Dr Sarah Davenport, Clinical Psychologist

When Drinking Shifts From Treat to Routine

For many women, alcohol can start to take on a more central role in midlife. There’s the laughter and release of sharing wine over dinner with friends. A way to blow off steam, celebrate the end of a hard week, loosen the reins of responsibility, and simply have fun. And then there’s the quiet glass at home after everyone’s gone to bed. The one that helps you switch off, feel calm, or momentarily escape the constant mental load.

Both can start as small comforts or well-earned rewards. But for some women, those moments can slowly shift from being a pleasure to a pattern - one that feels harder to step away from. If you’ve ever found yourself wondering whether alcohol is taking up more space in your life than you’d like, you’re not alone.

Rising Rates of Alcohol Use in Midlife Women

Across Australia, more women in their 40s, 50s, and 60s are drinking at risky levels than ever before. According to the Australian Drinking Guidelines, risky alcohol consumption can be defined by two key measures:

• Long-term risky drinking: whether or not a respondent consumed an average of more than two standard drinks per day in the last year.
• Risky-single occasion drinking: whether or not a respondent consumed five or more standard drinks on any occasion at least 12 times in the last year.

Research from the National Drug Strategy Household Survey (NDSHS) shows that the prevalence of long-term risky drinking in mid-life women rose from 8.8% in 2001 to 11.7% in 2019, and the rate of risky single occasion drinking (RSOD) increased from 13.5% to 21.2% over the same period. The proportion of women abstaining remained the same across the same time period (around 21%).

So what’s behind this trend?

Understanding the Factors Behind Midlife Women’s Drinking

Midlife is full of change - in our bodies, relationships, careers, and sense of identity. Many women are managing demanding jobs, supporting ageing parents, launching children into adulthood, and navigating menopause, often all at once.

For some, alcohol becomes a small comfort in the middle of all that change. Common reasons women report drinking more during this stage include:

Stress and Emotional Overload

Alcohol can feel like an easy way to take the edge off after a long day. Research shows that people who engage in risky drinking are more likely to experience anxiety and depression - both of which are rising among midlife women. Women are also more likely than men to use alcohol to manage stress and regulate difficult emotions.

Changing Social Norms

Drinking has become more normalised and socially acceptable among women. Increased financial and social freedoms due to increased participation in the workforce and evolving gender roles mean more opportunities for women to drink alcohol and less stigma attached to doing so.

Social Connection and Identity

Sharing drinks with friends can symbolise freedom and belonging - a chance to reconnect with who you are outside of duty and responsibility. Online “wine culture” messaging can make drinking feel like a natural part of self-care. It’s no surprise then that marketing often links alcohol to women’s desires for connection, pleasure and autonomy.

Work and Caregiving Pressures

Midlife women often juggle multiple roles and responsibilities. Alcohol can seem like a quick way to unwind, regain a sense of control, or claim a moment of freedom amid constant demands.

Isolation and Loneliness

Women living in rural or remote areas or those who are separated or single have a significantly greater likelihood of risky drinking. This may be because they have limited access to spaces and activities that provide opportunities to socialise, and many of those that do centre on alcohol. Drinking may also dampen feelings of loneliness or serve as a substitute for connection. 

Home-Based Drinking Habits

Undoubtedly, the COVID-19 pandemic blurred the boundaries between work and home life. Research shows that people working from home more than 15 hours per week were significantly more likely to consume alcohol. Online alcohol sales and home delivery has made alcohol more accessible than ever, facilitating longer and heavier drinking sessions.

Menopause and Alcohol

Many women say they use alcohol to manage the physical and emotional symptoms of perimenopause and menopause. Whether it’s difficulty relaxing, switching off their anxious thoughts, or getting to sleep, alcohol’s immediate sedative effect provides some short-term relief. Sadly, this is often replaced by worse vasomotor symptoms, mood, disrupted sleep, weight gain, and cognitive fog in the medium- to long-term.

Breaking the Cycle of Stress and Alcohol Use

These factors create a perfect storm where drinking feels both normal and deserved. Yet it can also deepen stress, anxiety, and fatigue, and erode your confidence and well-being. Many women find themselves in a frustrating cycle where alcohol promises relief but leaves them feeling worse.

