The Impact of Menopause: Implications for Mental Health Counselors

By Baldo, Tracy D.; Schneider, Mercedes K. et al. | Journal of Mental Health Counseling, October 2003 | Go to article overview

The Impact of Menopause: Implications for Mental Health Counselors


Baldo, Tracy D., Schneider, Mercedes K., Slyter, Marty, Journal of Mental Health Counseling


The purpose of this article is to present a brief, informative view of the impact of menopause along with implications for mental health counselors. Menopause and associated stages are defined; symptoms associated with these stages are discussed; the benefits, risks and consequences of hormone replacement therapy (HRT) are considered; and recommendations for mental health counselors are provided.

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Amy, a 42-year-old female, came to counseling to discuss her concerns with her marriage. She reported that she had been happily married for 11 years; yet she was currently struggling with intimacy issues with her husband. She felt very confused because her life was wonderful; yet she felt moody, irritable, and tired. She cried as she shared her frustration with not feeling like herself. She stated that she had a fulfilling career, enough time for her own needs, and a financially secure family. She and her husband had three children, two daughters, ages 9 and 5, and a son, age 3. Amy indicated that the children were wonderful and easy to parent. She and her husband spent over 2 hours each day during the week just playing with and spending time with the children. The weekends were often focused on the children in some fun manner (e.g., going to the zoo, renting a movie, or eating pizza together). She indicated that the family was very dose, and she felt truly blessed to have a husband who enjoyed spending time with the children.

Her overwhelming concern was her lack of desire for sexual intimacy with her husband. Over the past year or so, she stated that intercourse had become more difficult. Although she felt connected to and loved by her husband, she did not feel sexually aroused by him. Often she would pretend to be asleep when he came up to bed so that he would not want to make love. Although she appeared embarrassed to discuss her concerns, she expressed a strong desire to figure out what was wrong with her and her relationship. Amy had read a lot of articles and books about intimacy, and she kept trying to figure out how she might be mad at her husband as the articles suggested. Amy shared that she truly believed that she deeply loved her husband, and she felt very confused because she did not want to be touched by him. She was concerned about her husband feeling unloved because she didn't want to make love. Amy stated that intercourse was just too painful sometimes, and she was frustrated with her body's lack of response to intimacy. She felt that her body was betraying her by not feeling sexual anymore. Additionally, her sleeping had been restless, and she was tired of feeling irritable, moody, and exhausted. Mental health professionals will work with clients like Amy who struggle to understand their lives and the changes that are occurring. However, it is critical not to immediately assume that clients like Amy are struggling solely with mental health concerns. Many of Amy's presenting concerns are common complaints presented by women entering menopause, or more specifically, perimenopause. Mental health counselors need to be cautious not to discount the biological changes that occur for women in their 30s, 40s, and 50s. Menopause happens to all women regardless of race or ethnicity. Menopause will occur in 100% of the population of women, typically between the ages of 45 and 55 with perimenopause starting as early as the mid 30s.

The purpose of this article is to present a concise yet informative view of the impact of menopause to assist and inform the professional and client alike. The intention is not to have mental health counselors become medical experts, but rather to encourage an understanding of the biological changes that women undergo which may significantly effect their mental health. Included here is a definition of menopause and symptomology associated with its stages; the benefits, risks, and consequences of hormone replacement therapy (HRT) as the most common treatment for perimenopause/ menopause/postmenopause symptoms; and recommendations for mental health counselors. …

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