The life expectancy for women is the UK is 80, which means that women can be in perimenopause, menopause and post-menopause for nearly half of their lives.

Although all women are going through the menopause during the middle stages of life and it’s a normal and natural transition, it is not always an easy process.

It is now accepted that approx. 80% of women going through this stage of life, will experience low mood and anxiety symptoms from mild to moderate but in some cases extreme (such as a form of psychosis), symptoms that have been associated with the hormonal imbalance, primarily fluctuation in oestrogen levels.

So, in spite that all women will go through this transition, until recent years, menopause still appeared to be a taboo subject, unlike puberty, contraception and pregnancy. However, over the past few years, due to the relentless work of many brave women, the subject of menopause is approached more openly, talked about and addressed in the context of women’s physical and mental wellbeing.

There are many forms of psychological therapies that have been developed over the past 120 year since Sigmund Freud has developed psychoanalysis. Today, the field of therapy is a diverse milieu of approaches that are all claiming to offer a path to psychological wellbeing.

Among this vast array of therapies, Cognitive Behavioural Therapy (CBT) is one of the most researched approach that has been proven to be effective in helping individuals regain emotional wellbeing.

National Institute for Health and Care Excellence guidelines (NICE) and Royal College of Obstetricians and Gynaecologists (RCOG) recommend GPs and other health professionals to give women going through the menopausal transition, information and advice about CBT. This is because it is well accepted and recognised that this form of evidence based psychological therapy can be used effectively to aid with a range of emotional and physical difficulties, women encounter while navigating this stage of life.

CBT is designed to increase awareness of the links between thoughts, feelings and behaviours and can be used successfully to support women to learn strategies to cope with the emotional and mental health symptoms caused by the peri-menopause and menopause.

CBT is recognised as an effective treatment for treating mood swings, depression, anxiety, irritability, sleep problems, low self esteem and confidence (to name o few), the very symptoms women experience when navigating the menopausal transition. CBT has a wealth of evidence behind it that demonstrates its effectiveness in helping address these emotional difficulties, as well as other difficulties associated with the managing change and transition in life, support with coming to terms with feelings of loss of fertility and (for some women) loss of identity as a woman.

Moreover, CBT has been proven to be effective in helping women managing vasomotor symptoms associated with menopause such as hot flushes and night sweats (Ayers B, Smith M, Hellier J, Mann E, Hunter MS.,- 2012)

It is well established that the fluctuations in oestrogen, progesterone and testosterone levels during the peri-menopause and menopause have an impact not only on the physical body but on our mental and emotional wellbeing. All too often, during our 40s and 50s when women experience emotional difficulties, we can be diagnosed with depression, anxiety, adjustment disorder, etc. and treated with antidepressants, without much consideration for how the hormonal changes may have impacted on our mental health.

Research looking at the depression experienced by women during the perimenopause have concluded that although there is an overlap between major depression and the depression women experienced during the menopausal transition, the differences may indicate that ‘perimenopausal depression’ is a unique subtype of depression which has its own characteristics.

The main differentiating characteristics of ‘perimenopausal depression’ are: milder mood presentation, unhelpful thought processes related to others perception of self, irritability and anger (rather than sadness displayed in major depression), increased levels of tiredness and reduced energy levels that are not necessarily related to sleep disturbance.

Studies looking at how women respond to antidepressant medication when they have ‘perimenopausal depression’ have shown that they respond differently to this type of medication that those women who have major depression prior of entering the menopausal transition.

To help you determine if you are struggling with ‘Perimenopausal depression’ and may benefit from CBT for Menopause, please click on the link below to fill in the Meno – D,Perimenopause Depression Scale, a clinically validated depression scale, which has been developed in 2018 by Prof. J. Kulkarni and her team from Monash Albert Psychiatry Research Centre, Melbourne, Australia.

So, when you are ready to take the first step on this journey, please contact me using the box below and I will show you how to use the theory and practice of CBT – Cognitive Behavioural Therapy – to become CBT – Confident, Brave and Thriving again.

Simon Stokes Counselling Psychologist


Best wishes,

Simona Stokes

Counselling Psychologist

Menopause CBT Clinic







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