If you’ve been feeling uneasy about your drinking, it can help to pause and gently check in with yourself. Try reflecting on questions like:

• When and why do I reach for a drink?
• How do I feel the next day — physically and emotionally?
• Have I noticed needing more to feel the same effect?
• What would it feel like to take a short break or reduce my intake?

There’s no need to label yourself or make sweeping decisions. Small, curious steps are often the best place to start. Some women find it helpful to track their drinking, plan alcohol-free days, or explore other ways to unwind, connect, and have fun.

Addressing Alcohol Use in Midlife

If you’re worried about your relationship with alcohol, it doesn’t mean you’ve failed or lost control. It means you’re human, and you’re paying attention. The truth is, alcohol use in midlife isn’t about weakness or willpower. It’s about stress, coping, culture, hormones, and the deep human need for relief, agency, and connection.

Reach out to explore your next steps. With the right support, you can uncover what’s driving your drinking, find healthier ways to manage stress, and create a more balanced, fulfilling midlife.

Visit Dr. Sarah Davenport’s Website
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Sound familiar?

Food cravings in peri/post-menopause are incredibly common – and not a sign of failure or a lack of willpower. Understanding and managing food cravings can lead to major improvements in energy, emotional wellbeing, and overall health.

Why Food Cravings Spike in Midlife

Between the ages of 40 and 60, we see significant shifts in women’s lives. There can be changes in occupational or marital status, increased risk of health problems, loss of loved ones, and/or balancing caring for children or grandchildren as well as elderly parents. All these experiences can cause stress and fatigue. At the same time, you are experiencing biological changes. The menopausal transition involves dramatic variations in ovarian hormones, namely estrogen and progesterone. Research shows that ovarian hormone fluctuations and levels during the menopausal transition may also influence your eating habits and lead you to eat more. But there is lots of individual variability.

Two women of the same age with the same ovarian hormone levels and the same menopausal symptoms, will not necessarily both have difficulty with overeating. Those that overeat may be more sensitive to the hormone changes. What makes people more sensitive to hormone changes is not yet well understood but it may be due to other psychological factors, like the person’s ability to manage stress generally, their thoughts around food and their body, and the level of body shame or weight stigma they feel.

The Cost of Ignoring Food Cravings

When you try to battle cravings with willpower alone, you may see a restrict-binge cycle where you vacillate between periods of undereating or restricting certain foods to then overeating or binging on sugary, salty or fatty convenience foods.  Overeating can lead to negative emotions, like guilt and shame, which can in turn lead you to seek comfort in food. While this might provide short-term relief, it can lead to a host of negative long-term consequences, including unwanted weight gain, irritability and fatigue. The restrict-binge cycle not only affects your physical health, but also your confidence, relationships and daily enjoyment.

The Benefits of Managing Food Cravings Effectively

A mindful eating approach that focuses less on restriction and more on nourishment has many benefits. It can lead to improved energy and mood, better hormonal balance and digestion, more confidence in your decision-making and body trust.  It can also help you avoid turning to food to manage your emotions. In fact, when you are calmer and more in control generally, you will tend to make healthier choices in all aspects of your life. Unfortunately, most weight-loss and fitness programs focus on what to eat but not why you eat. When you learn the triggers that lead you to grab that piece of chocolate or whatever your favourite comfort food is, you can start implementing strategies to eat more mindfully.

How to Start

Eating regularly and not skipping meals is important to sustain energy and maintain a stable mood. However, in those risky moments when you are stressed, tired or upset, you may be more inclined to reach for something sugary, salty or fatty. Try this instead: Pause and ask yourself “Am I hungry, or do I need comfort?” This simple act of tuning inwards can help you reassess if your body is craving more than food. Remember the goal here is not to deprive yourself but rather to enrich yourself.

Where Can I Get More Help

If you are a woman in peri/post-menopause (roughly aged 35+) and you’d like help managing your eating habits, then you might be interested in working with me. I run an online group program for women like you who want to go from feeling bad about themselves and not in control, to confidently able to manage life’s many stressors without turning to food for comfort. If you want to learn from an expert who is body positive and has a feminist spirit, then I invite you to book a free, 15-minute consultation with me to see if my program is a good fit for you.

