Menopause counselling in the UK is one of the most underused and undervalued forms of support available to women going through perimenopause and menopause. While hot flushes and night sweats tend to dominate the conversation, the mental and emotional impact of this transition is often just as significant, and for many women it is the hardest part.
This guide explains why menopause affects mental health, what types of counselling and therapy are available in the UK, how to choose the right therapist, and how to access support through both NHS and private routes.
If you are ready to compare providers, you can search menopause counsellors and therapists in The Menopause Directory.
Why menopause affects mental health
The connection between hormonal change and mental health is direct and well-established. Oestrogen plays a role in mood, anxiety, sleep and cognitive function. As oestrogen levels decline and fluctuate during perimenopause, women can experience psychological symptoms that have a genuine biological basis, not simply a lifestyle or stress response.
Anxiety, irritability, low mood, emotional volatility, panic attacks, brain fog and memory changes can all occur during perimenopause and menopause. Sleep disruption compounds all of these effects, making symptoms feel more intense and harder to manage.
At the same time, menopause is often a period of significant life change. Children leaving home, ageing parents, career transitions, and shifts in relationships and identity can coincide with hormonal change. The psychological experience of menopause is therefore rarely just hormonal. It is personal, contextual, and deeply individual.
This is precisely why counselling and therapy can make such a difference. The right therapist does not just help you manage symptoms. They can help you make sense of what you are experiencing, process the emotional dimensions of this transition, and build the resilience and insight needed to navigate it well.
The mental health impact of menopause
The scale of the mental health impact of menopause in the UK is significant. Many women report anxiety, low mood, loss of confidence, irritability, sleep disturbance and cognitive changes during the perimenopause and menopause transition.
Workplace impact is also substantial. The Menopause Charity and other UK organisations have highlighted that some women reduce hours, avoid promotion, or leave work because menopause symptoms are not properly recognised or supported.
These experiences reflect a real public health issue that counselling and therapy are well-placed to address, both alongside medical treatment and, for some women, as a standalone intervention.
Types of menopause counselling and therapy available in the UK
There is no single type of menopause counselling. Different therapeutic approaches address different aspects of the experience, and the right type depends on your symptoms, your history, and what you want to get from therapy.
Cognitive behavioural therapy (CBT)
CBT is the most extensively researched psychological therapy for menopause and is included in NICE menopause guidance as a management option for vasomotor symptoms, sleep problems and depressive symptoms associated with menopause.
CBT works by helping you identify and challenge unhelpful thought patterns and behaviours. During menopause, this might include catastrophic thinking about symptoms, anxiety about ageing or identity changes, avoidance behaviours that reduce quality of life, and negative beliefs about yourself or your future.
A course of CBT for menopause typically involves six to twelve sessions, either individually or in a group format. CBT is available free on the NHS through Talking Therapies services in England, though waiting times vary. Private CBT typically costs between £70 and £120 per session.
Person-centred counselling
Person-centred counselling provides a confidential, non-judgemental space to explore your experience of menopause in your own terms. Rather than following a structured programme, person-centred counselling is led by what you bring to the session.
This approach can be valuable for women who want space to process the emotional complexity of menopause, including grief at the end of the reproductive years, shifts in identity and purpose, changes in relationships and sexuality, and feelings of loss or uncertainty about the future.
Sessions are typically weekly or fortnightly and can be short term, over six to twelve weeks, or longer term depending on what you are working through. Private person-centred counsellors typically charge between £50 and £100 per session.
Psychotherapy
Psychotherapy, including psychodynamic and integrative approaches, explores the deeper psychological dimensions of what you are experiencing during menopause. This can be relevant for women whose menopause symptoms connect with earlier experiences, trauma, attachment difficulties, or longstanding patterns in relationships and self-worth.
Menopause can bring buried emotions and unresolved difficulties to the surface. Psychotherapy provides the depth of space needed to explore these meaningfully, rather than simply managing symptoms at the surface level.
Private psychotherapy typically costs between £70 and £150 per session. Longer-term therapeutic work is often more cost-effective per session when seen with a therapist regularly over time.
