in many circles. Some women fear being judged as less capable or emotional. Others feel invisible, as though their experiences do not matter. This silence adds to the emotional weight.
Studies have shown that when women receive social and workplace support, their mental health outcomes improve. Simply feeling understood can reduce stress and prevent depressive symptoms from developing. When menopause is spoken about as a natural stage of life rather than a decline, women can approach it with confidence and self-respect.
Many women also experience challenges in the workplace during this time. Concentration, confidence, and emotional steadiness can fluctuate, and without understanding or flexibility, this can lead to isolation. Workplaces that acknowledge menopause as a normal life stage help women continue to thrive with dignity.
Every woman’s experience of menopause is shaped by her body, background, and circumstances. There is no single story, which is why listening with empathy matters so much.
A counsellor’s reflection
As a counsellor, I have walked alongside many women through this transition. Each story is unique, yet the themes are familiar: exhaustion, irritability, teariness, loss of confidence, and a sense of drifting. Beneath that, there is often a quiet strength waiting to be rediscovered.
It is also worth remembering that hormonal changes begin long before menopause officially starts. From around the age of forty, oestrogen begins to decline gradually, and for some women this can bring subtle emotional and physical changes years before their periods stop. Knowing this can be reassuring. It reminds us that what we feel is part of a natural and gradual process.
I often describe menopause as an invitation to slow down and listen. The body is asking for gentleness, the mind for reflection. It can be a time to examine long-held patterns of over-giving, perfectionism, or self-criticism, and to replace them with care, rest, and honesty.
One resource I often recommend to clients is the book Menopausing by Davina McCall. It offers a balanced blend of science, honesty, and empowerment, and it helps women and their partners understand the realities of menopause while challenging the stigma that still surrounds it.
In my own experience, I’ve found that testosterone is often overlooked in standard HRT and it can be the missing link in helping women feel more balanced, energised, and emotionally grounded.
I am fifty-eight, and I can honestly say that I have never felt stronger or more grounded in myself. This stage of life has taught me to create balance, to choose what truly matters, and to build relationships that feel authentic and nourishing. Menopause, for me, has been both a teacher and a turning point.
Once hormone levels stabilise and women learn to honour their own needs, a deeper sense of self often emerges. Many women describe feeling more authentic, more direct, and more at peace with who they are. This phase is not the end of vitality; it is the beginning of a more conscious way of living.
Rediscovering balance
Managing menopausal mental health involves more than one approach. Emotional wellbeing comes from attention to both inner and outer worlds. It can mean:
- Seeking support through counselling to process identity changes.
- Using HRT or natural approaches under professional guidance.
- Finding community with other women going through similar experiences.
- Creating rituals of rest and nourishment that remind the body it is safe.
Menopause asks for a kinder self-dialogue. It is a time to rebuild trust with the body and to recognise that growth can happen at any stage of life.
Closing Reflection
The silent impact of menopause on mental health deserves more space in conversation and in care. Behind the statistics and hormonal explanations is the lived reality of women navigating change in a world that often values youth and productivity above inner wisdom.
If you are in this stage, know that you are not alone. Your emotions are valid. Your body is responding to real physiological shifts, and it is possible to find balance again. The process may feel unpredictable at times, but it also holds the potential for clarity and renewal.
In my practice, I have seen women emerge from this chapter feeling more grounded and self-assured than they have in years. Menopause does not define the end of womanhood; it redefines what it means to live with presence, compassion, and self-respect.
A gentle invitation
If something in this blog resonates with you, please know that you do not have to navigate it alone. Whether you are a woman experiencing change yourself, or a man wanting to better understand and support someone you love, counselling can provide a safe and reflective space to explore what this stage means for you.
To learn more about my work or to arrange a session, you are welcome to visit my website.