About the Author

Dr Cristina Cavezza is a clinical psychologist with a private practice in Melbourne, Australia. She is a busy perimenopausal mother of twins and understands firsthand the challenges with maintaining healthy eating habits while juggling career, family and one’s own health needs. She has over 15 years’ experience and provides one-to-one therapy in-person or via telehealth. She also runs the online group program for peri/post-menopausal women who want help managing their emotions better so that they are less likely to turn to food for comfort. 

If you’ve ever ugly cried in the Woolies car park, sworn at the printer for jamming again, stared at the fridge like it holds the answers to life… and wondered who the fck you are now that you can’t spin the plates you used to spin, you’re in good company. You’re in perimenopause. And perimenopause isn’t just about hot flushes and night sweats, it’s a mental health, identity, and self-sovereignty revolution. Perimenopause is the transitional stage leading up to menopause where hormonal, neurological and psychological changes collide, often triggering brain fog, mood swings, anxiety, relationship shifts and a deep reassessment of what you can keep doing and what you’re finally done with.

And because this is written in full meno-solidarity with Em Rusciano and her Rage Against the Vagine community, I want to speak to you directly.

Dear Em and every glorious human in the Rage Against the Vagine posse,

Consider this a rally cry, a hug, and a knowing smirk all rolled into one. Because if you’re here, you already know perimenopause is not just a “stage of life”. It’s a psychological, emotional and identity-shaking rock show that does not give a flying fck about your to-do list.

I’m a psychologist who works with women riding this exact rollercoaster. And let me tell you… you’re not imagining the emotional whiplash. Perimenopause mental health is a 'thing' and support, in whatever shape or form, vital. Because the brain fog, the mood swings, the late-night overthinking, the sudden nope, I’m done moments… they’re as real as your vagina is dry.

And it’s not just my clients. In my own perimenopause years, I was caught completely off guard. Despite decades in women’s mental health, I didn’t connect the dots between the shifting moods, the bone-deep fatigue, the sleep disruption, and that jarring feeling that I didn’t quite recognise the woman looking back at me in the mirror.

And woman after woman was sitting in front of me, describing the same thing. We were all trying to keep functioning, all wondering what we were doing wrong, all unaware that this storm was perimenopause and not a personal failing (oh and for me and many, a little ol' late diagnosis of ADHD too).

We should at least be given a bloody pamphlet by the time we’re 35. Clearly that’s been too much to ask… even in 2025.

It’s Not Just Hormones… It’s a Whole Life Shake-Up

The old story says menopause is about hot flushes, vaginal dryness and a few grumpy moods. But here’s the truth… perimenopause isn’t just a biological event. It’s a developmental stage as big and identity-shifting as puberty and motherhood. And it’s designed to disrupt you.

Why? Because it’s not only your hormones changing, it’s your brain health, your priorities, your tolerance for crap, and your willingness to keep performing roles that no longer fit.

Think of it like this…

In puberty, you become someone new.

In perimenopause, you are invited (sometimes pushed) to return to your truest, unfiltered self. The self you were before a lifetime of patriarchal conditioning taught you the most soul-destroying definitions of what it means to be a “good girl” or “good woman”. This is the woman who knows her worth, who owns her voice, who wears her invisible crown without apology.

“There’s got to be a voice deep within you that is untouched by definitions. And it is there that you become divinely who You are.” Viola Davis

Oestrogen, sometimes called the hormone of accommodation and servitude (eww), starts to fluctuate and decline. That’s the hormone that’s been helping you tolerate, smooth over and juggle everyone else’s needs. When it goes AWOL, the rose-coloured glasses come off… and you see all the ways you’ve been settling or self-silencing.

And then? SNIP.

No more saying yes just to keep the peace.
No more putting yourself dead last.
No more martyr cape membership.

This is where the Queen in you starts to rise. She’s not here to please. She’s here to reign.

Your Brain is Rewiring for the Next Chapter

The hormonal rollercoaster of perimenopause doesn’t just make you feel tired and wired at the same time… it also triggers neuroplasticity. That’s your brain’s ability to rewire and reshape itself.

