menopause-informed individual & couples therapy

menopause & perimenopause informed therapy

The impact of the symptoms of perimenopause and menopause on mental health, relationship with self and relationships with others is broad but often misunderstood. Arriving at a transitional time in life, symptoms of perimenopause or menopause can often influence or be mistaken for the impacts of: parenting tweens/teens/young adults, preparing to launch children, care for aging parents, navigate shifts in physical self, new or exacerbated experiences of depression, anxiety or insomnia, shifting attitudes on career, personal values, direction in life and aging, saying goodbye to or preparing for the loss of roles and responsibilities. 

While all of these stressors and changes may play a role in symptoms also associated with perimenopause or menopause, your hormonal shifts may also be playing an influential role as well. Assessing, understanding and focusing treatment on the management of symptoms influenced by perimenopause is a crucial step to effectively reducing or eliminating symptoms, navigating the transitional period healthily, and healing and maintaining your sense of self and your relationships.

common peri/menopausal symptoms and their impacts on self and relationships

Do you feel more irritable with others? Is your partner becoming more annoying or frustrating now more than ever? Do you find yourself arguing more with your kids and family members than actually having pleasant and easy interactions? Do you find yourself not reaching for physical connection with your partner anymore? Do you employ excuses to avoid physical intimacy before your partner asks for it? Do you feel disconnected with yourself, often asking yourself, “who am I?” Do you spend time feeling like you should be doing something to help yourself but completely unsure of what that should be? Do you find yourself feeling less satisfied with life and more concerned about the future?

These thoughts, and many more, are often shared by women experiencing the mental health impact of the menopausal transition [see the table at the bottom of the page for more symptoms and their impacts]. Some of the most common symptoms associated with perimenopause and menopause are on mental health (anxiety, depression), but even the physical symptoms have significant impact on daily life and relationships with self and others. 

When women discuss their experiences, they often include the impact of symptoms on how they feel in their lives. Brain fog may be discussed as feeling like something is wrong with their brain, feeling like they’ve lost an important part of themselves, feeling old all of a sudden, wondering who they are without the familiarity of recall, memories, or the ability to express themselves the way they used to, feeling distressed in their careers like they are missing the capacity to perform their jobs as they once did. Low libido/low sexual desire may be described as feeling old, disconnected from their sexual self, wondering what’s “wrong” with them that they don’t want sex anymore, resulting in feelings of being just “roommates” in their intimate partnerships, or fear that their partner may leave them for a more sexually compatible relationship.

While medical therapies can treat most of the symptoms of perimenopause and menopause, the impacts on self and relationships don’t often resolve at the same time. Your physician may prescribe Hormone Replacement Therapy (HRT), relieving you of low sexual desire, but the emotional disconnection and shift to “roommates” will likely still be in place until the emotional connections are reestablished, healed, and secured. HRT may provide relief of brain fog, but navigating, accepting, and taking charge of the transitional period in your life, marked by the question, “who am I, and what do I want for my future?” will still be before you. 

menopause-informed therapy for individuals

As a Licensed Marriage & Family Therapist with training to assess and navigate the impact of perimenopause and menopause on individuals mental health and well-being, I take a holistic approach to the therapy I provide. 

Together, we will identify what is having an influence on your sense of well-being, across the biological, psychological, and social aspects of your life. These include identifying what physical symptoms of menopausal transition you’re experiencing, other biological influences (medications, diagnoses, etc), what psychological symptoms are impacting you (anxiety, depression, etc) and their histories, and finally the the social influences in your life that may represent stressors (raising children, caring for aging parents, stressful or dissatisfying career). 

We will discuss what treatments you are receiving from healthcare providers, what treatments you may want to discuss with your healthcare provider, and navigating any obstacles you identify to receiving informed menopausal treatment. Should hormonal therapies not be indicated for you (typically based on history of breast cancer), we will assess non-hormonal therapies (CBT, mindfulness techniques) to help manage expressed symptoms.

For the mental health symptoms, impacts on relational well-being and self, we will work together to help you process, understand, and navigate symptom management and relationship with self to a more loving, accepting and empowered self, as well as improved relationships with others. Utilizing Emotionally Focused Individual Therapy (EFIT) techniques as well as mindfulness, healthy boundary setting, and some CBT, our work together is focused on successfully transitioning through the menopausal journey to feel more in control, healthier, and loving. 

menopause-informed couples therapy

As a Licensed Marriage and Family Therapist with a specific focus on couples therapy, I am committed to bringing a menopause-informed approach to couples therapy where appropriate. For far too long, the impact of the menopausal transition on the health and satisfaction of intimate relationships has been overlooked. Therapy fails when an appropriate and important focus of distress is undiagnosed and untreated, and this is often the case for couples. 

My approach to menopause-informed couples therapy largely resembles the work I do in couples therapy generally; using an Emotionally Focused Therapy (EFT) approach, I work with couples to increase effective communication and deepen mutual understanding and acceptance, increasing security, trust, emotional connection and the relational bond. EFT also provides the groundwork approach for healing new or past ruptures in the relationship, including betrayal or infidelity. 

EFT work pairs very well with a menopause-informed approach. According to several studies on marital satisfaction and menopause, when non-menopausal partners were provided education on the menopause transition and understanding of their partners’ experiences, marital satisfaction rose for both partners. Additionally, reports of sexual satisfaction also increased just based on the mutual understanding of menopausal impacts generally and specifically to the menopausal partner. 