Menopause-informed therapy
An important development in the UK is the growth of menopause-informed therapy: practitioners who have trained not only as therapists but also in the intersection of hormonal health and mental wellbeing.
These therapists understand the biological mechanisms of menopause, can distinguish between symptoms driven primarily by hormonal fluctuation and those with deeper psychological roots, and can adapt their therapeutic approach accordingly.
When searching for a menopause counsellor or therapist, look for practitioners who can demonstrate specific menopause training in addition to their core therapeutic qualifications. This can be particularly important if your symptoms include severe anxiety, cognitive changes, sleep disruption, or a sudden loss of confidence.
Couples and relationship therapy
Menopause affects relationships as well as individuals. Changes in libido, mood, communication, and identity during perimenopause can create significant strain in partnerships. Couples counselling provides a space for both partners to understand what is happening and to navigate the transition together.
Relationship therapy is available privately from counsellors and psychotherapists. Sessions typically cost between £60 and £120 per hour. Some therapists offer both individual menopause counselling and couples work, which can be useful if you want to address both dimensions with the same practitioner.
How to choose the right menopause therapist
Choosing a therapist is one of the most personal decisions you will make. The quality of the therapeutic relationship, the sense of feeling genuinely heard and understood, is one of the most important factors in whether therapy is effective. Credentials matter, but connection matters too.
Check professional registration
Reputable counsellors and psychotherapists in the UK should be registered with a recognised professional body. The main ones include the British Association for Counselling and Psychotherapy, the UK Council for Psychotherapy, and the British Psychological Society.
Psychologists using protected practitioner titles, such as Clinical Psychologist, should be registered with the Health and Care Professions Council.
Look for specific menopause experience or training
Ask any therapist you are considering whether they have specific experience working with women through perimenopause and menopause. Ask whether they have completed any specific menopause training in addition to their core qualification. A therapist who understands the hormonal dimension of what you are experiencing may be better placed to support you than one who has only general experience.
Consider the therapeutic approach
Think about what you are looking for from therapy. If you want structured, evidence-based techniques for managing anxiety, low mood and sleep problems, CBT may be the most appropriate starting point. If you want space to explore the emotional complexity of the transition in a more open-ended way, person-centred counselling or psychotherapy may be a better fit.
Many therapists work in an integrative way, drawing on multiple approaches, which can be valuable for the multi-layered experience of menopause.
Have an initial conversation before committing
Most reputable therapists offer a brief initial consultation, often free of charge, before you commit to working together. Use this time to get a sense of whether you feel comfortable with this person, whether they understand what you are looking for, and whether their approach feels right for you. It is absolutely fine to speak to two or three therapists before deciding.
Accessing menopause counselling on the NHS
NHS Talking Therapies for anxiety and depression are available free of charge in England and do not require a GP referral. You can self-refer directly through the NHS Talking Therapies service.
NHS Talking Therapies primarily deliver evidence-based therapies such as CBT and are well-suited to the management of menopause-related anxiety and low mood. Waiting times vary by area. Where waiting times are long, ask about online or telephone CBT options, which may be available more quickly.
For more complex psychological needs, your GP can refer you to a community mental health team or psychology service. If your mental health symptoms are significantly affecting your daily functioning, be clear with your GP about the severity of what you are experiencing.
Accessing private menopause counselling
Private menopause counsellors and therapists can be accessed directly without a GP referral. The main directories for finding qualified private therapists in the UK include the BACP therapist directory, the UKCP register, and Psychology Today UK.
When using a directory, filter for therapists who list menopause, women’s health, hormonal mental health, anxiety, life transitions or relationship difficulties as areas of work. Read profiles carefully and make use of any initial consultation offered.
Private menopause counselling typically costs between £50 and £150 per session depending on the type of therapy, the therapist’s experience, and whether sessions take place in person or online. Online therapy is widely available and can be effective for many therapeutic approaches.
Menopause counselling alongside HRT and medical treatment
Counselling and therapy are not alternatives to medical treatment for menopause. For many women, the most effective approach combines both.
HRT may address the hormonal root of many mental health symptoms during menopause, including anxiety, low mood, sleep disruption and cognitive changes where clinically appropriate. Counselling and therapy address the psychological dimensions: the thoughts, beliefs and emotional responses that shape how you experience and cope with symptoms, as well as the deeper personal and relational dimensions of the transition.
