Diane’s journey to giving this talk to HACP members, was and is a deeply personal one.  She shared very crucial aspects of her journey, including serious and one could arguably say dangerous gaps in our medical system.

Diane had a full hysterectomy (i.e including ovaries), which immediately meant that her body went into (medically induced) menopause.  As she left to recover at home, there was a casual mention of, if you don’t feel okay, see your doctor.  As we learnt later in the talk, Diane’s levels of hormones, predominantly oestrogen crashed over the coming months, leaving her feeling unrecognisable to herself, full of unexplained anxiety and tempted to end her life.

Much of Diane’s information sharing is about the physiology of


  1. perimenopause – the period leading up to
  2. menopause (a very specific date 1 year and 1 day post last period] after that a woman is
  3. Post-menopausal


GPs across the UK do not having any training on menopause in their training to be a doctor.  From 2024 , this will change, thanks to the work done through her campaign #makemenopausematter

Check out menopausesupport.co.uk – for this campaign and a plethora of information.

The British Menopause Society (BMS) is a key player in educating GPs and other practitioners.  If you wish to know if a GP is informed, you can ask if they have been trained by BMS.

So why do we as therapists, supervisors and trainers, need to know about perimenopausal symptoms?


The BMS lists 32 symptoms of perimenopause, some of which will include psychological aspects like

  • Low mood
  • Erratic mood
  • Severe/moderate anxiety
  • Suicidal ideation/intention
  • Lack of libido
  • Lack of interest in usual activities
  • Insomnia

To the untrained practitioner this could be seen as standard issue of presentations we see very often.

The problem is these are often accompanied by a few or a host of physiological issues, to name a few include

  • Dry mouth
  • Poor hair and skin
  • genitourinary syndrome of menopause [a cluster of symptoms affecting the vulva, often very painful]
  • Heart palpitations
  • Insomnia
  • Lack of libido
  • Itchy skin
  • Weight gain


If a client is under 45, usually a GP will not even consider that it could be perimenopause causing the issues.   Family history of early menopause will increase the likelihood of early menopause.  So without the knowledge of what a cluster of symptoms looks like, clients will often been referred to various medical departments

  • Psychology
  • Urinary
  • Cardiology
  • Dermatology


The Good news

With the right information and access to well-trained GPs and health practitioners there is a host of things that can positively impact a person’s experience of menopause.


Lifestyle – as with most medical challenges, adapting positive changes to your lifestyle can impact in a positive way

  • Cutting out/reducing alcohol intake (can greatly affect hot flushes)
  • Cutting out/reducing caffeine (same reason)
  • Eating nutritious food
  • Getting a decent amount of exercise
  • Time in nature
  • Exposing oneself to good company
  • Saying no to challenging people or situations that don’t serve your mental wellbeing
  • Informing friends, family and colleagues and asking for support when needed



Despite the bad rap HRT has had, the research and statistics show that the increased risk of cancers is very minute compared the rate when someone doesn’t take HRT.

Taking HRT itself can be a complicated process to acquire the desired level of change needed for the individual.  Having a GP who is willing to help you trial different combinations is essential.

Alternative/complementary therapies

Many individual cannot take HRT or wish to avoid taking it.  There are a host of people who can help including medical herbalists and acupuncture.

Talking therapies

Accessing talking therapies can support the individual through the emotional rollercoaster that perimenopause can bring with it.

Another area for consideration highlighted by Diane is the Trans population.  Some will be taking hormone therapy to assist with transition.  Being aware of the needs of trans people will be key as more people transition.

There are many people supporting menopause awareness on Instagram, these include

@menopause_doctor (Dr Louise Newman)

@hormones.on.the.blink (menopause coach)




Diane’s talk was invaluable and there is some much more to learn from here.  We are very grateful for her time and sharing of her knowledge.

 Sinead Mitchell