Vhi Clinical Psychologist, Dr Aoife Dáibhis, sat with us to discuss how women’s sense of self can change during menopause, what role HRT and other treatments can play, and how to regain a sense of identity through lifestyle measures. 

What is menopause and how does it affect women?

Menopause is a natural time of transition for women. You’re considered to be in menopause when you haven’t had a period for 12 months, and the average age for menopause is 51, dependent on factors like ethnicity and lifestyle factors.

What exactly is a sense of self?

A sense of self, also known as self-concept, is your perspective of who you are, what defines you, and how you see your value in the world. It includes your sense of purpose, values, beliefs, abilities, contributions to society, and moral code (a set of rules or ethics you live by to align with your culture of upbringing).

What causes women to feel like they’ve lost their identity during menopause? Is it a mix of the physical and emotional symptoms of menopause?

Dr Dáibhis says a loss of identity that may occur during menopause is very understandable because menopause doesn’t occur in isolation from all the other changes that happen to you during this life stage. Our identity is shaped by how we see ourselves as professionals, friends, daughters, mothers, and as women. Because of the life stage that menopause occurs at, it’s likely lots of changes are taking place in these roles - your position in work may be changing, your kids might be growing up, your parents are becoming more elderly - so we feel less confident and sure of these things that define us, and our identity feels shaken.

In addition to that, hormonal fluctuations that happen during menopause can have an impact on identity and sense of self. If you’re usually the calm, rational one in the home that helps everyone avoid an argument, but now you feel your mood swings make you snap at people instead, you’re going to struggle with not feeling like yourself. Or maybe you’re used to being the person in work who never gets flustered and juggles 10 things at once, but suddenly your menopause symptoms like brain fog and low mood make this more difficult. On top of this, you might find your body changing during menopause, which can impact your body image and self-esteem, which can be very unsettling for your sense of self.

How can women try to feel more ‘like themselves’ again during menopause? Is it effective to try old hobbies & interests, or is it better to create new hobbies?

It’s valuable to see that menopause is a good opportunity to actually take stock and re-evaluate things in your life. If you feel it’s a good time to change up your hobbies or try new ones, Dr Dáibhis recommends doing whatever feels best for you. We develop confidence when we try new things and succeed - so if menopause is causing you to feel less confident in yourself, trying something new could be impactful (even if it takes time to succeed at it!) Dr Dáibhis believes it’s equally valuable to spend time on hobbies or interests you’ve always had but didn’t have the time for over the last few years. Whatever brings you joy and is part of your personality or identity, do it.

How can women deal with feelings of losing their youth during menopause?

While it might seem difficult, try to change your perspective to see what you’re actually gaining from menopause, rather than it being a time of loss. You could think about the life experience you have, and the freedom you might have at this life stage due to financial stability or kids being grown up and moved out. Dr Dáibhis says it can be useful for some women to speak to a healthcare professional, in a safe and trusting space, to discuss their feelings and to identify tools that would help them reconcile with their beliefs and perceptions of ageing.  

Can there be a sense of freedom for some women in shedding ‘existing identities’?

This is most definitely true for lots of women, says Dr Dáibhis. During menopause there can be a real sense of feeling free from things like menstruation, taking contraception and parenting children. Take the time to think about what you value, what’s important to you, what areas do you actually want to step back from, and what areas do you want to step into. It’s a time for some women to explore different aspects of themselves and their hobbies - give yourself the permission to find out what makes you tick!

Can HRT help alleviate feelings of loss of identity?

HRT may help you to manage the symptoms of menopause that can make you feel less in control and therefore less like yourself―symptoms like mood fluctuations and disturbed sleep due to hot flushes. When these symptoms are treated, women may find it far easier to regain a sense of self and feel in control.

What other treatments can help?

If you have addressed your physical and emotional symptoms with medical treatment, and you’re still suffering from low mood that’s preventing you from socialising or enjoying yourself, Dr Dáibhis recommends speaking to a healthcare professional. They will advise on the best treatment for you that can provide some structure and support to manage your menopause symptoms―in tandem with the medical support for your physical symptoms. They can also give you guidance around lifestyle factors that impact your sense of self.

There are a number of emotion-regulation strategies and therapeutic techniques that can also be useful in addressing symptoms of low mood, anxiety or emotion dysregulation or imbalance. Well-known strategies and skills include mindfulness and meditation, which can be effective tools for some women who feel like they’re struggling with their sense of self. Mindfulness and meditation, for example, can help in two ways:

1. Building resilience and better mental health
2. Coping with mood fluctuations

These and similar strategies may be helpful in terms of making you feel more in control and less shaken by feelings of loss of identity. Dr Dáibhis highlights that there’s no one size fits all when it comes to ways of alleviating a loss of sense of self. Try out different methods and things that help you better manage things like fluctuating moods or anxiety, which will directly impact your mental health and indirectly impact your sense of identity.  

Is it possible to regain your pre-menopausal sense of self once menopause ends? Or is it more common for women to feel that that was their ‘old’ selves?

On the one hand, Dr Dáibhis believes that, yes, when the stresses and symptoms of menopause subside, a lot of women can feel like they’re “back to themselves”. But, at the same time, because menopause takes place on average over a four-year period, people would naturally change over that period of time, irrespective of menopause. The core of you will remain the same, but certain aspects can change. Dr Dáibhis highlights that there is no norm for how every woman feels post-menopause, so don’t worry whether your sense of identity has shifted somewhat or reverted to what it was pre-menopause. 

Whether your sense of self has changed, stayed the same, or provided you with more freedom and confidence than before, it’s completely normal during menopause. In fact, it’s normal during any time of change in life. The important thing is to take the time to adjust to it and take actions that will help you to feel more in control and content during menopause. Hopefully, the actions listed above will prove useful for you during your menopause journey.

This content is for information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment. Always seek advice from your GP or an appropriate medical professional if you have concerns about your health, or before commencing a new healthcare regime. If you believe that you are experiencing a medical emergency call 999 / 112 or seek emergency assistance immediately. 

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