If you are already on HRT and still struggling with the mental health aspects of menopause, counselling may be a logical next step. If you are not on HRT, counselling can still offer meaningful support and can sit alongside conversations with your GP or menopause specialist.
Find a menopause counsellor or therapist near you
The Menopause Directory lists menopause-specialist counsellors, therapists, and psychological support services across the UK. Search by location to find practitioners near you, or filter for online services if you prefer to work with a therapist remotely.
Helpful places to start include:
- Menopause counselling services
- Menopause psychologists
- Perimenopause support in the UK
- NHS menopause support
- Online menopause clinics
Whether you are looking for CBT for menopause-related anxiety, person-centred counselling to process the emotional dimensions of this transition, or couples therapy to navigate the impact on your relationship, the directory connects you with practitioners who understand this stage of life.
Frequently asked questions
What is menopause counselling and how can it help?
Menopause counselling is talking therapy focused on the mental and emotional aspects of perimenopause and menopause. It can help with anxiety, low mood, depression, loss of confidence, identity changes, relationship difficulties, and the psychological complexity of navigating this major life transition.
What type of therapy is most effective for menopause mental health?
CBT is the most extensively researched approach and is included in NICE guidance as an option for menopause-related vasomotor symptoms, sleep problems and depressive symptoms. Person-centred counselling and psychotherapy can be valuable for women who want to explore the deeper emotional and identity dimensions of the transition. Many therapists work in an integrative way, combining approaches.
Can I get menopause counselling on the NHS?
Yes. NHS Talking Therapies services provide CBT and other evidence-based therapies free of charge in England. You can self-refer without a GP appointment by searching for your local NHS Talking Therapies service online. Your GP can also refer you to community psychology or mental health services for more complex needs.
How much does private menopause counselling cost in the UK?
Private counselling and therapy typically costs between £50 and £150 per session, depending on the type of therapy, the therapist’s qualifications and experience, and whether sessions are in person or online. CBT sessions are often at the higher end of this range. Many therapists offer an initial consultation at a lower cost or free of charge.
Should I try HRT or counselling for menopause-related mental health symptoms?
For many women, both can be helpful. HRT may address hormonal drivers of mental health symptoms where clinically appropriate. Counselling and therapy address the psychological, emotional and relational dimensions. If you are already on HRT and still struggling with anxiety, low mood or emotional difficulties, menopause counselling can be a valuable next step.
How do I find a therapist who specialises in menopause?
Look for therapists registered with BACP, UKCP, BPS or another recognised professional body who list menopause, women’s health, hormonal mental health or life transitions as areas of work. Ask whether they have specific menopause training or experience. The Menopause Directory lists menopause-specialist therapists and counsellors across the UK.
Do I need a GP referral to see a menopause counsellor privately?
No. Private counsellors and therapists can be accessed directly without a GP referral. You can search for practitioners through professional directories or through The Menopause Directory and book directly. NHS Talking Therapies also accept self-referrals in England.
Can menopause counselling help with physical symptoms as well as emotional ones?
Yes, particularly CBT. NICE includes CBT as an option for vasomotor symptoms, sleep problems and depressive symptoms associated with menopause. Addressing the psychological response to physical symptoms can reduce their overall impact and improve coping, sleep and quality of life.
Where to get support next
If symptoms are affecting your sleep, work, relationships or day-to-day wellbeing, it is sensible to speak with your GP, pharmacist or a qualified menopause clinician. The Menopause Directory can also help you compare menopause symptoms hub menopause-informed counselling Ask MenoAI.
This guide is general information only and is not a diagnosis or personalised medical advice. Seek urgent medical help if symptoms feel severe, sudden or worrying.
Useful UK references: NHS menopause information, NICE menopause guideline NG23 and British Menopause Society publications.
Author: The Menopause Directory
About this guide
This guide is published by The Menopause Directory editorial team to help UK readers understand menopause symptoms, support options and services. It is for general information only and should not replace advice from a GP, pharmacist or qualified menopause specialist.
Last reviewed by The Menopause Directory editorial team.