On Becoming: Coaching Psychology for Menopause.

The need for holist approach and empowerment

What is the value of developing a lifestyle intervention that caters to the cognitive, behavioral, spiritual, and social impact of menopausal symptoms? I am a coaching psychologist and psychotherapist, in my clinical practice I can hardly separate menopausal symptoms and box them into categories. All these years working with women experiencing menopausal symptoms, from naturally transitioning, or surgically, or due to cancer treatment, I learned that menopause is like breaking into pieces. My clients come to me with different life stories, however, when they describe the impact of menopause, they refer to a sense of breaking, losing control of what they believe to be themselves. They don’t sleep well, there is difficulty in communication affecting their relationships, there is an identity piece that needs to be addressed and the body feels like entrapment, untrustworthy. Many of my clients have addressed the hormonal changes with hormonal treatment, but some cannot and use complementary alternative medicine and these treatments help them to bear some of the symptoms. What is left to all women transitioning is to answer for the menopausal insistence on change, renewal, and acceptance. Those are hard tasks for a woman to face alone. It requires that this woman look at her lifestyle and determine if her coping skills are serving her well. Coping skills are the things that we think and do in order to manage internal and external stressful situations. Although you teach good coping skills, effective use of coping skills is only possible when core beliefs are explored. Core beliefs add another inner layer to the management of menopause symptoms. It refers to the inner experience of oneself to feel loved, wanted and accepted. How many clinicians ask their clients if past trauma is resurfacing during menopause?

I am developing a research proposal that examines the impact of ‘On Becoming: Coaching Psychology for Menopause. This intervention addresses: 1. Resilience by working on cognitive restructuring; 2. Physical well-being by encouraging behavior activation on sleep, healthy eating, and walking; 3. Spirituality – It also pays attention to inner turmoil during menopause, by addressing aspirations, values, and purpose. I believe that a holistic biopsychosocial intervention aimed at improving mental well-being and quality of life in women will be welcomed by women experiencing menopausal symptoms and also by clinicians looking to best support the needs of their perimenopausal and menopausal patients.

Menopause is an umbrella term, characterized by hormone imbalance. Common symptoms include hot flushes and sweats, tiredness, fatigue, lack of concentration, brain fog, sleep disturbance, insomnia, mood swings, depression, anxiety, forgetfulness, discomfort during sex, loss of libido, urinary frequency, or urgency (Whiteley et al., 2013).

The British Menopause Society (2020) states that a healthy lifestyle can minimize the impact of menopausal symptoms and serves as a protective factor against the increased risk of cardiovascular disease and stroke.

Research in Ireland and Britain suggests there is a need for a structured lifestyle program to support women through menopause transition (Lillis, et al. 2021). Findings suggest women believe that menopause education is the most important aspect, followed by weight management, weight loss, and physical activity sessions.

‘On Becoming: Coaching Psychology for Menopause’ aims to address the gap in treatment availability, adding to the body of research and providing an understanding of the mechanisms by which behavior change can promote a healthier lifestyle and support the management of menopausal symptoms.

As seen in clinical presentation menopause symptoms are complex, highly individual, and are also intertwined with biopsychosocial factors. Even though menopause is old as time, there are a lot of women that feel lonely and isolated in their struggle. Health promotion and group-designed intervention are essential to empower women and destigmatize menopause.

Carpenter and colleagues (2011) state that there is a great deal of inter-individual variability in both the type and severity of menopausal symptoms experienced. Furthermore, symptoms vary within individuals on a day-to-day basis, making symptoms unpredictable and difficult to manage.

Bondarev and colleagues (2020), suggest that physical activity may maintain positive mental well-being and buffer depressive symptoms associated with menopause. However, the authors cannot exclude the possibility that women experiencing lower levels of menopausal symptoms are more active and have a higher level of mental well-being. there is also the onset of depression due to hormonal changes. My treatment and research proposal recognizes the complexity of the menopausal transition and its fluctuations in symptom presentation, accepting the methodological concerns raised by Matti and colleagues (2021), and highlighting the importance of understanding the complex systems that underpin behavior change in lifestyle medicine.

Menopausal symptoms like hot flushes and night sweats have a negative impact on physical activity, or, perhaps physical activity improves sleep and therefore reduces fatigue. It is important to understand the direction of these associations and their dynamics. Menopausal symptoms may extend throughout 8 years of a woman’s life span and not all women will experience the same symptoms or severity.

The focus of the intervention may vary, depending on the phase and presentation of the menopausal symptoms. A woman in an early perimenopausal phase might benefit more from focusing on diet, whereas a woman in later perimenopause may benefit more from focusing on sleep in order to sustain physical activity levels. Do different stages of menopause transition require different approaches to lifestyle intervention? There is a need for establishing the therapeutic value of integrative, holistic programs for women with a specific focus on typical menopause symptoms at different stages, as highlighted by Syndora and colleagues (2020).

I believe that women’s health and empowerment are essential for a healthy society, no efforts are too much. I am open to adding and multiplying knowledge, if you feel as passionate as I do, whether as a client or clinician, please don’t hesitate to contact me for a collaborative partnership.