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Why our confidence plunges in the menopause and how to get it back!

Updated: Aug 15, 2023

Women entering the menopause often notice a loss of self-confidence.

Laying in field of wheat

Written By Kate Organ


Almost all my patients to some degree experience a distressing reduction in their self-assurance, the way they view their value to others and contribution to society. It is heart-breaking to hear so many strong, intelligent, talented and capable ladies talk so negatively about the effects of diminishing confidence. There are shocking statistics of increases in divorce rates, career slumps and even suicide for women of average menopausal age.

As a healthcare professional working within hospital mental health services for several decades it is so heartening to see these issues being recognised and being involved in attempting to address them.

Psychological and cognitive symptoms of the menopause It is quite common for women to experience psychological symptoms of the menopause such as anxiety, low mood, reduced energy, motivation, and severe fatigue. This coupled with the cognitive symptoms often described as brain fog; poor concentration, memory issues and inability to learn new skills, it is not surprising that we feel low in self-worth.

Don’t make any life changing plans before you get treatment! My biggest piece of advice to avoid making any life changing plans before you have tried evidence-based treatments and lifestyle support. For many women, starting HRT can be transformational to both their physical and mental health. It is so important to have clarity of mind when making consequential decisions.

What can we do to address confidence? When women come to me who have significant psychological symptoms impacting on their quality of life, I use a combination of pharmacological and lifestyle medicine options to really improve symptoms. I focus on addressing the following issues.

  • Balancing and replacing hormones using body-identical HRT often including testosterone, to improve both psychological and cognitive symptoms

  • Using non-hormonal alternatives for symptom relief if HRT is not recommended or patient preference

  • Addressing sleep; however this often this improves naturally as night sweats and nocturnal urinary frequency improve with HRT treatment

  • We look at the huge role that exercise has on our feel-good hormonal feedback mechanisms within the brain and make sustainable lifestyle adjustments to improve energy, mental agility and happiness

And we also

  • look at minimising harmful substances that can act as cognitive and mood depressants including alcohol, sugar and processed foods

It’s important to know that symptoms of mild anxiety and low mood are often alleviated with effective treatment. Don’t let your healthcare professional try those antidepressants just yet! As our symptoms resolve we feel back in control of our health and women often feel they have the energy and clarity to tackle those big decisions confidently. Believe in yourself, you have so much to offer. Get the right help.

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