This “brain pruning” is like a ruthless spring clean.
Old neural connections you no longer need get cut away.
The ones that matter for this next phase of life get strengthened.

Yes, that pruning can feel like chaos. Hello brain fog, mood swings, overwhelm. But it’s also an opportunity to rewire in ways that align with your values now, not the ones you inherited 20, 30, 40… even 50 years ago.

Your brain is making space for the woman who leads herself, who knows what she stands for, and who is no longer afraid to claim her throne.

Reverse Puberty Is Real

Just like adolescence, this is a threshold moment. In puberty, the question is… “Who am I apart from my family?”

In perimenopause, it’s… “Who am I apart from my roles?”

Roles like wife, partner, mother, daughter, carer.
The dependable one. The over-giver. The peacekeeper. The one who holds it all together. The one who always gets shit done.

When those roles no longer fit, you might feel lost for a while. That’s not failure… that’s the work.

What Helps While You’re in the Thick of It

You don’t need to burn your life down overnight. In fact, that’s the fastest way to fry your nervous system. Start small. But start deliberately.

Claim breathing space in your day… moments with no output, no caretaking, no explaining. Even five minutes can shift your whole system.

Notice your “full body no”… the sigh, the tension, the dread. They’re early warning signs something’s no longer sustainable.

Speak out loud what you’ve been swallowing… even if it’s just to yourself or a trusted friend. Silence feeds the stuckness.

Let relationships evolve. Some will deepen. Others will loosen. Both can be healthy.

Find your anchors… practices, places, people that remind you who you are outside your roles.

None of these are quick fixes. They’re acts of reclamation.

You’re Not Broken… You’re Becoming

The physical symptoms of perimenopause are real and deserve support. But that “WTF is happening to me?” feeling isn’t a sign you’re losing yourself… it’s a sign you’re finding yourself again.

Perimenopause is the invitation (and sometimes the shove) to reassess what’s sustainable, throw out what isn’t, and speak up about what you need… more clearly and unapologetically than ever before.

It’s a recalibration. A remembering. A re-emergence.

If you don’t feel like yourself right now, you’re in good company. You’re stripping away what no longer fits so you can step into the next chapter with a clear mind, strong back, wild heart and wise soul.

That’s not just “not a bad thing”… that’s the point.

You’re not failing. You’re evolving. And in meno-solidarity, we can do it together.

We come to these turning points in life. Watershed moments that wake us up, shock us into action or send us stumbling, maybe even falling to our knees. Sounds dramatic doesn’t it? Well, the menopause transition can be, but with a little bit of knowledge, support and planning, it doesn’t have to be this way.

One of the tricky patterns I’ve seen in my work as a psychologist that causes additional stress as women enter perimenopause, is the drive to try really hard in life and as a result, put oneself last. She might be the super-mum, corporate executive, business owner, marathon runner, gym-junkie, volunteer extraordinaire or helper/healer who gives too much. She’s busy, driven, motivated and tired. Oh so tired.

Is it time to stop running?

What I’m talking about here is toxic striving. And although the term seemingly popped into my head from nowhere the other day, it turns out a very knowledgeable-sounding clinical psychologist named Paula Freedman-Diamond published a book in 2024 called Toxic Striving. 

Freedman defines toxic striving as; “…the relentless pursuit of perfection, societal ideals, and external validation at the expense of your physical, mental, and emotional health…” 

Ringing any bells? The way toxic striving shows up for many, is in our focus on keeping other people happy and maintaining levels of validation and approval that are ultimately unsustainable.

By the time we reach our mid-forties (when perimenopause often starts), we may have been people pleasing, over-giving, high achieving and down right striving our butts off for more than 25 years! That’s going to take a toll on wellbeing in all imaginable ways wouldn’t you say? It catches up with us due to the sheer level of self-sacrifice and self-denial involved. Persistent feelings of resentment and anger are clear signs toxic striving is an issue in your life.

Where did this begin?

It's an unfortunate truth that girls and women in our culture are conditioned to be likeable, kind, caring and yep, I’ll say it, demure. What it takes for us to meet these standards is to ignore our own emotions, basic physical needs, desires, intuition and sometimes our very intelligence. The tricky thing, is that humans are wired to respond to positive reinforcement and if you got the continual feedback that you’re a ‘good girl’ for being nice, kind etc., then that’s what you’ll keep on doing. It feels reassuring and safe to be liked. 

