The female sexual hormones – Oestrogen, Progesterone and Testosterone – govern not only women’s reproductive cycle and dictate the physical and emotional characteristics but also play a vital role in our physical and emotional health. Fluctuating levels of these hormones during Perimenopause and Menopause are responsible for a range of physical and emotional symptoms felt throughout this transitionary period. By the time women get to the menopause, the production of the female sexual hormones drop by around 90%, leaving us exposed to the risks of developing physical and emotional difficulties related to the hormonal imbalance.

The psychological Menopausal symptoms such as sleep issues, low mood, anxiety, irritability, poor concentration and brain fog, can present alongside the well-known physical symptoms of hot flushes, night sweats, joint pain and weight gain which in combination can adversely affect women’s ability to function on day to day basis.


Oestrogen is the ‘master’ hormone that is responsible for female brain health, regulating many functions in the body. Usually associated with sexuality and reproduction, this hormone also plays a key role in energy production, protection of the brain cells from damage and supporting the development of new connections between neurons.

Oestrogen is often referred to as natures Prozac as it supports the creation of serotonin, the ‘feel good hormone’ and the production on GABA (Gamma Amino-Butyric Acid) which is a neurotransmitter that has a protective, soothing function in the brain.

This often means that when Oestrogen levels drop,  the serotonin and GABA levels go down too, which has been linked to sleep difficulties, low mood and heightened anxiety levels.


This female hormone is responsible for a calming effect on the brain and has been linked to improved cognitive functioning, aiding sleep and calmer emotional states. When progesterone starts to drop during menopause, it can lead to sleep difficulties, irritability, anxiety, memory issues and brain fog, which can have a huge impact on a woman’s overall wellbeing and their ability to function.


Often mistaken as a male-only hormone, women’s bodies produce testosterone too, albeit at much lower levels than in men. Testosterone plays a key role in women’s health, being responsible among many functions for increased concentration, physical strength and energy levels. As with all the other female hormones, testosterone production starts to deplete in menopause, which can trigger a loss of concentration, low mood, low libido, lower energy levels and weight gain.

When we are experiencing increased levels of stress during the menopausal transition, this is more likely to compound the effect of all the other hormonal changes described above and make us more vulnerable to low mood and increased anxiety.

Cognitive Behavioural Therapy (CBT) is recognised as an effective treatment for treating a range of psychological Menopausal symptoms women encounter during this stage of life such as sleep difficulties, anxiety, low mood, anger, loss of self-esteem, etc. CBT can be used successfully in supporting women to learn strategies to cope by increasing awareness of the links between thoughts, feelings and behaviours and how we can effect change to improve the way we respond to situations that trigger an emotional response in us.

Simon Stokes Counselling Psychologist


Best wishes,

Simona Stokes

Counselling Psychologist

Menopause CBT Clinic







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