Menopause and Psychological Change by Joanne Koegl, MA, LMFT in Pasadena, CA

  • Nov 3 2012


Menopause is different for every woman and I have observed in my practice the mental health effects on woman going through menopause.  When women between the ages of 40-60 come in for therapy  with complaints they are “feeling depressed”, “angry”, “anxious”, “ I don’t recognize myself” wanting to divorce their husband and that they feel they are going “crazy”,  I usually will ask them if they have seen their gynecologist for a hormone evaluation.  I am not a medical doctor but have enough knowledge through personal experience, and many other women’s experiences. the noticeable changes that occur during perimenopause and menopause years.  As a psychotherapist I take into account a person’s mind, body and spirit and since I discovered firsthand the sometimes debilitating symptoms associated with hormonal changes, I feel it is critical for me to address the physical and psychological aspects of menopause with woman.  After I take a history of my female client and hear her symptoms I will inform and link the psychological and physical symptoms of menopause.  I recommend, if they haven’t already, to see a physician before my just addressing the psychological aspects of her symptoms.  Psychological and emotional issues are common and complex around menopause and also an age when situations and life events tend to peak into woman’s lives.  Symptoms of Mental Changes in Menopause are:

  • Irritability
  • Tearfulness (not caused by a sad event)
  • Excessive worry
  • Anxiety
  • Diminished energy
  • Problems in concentrating
  • Feelings of low self esteem
  • Loss of memory

Whatever the psychological symptoms and whatever the cause of these symptoms, the important thing is that they are real.  The lack of knowledge on the effects of hormone changes is astonishing and seeing the number of clients that make such positive changes after they address what is occurring physically is rewarding.  The choice of treatment is a very individual decision, and often just knowing what is occurring in one’s body helps to cope with the distress. I will often share my story to educate what I learned and how a combination of bio-identicals and supplements to balance my “unique” symptoms was life-changing FOR ME.  I write unique and FOR ME because, we are all unique and often doctors will not take into consideration that sometimes “normal blood levels” are not normal for everyone and also certain treatments work differently on people. Between my gynecologist and Dr. Stephanie King, DC’s personalized treatment plan I finally felt understood, it took some time to find my balance but knowing that Dr. King, DC was confident I would feel better was a tremendous relief in itself.  With Dr. King, DC taking her time to explain how the endocrine systems works and why my personal blood levels fluctuated so much provided an insight to the complexity of a woman’s body and that there are so much we can do naturally to alleviate or eliminate the physical symptoms of menopause.  Feeling better physically one can approach the emotional issues associated with mid-life with more clarity and less anxiety.

In saying this, there is a tendency in our culture to give credence to problems where a physical cause can be found and to dismiss those to be purely psychological in origin. Menopause is both physical and psychological.  The emotional issues can vary from:

  • Children leaving home
  • Divorce
  • Widowhood
  • Retirement
  • Financial issues
  • Illness or death of parents
  • Physical aging
  • Feeling invisible
  • And of course being menopausal.


Once my client feels “balanced” and able to concentrate better, we approach the emotional issues being

confronted by  the client especially if it is interfering with her quality of life.  Unfortunately many life issues as outlined above occur simultaneously with menopause and stress contributes to additional hormone changes. A quick fix for some physicians is to prescribe anti-depressants which I do not always wholeheartedly agree.  I witness the benefits of talk therapy, having someone to talk in a safe, unbiased, empathic environment are often what most woman need. It’s a time of being heard and supported not dismissed as “It’s menopause”.  It’s a time of needing to express the fears and thoughts that come with aging, health, being lonely, relationship issues and feeling dismissed and to focus on coping with day to day realities and finding practical solutions to problems.   Menopause does not have to be a negative transition but an optimistic time associated with new beginnings, embracing what life experiences have taught us, our strengths, continued growth and self-love.  How we approach menopause physically, psychologically (cognitively) and spiritually will have a tremendous increase to well-being.  I am happy my energy has returned, my foggy brain in clearer and that I. as you, have so much more to offer this world than I did in my 20’s and even 30’s. Seek help.


Joanne Koegl, LMFT is a Marriage Family Therapist in Pasadena, CA, specializing in Woman’s Issues, Couples Therapy and Loss and Grief.  She is also an adjunct Professor at Pacific Oaks College and an After Care Specialist on The Ricki Lake Show and Dr. Drew’s Life Changers.


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Posted in: Adrenal Gland Dysfunction, Hormones & BHRT, Natural Medicine