And then comes your twenties and thirties; romances, study, travel, careers, marriage, motherhood, friendships, health challenges, divorce, relocations, loss, grief…. If you reach 40 largely unscathed, then you’re either very lucky or lying to yourself. Many women hit their early forties and have a moment of reflection where change feels on the cards. And this is just the start of what’s to come.

They called it “the change of life” for a reason

As our forties wear on, many of us still have school-aged children and parents who are beginning to age and need extra support. Having had children later in life than our mothers did, and retirement being well into the future, we end up in the situation of being actively involved parents, income earners and elder caregivers all at once. It’s no wonder that when the hormonal changes initiated by perimenopause kick in, the wheels fall off.

This is where toxic striving needs to be addressed and stamped out because the time for being everyone’s ‘go to’ person has reached its expiry date. Your capacity to give, or at least over-give, is swept out from underneath you and believe it or not, this is a good thing.

But then, who am I?

The discomfort of feeling increasingly fed up, annoyed and put upon as we move into our late forties gives us a wonderful opportunity to take a good hard look at our own decision-making, priorities and desires. Are there parts of your life that aren’t working anymore? What needs to change and how are you being supported to make the changes that would make you feel better?

But before you decide you hate everything and escape to Greece for an extended sabbatical – although that would be nice – take an honest look at how you identify with being the ‘good girl’, people pleaser or martyr. Take responsibility for what you’ve created as habits in how you put yourself last and begin little by little, with putting yourself first.

This might look as small as making it to that yoga class once a week, delegating a housework job to someone else or gently pulling back on how much contact you have with a certain friend or relative who drains you. It also might look like booking a counselling session, carving out a solo weekend away or reducing your working hours.

It might take time and effort to make these changes and you might need some support to make them but believe me, it’s worth it.

Tricia Woods is a psychologist and intuitive counsellor who loves supporting women navigating the menopause transition. She’s available for online or in-person sessions and is based in Fremantle, Western Australia.

Session 3 of WANT: Why the Holds Us Back

In Session 3 of the WANT Program, we dug into one of the biggest blocks to knowing… and going after… what we truly want.

The good woman role.

Most of us never consciously agreed to it. Yet here we are, living by it for decades.

Gender Roles, Patriarchy and Women’s Identity

The rules? They’re rarely spoken out loud. They slip into our identity early. Taught through family, culture, workplaces, media. Reinforced every day.
Put others first. Keep the peace. Don’t need too much. Don’t be difficult. Definitely don’t be selfish or high maintenance.

On the surface, it sounds like kindness, reliability, capability.
Underneath, it’s something else entirely.
The slow erasure of self.

Self Silencing: The Hidden Cost of Being a “Good Woman”

And that’s where self silencing comes in.
We swallow words. We shelve what we want to do. We tuck away needs, opinions, desires. All to preserve connection, avoid conflict, or keep the peace.

It’s not a character flaw. It’s a survival strategy. One that patriarchy rewards in women — and one that can cost us our health, our relationships, and our sense of self.

The Impact on Women’s Mental Health

Over time, self silencing corrodes women’s mental health. It’s linked to depression, anxiety, burnout. Even inflammation, immune issues, and chronic stress. And it chips away at intimacy, because genuine connection needs mutual authenticity… which is impossible if we’re always centring others and never letting ourselves be fully seen.

Why the Persists

The good woman role persists because it works — for other people.
It keeps the wheels of families, workplaces, and communities turning. It also keeps women compliant, overextended, and disconnected from our own needs and wants.

Boundaries for Women: Redefining the Rules

Breaking free isn’t just about boundaries for women. Or saying no more often. It’s about questioning the gender roles we’ve inherited, the rules we’ve absorbed, and deciding whether they align with the woman you are now. The wise woman you are now.

Because you don’t stop being a good woman when you centre yourself.
You become a whole one.

Women’s Empowerment Through WANT

And that’s what women’s empowerment really looks like.

