As a clinical psychologist, I’ve had many conversations with women who feel adrift during menopause. They’ll say things like, “I just don’t feel like myself anymore,” “I feel overwhelmed all the time,” or “I don’t know how to move forward.”  Menopause, after all, isn’t just about changing hormones—it touches everything: our identity, self-worth, relationships, sense of purpose, and even our future plans and dreams. Women may welcome these some of these changes, finding freedom from past expectations, roles, or responsibilities. Others may experience the changes in menopause as loss, resulting in grief.

If this resonates with you, you’re not alone.

The Quiet Grief of Menopause

Grief during menopause is not the kind tied to a single event, like death or divorce. Instead, it’s often cumulative, subtle, and unseen. It’s the grief of change, of letting go—of who we were, what could have been, and what may no longer be possible. For some, this grief can echo previous life losses, amplifying unresolved emotions.

Primary and Secondary Loss in Menopause

Grief during menopause can come from primary and secondary losses. A primary loss is described as the initial or central loss. In menopause, the primary loss is fertility. Even for women who don’t want more children—or never wanted children at all—reaching the end of reproductive years can carry an unexpected emotional weight. It might give a sense of finality, symbolizing the end of a chapter.

Then come the secondary losses. These are losses that occur as a consequence of the primary loss. Many people will readily identify the primary loss and assume that it is the source of all pain and difficulty for the woman grieving. However, secondary losses can be just as important, painful, and challenging. 

Secondary losses vary from woman to woman, but might include:

Physical health

Menopause can involve myriad physical symptoms, including hot flushes, night sweats, disrupted sleep, joint pain, overactive bladder, to name a few. It can also be associated with a range of significant health issues, such as increased risks of osteoporosis and cardiovascular disease. These issues can lead to a loss of energy, sense of vitality, and/or physical capabilities, resulting in feelings of vulnerability.

Physical appearance

Women may grieve the loss of their youthful appearance. Menopause can bring about physical changes, such as body composition ratios of fat and lean mass and skin concerns. These changes are often compounded by societal attitudes that value youth and fertility, leading women to feel less valuable or desirable. In fact, a recent study of over 1, 000 Australians found that women in the menopause transition are at risk of negative body image and disordered eating.

Cognitive functioning

Some women experience cognitive changes during menopause, such as difficulties in verbal learning and memory, processing speed, attention, and working memory. These can lead women to frustration and self-doubt regarding their mental sharpness and efficiency.

Emotional well-being

Fluctuating hormone levels can lead to increased emotional vulnerability, including symptoms of depression and anxiety, emotion-regulation difficulties, and lowered quality of life. These changes can make women feel their emotions are unstable, overwhelming, and out of their control. This loss of emotional equilibrium can be distressing and affect all areas of life.

Sexual health

The hormonal changes of menopause can lead to negative impacts on sexual health for many women, including a decrease in libido or changes in sexual function, such as vaginal dryness and discomfort during intercourse. These changes can contribute to a sense of loss in sexual identity and physical intimacy, which may in turn impact relationships.

Work life

The physical and psychological impact of menopause can coincide with critical career stages, significantly affecting women’s experience of work. Some women may experience negative impacts on their work life, including difficulty managing work stress, reduced job satisfaction, and the need to reduce work hours. This can lead to a loss of professional identity, perceived success, and sense of competency.

Roles and Relationships

Menopause coincides with the shifting family dynamics and personal relationships that occur for many mid-life women. For example, children may leave home or start their own families, and ageing parents may require care. These shifts may result in the loss of familiar roles and routines. They may also prompt a re-evaluation of life goals and sense of life purpose.

Tangible and Intangible Loss in Menopause

Some of these losses are tangible—we can see and measure them. Others are intangible, such as a loss of confidence, identity, or long-held dreams. And sadly, many of these losses go unacknowledged by those around us and society at large – what’s known as disenfranchised grief. When our pain is unseen or invalidated, it only deepens the hurt. This has the potential to add further pain and suffering to women’s experience and prevent them from accessing the support and care they require.

Menopause as a New Beginning

But here’s the good news.

Every woman’s experience of menopause is unique, complex and deeply personal. Fortunately, many women emerge from the experience with positive outcomes. The research and lived experience of mid-life women shows post-menopausal women report more positive attitudes towards menopause than those in pre- and peri-menopause. Moreover, those who receive education and support during the transition report greater well-being and quality of life than those who do not.

Understanding and acknowledging the losses of menopause and allowing yourself to grieve are importance steps in navigating this transition. Grief helps us to release painful emotions and let go of unhelpful patterns of thinking and behaving. This means we can embrace opportunities for new perspectives, new connections, and a new sense of purpose in the next chapter of our lives.

If feelings of grief and loss become overwhelming or interfere with your everyday life, seeking support is an important next step. Whether it’s seeking more information, connecting with trusted family and friends, or reaching out to your GP or other healthcare professional, support is available to help you navigate this transition.

Resources

The Headstrong Psychology team are passionate about supporting women during the menopause transition. Please get in touch to discuss our team and availability on 0431 998 351.

The All About Her Centre for Menopause offers a wide range of resources as well as a network of healthcare professionals who support women during the menopause transition.

Image credit: Photo by Maria Lupan on Unsplash