Together, we will assess the menopausal symptoms being experienced, and the impacts they are having on the relationship. Though not exclusive, they generally fall under communication (more conflict, increased feelings of emotional disconnection), and sexual intimacy (mismatched desire, dissatisfaction with sexual activities in frequency and/or encounters). With a holistic approach to menopause-informed care, I will collaborate with the menopausal partner on the treatment they are seeking/may seek from healthcare providers to manage symptoms as appropriate. In couples therapy, I will provide some education on the menopausal transition for both partners, setting the foundation for mutual understanding. In-session EFT therapeutic work will increase effective communication, mutual understanding, emotional security and trust. Sexual desire discrepancies will be assessed, with both medical referrals as appropriate, as well as therapeutic interventions to help increase desire and satisfaction for both partners. 

YOUR MENOPAUSE-INFORMED THERAPIST

Olivia Wright, LMFT, practitioner and owner of Magnolia Therapy & Wellness, began recognizing through her therapy clients and personal friends how much influence the menopausal transition (perimenopause through postmenopause, typically ages 40-65) was having on so many individual and relational experiences. Her curiosity drove her to investigate therapeutic approaches for couples and individuals experiencing the menopausal transition, only to find little to no attention. Quickly, this became an ethical concern for her practice; seeing women in their mid-40s coming to therapy for the first time due to anxiety they had not previously experienced, distress and dissatisfaction with self, lowered self esteem, and worry for the future. Seeing couples describing their mismatch in sexual desire as hopeless, frustration over increase in bickering or other conflicts, concerns over the next chapter in their relationship as they navigate empty-nesting and caring for aging parents.

For many clients, focusing on traditional understanding of an individuals’ or couples’ distress and goals without assessing for and understanding the impact of the largest hormonal shift in a woman’s life was like doing therapy with one arm tied behind your back. As a member of the North American Menopause Society, Olivia sought menopause provider training to bring back to her practice and her clients to make sure the scope of the influencing factors of distress were being addressed. 

This approach has transformed the therapeutic outcomes for many of her individual and couples therapy clients, and continues to be an area of treatment she is passionate about and dedicated to. 

If you’re ready to start your healing with a deeper understanding of what’s influencing your distress, dissatisfaction, or mismatched sense of self, please reach out today.

symptoms & impacts of menopausal transition

The list below identifies some of the most common symptoms associated with perimenopause and menopause, and the impacts it can have on the individual and relationships. For more comprehensive list of potential symptoms, as well a more detailed overview of perimenopause and menopause including onset timelines and treatment options, please visit my page on menopause.

• Hot flashes/night sweats

  • Anxiety/nervousness around unexpected hot flashes; withdrawal from social situations for fear of hot flashes; Distress or embarrassment on reminder of aging; Feeling out of control of body, disconnected or betrayed by your body; Feeling less sexy or desirable to your partner

• Fatigue

  • Low mood; Frustration with self over inability to accomplish tasks you feel you should be able to; Withdrawal from social engagement or things that bring you joy because you’re too exhausted; Loss of sense of self

• Irritability/Mood instability

  • Snappiness; Frequent thoughts and expressions of negativity; Emotional lability (easy to cry, moody, annoyed); Frustration with self on not being able to stop; Feelings of disconnection in relationships due to expressions of irritability; Difficulty with patience or enjoying positive interactions with others like you once did; Increased conflict with loved ones, friends, coworkers

• Anxiety, Depression

  • Unable to manage racing thoughts contributing to insomnia, disconnection in life experiences; Feeling nervous, anxious or worried more than usual; Modifying interactions and activities you’d like to enjoy in order to soothe anxiety; New or worsening depression; Low mood and withdrawal; Difficulty engaging in activities that once brought you joy; Withdrawing or disconnecting from important relationships; Feeling alone in relationships; Anger or frustration with self for feeling depressed or anxious “without reason”

• Worsening existing Mental Health Disorders

  • Increase, new onset, or resurfacing mental health issues; Frustration on not being able to manage them well; Misunderstanding by loved ones on what you’re experiencing; Fear of future with recurrence or new onsets; Withdrawal from relationships to not “burden” others

• Brain Fog (Intense Forgetfulness)

  • Feeling not like your usual self; Distress over being unable to access your brain, thoughts, memories as you once did; Fear or distress over aging; Anxiety over source of forgetfulness; Difficulty engaging with others leading to withdrawal; Increased difficulty in doing your job or completing tasks leading to potential reconsideration of career; Grief over sense of loss of self

• Weight Gain/Shifts in Body/Physical Changes

  • Feelings of despair over weight gain or physical shifts in your body; Dissatisfaction with self; Feeling less sexy or desirable to partner; Withdrawal from social engagements due to discomfort with physical appearance; Shame or guilt for weight or physical appearance

• Low Libido/Decreased Orgasms

  • Distress over mismatched sex drives in intimate relationships; Fear of never feeling desire again; Frustration or despair over reduction in physical enjoyment of sexual activities; Withdrawal from intimate activities in relationship due to lack of desire or performance anxiety; Feeling less desirable to partner; Distress over aging

• Vaginal Dryness/Painful Sex

  • Fear over physical distress; Withdrawal from sexual intimacy with partner; Distress in relationship; Sadness, anxiety and despair

• Insomnia

  • Distress over lack of sleep; Feeling disconnected from yourself; Distress over feeling capable; Withdrawal from activities and engagement with others due to exhaustion; Frustration with self over not “fixing” sleep issues

• Irregular Cycles

  • Hypervigilance over absent or irregular periods; Feeling the aging shift; Withdrawal from work settings or social engagements due to fear of unexpected bleeding; Feeling disconnected from your self