WANT is where we start unravelling those old rules. Where we notice the ways patriarchy has shaped our choices and identity. Where we take off the mask, explore what’s underneath, and practise the courage to live from that place.

If that sounds like the next step you’ve been craving, you can find out more here.

If that sounds like something you’ve been craving… you can find out more here WANT Program .

That deep, chronic tiredness.

Not just “I didn’t sleep well” tired. Not “work’s been a lot” tired. I’m talking about the kind of tired that lives in your bones. That no holiday, green smoothie, or mindfulness app can really touch. The kind of tired that makes you question who you even are underneath all the coping.

And look... it’s not all hormonal. Yes, perimenopause messes with our sleep, our focus, our tolerance for bullshit. But this exhaustion? It’s not just physical.

It’s emotional. Mental. Existential.

And it’s coming from the invisible load we’ve been carrying for decades.

The Stuff No One Sees (But You Feel Every Day)

We started naming it. Not just the obvious stuff like schedules, bills, and school notes... but the internal running commentary most women have going 24/7. The tracking. The anticipating. The emotional temperature checking of every bloody room we walk into.

The “Who’s okay? What needs to be done? What’s about to fall over that I’ll have to catch?”

It’s relentless. And the wild part? No one sees it. Because we’ve been trained to make it invisible. Seamless. Graceful. Bonus points if you smile while doing it.

We carry other people’s lives inside our heads. Their preferences. Their moods. Their bloody dental appointments. And most of the time, they have no idea.

And honestly? It’s exhausting.

This Isn’t Just Your Personality… It’s Programming

One of the things we talked about — and I mean really talked about — is how so many of the things we think are “just how we are” are actually adaptations. Survival strategies. Socially rewarded coping mechanisms that have been with us for so long they feel like personality traits.

Being the capable one. The helper. The rock. The one who doesn’t drop the ball.

But that version of you? She was built. Shaped. Rewarded. And maybe… she’s tired.

We explored how perimenopause starts to strip some of that away. Whether you want it to or not. Suddenly, the things you used to tolerate feel intolerable. The energy you used to muster just isn’t there. You can’t be all things to all people anymore... and if we’re being honest, you don’t want to be.

That right there? That’s the crack. The turning point. The chance to ask... what’s mine to carry, and what have I been dragging around just because I thought I had to?

What’s in Your Hermès Birkin handbag? (Don’t have one. Me neither)

We spent time looking at this metaphorical handbag so many women are carrying around.

What’s in it?

Old roles. Inherited expectations. Invisible responsibilities. Emotional labour. The “good girl” script. The “strong woman” mask. The “I’ve got it” energy, even when you don’t.

Some of the stuff in there was handed to you when you were a kid. Some of it you picked up along the way without even realising. And some of it... some of it used to serve you. It made sense once. But now? Now it’s weighing you down.

And here’s the permission slip — you’re allowed to take things out.

You don’t need to carry the whole damn lot to be a good person. Or a good mum. Or a good partner. Or a good anything.

You can let something drop and still be worthy.

Honestly, I don’t even care what it is — the after-school schedule, the relationship maintenance you’re always initiating, the need to always respond with grace and empathy. Drop it. Even just for today.

The Power of Tiny Rebellions

We finished the session talking about the small ways women start to reclaim themselves.

The micro acts of rebellion.

Not buying the milk. Not replying to the group text. Saying no without cushioning it. Leaving someone else’s mess right where they left it. Eating lunch alone and not talking to anyone. Ordering takeaway without apologising.

Tiny. But potent.

Because every time you stop performing the “good woman”, every time you honour what you need instead of what’s expected, you get a little closer to yourself.

And that’s the thing no one tells you — reclaiming your life doesn’t have to look like a total reinvention. It can start with not doing. With letting go. With sitting down when you’d usually get up. With saying, “I don’t want to anymore.”

That counts. That matters. That shifts things.

One Final Thought...

If you’ve been feeling that tiredness — the kind that no amount of rest seems to fix — you’re not lazy, broken, or weak.

You’re carrying too much. And you’re starting to wake up to that fact.

That’s what we did this week in WANT.

We named it. We unpacked some of it. We got honest about how much of it was never ours to begin with.

And we started, in our own quiet and fierce way, putting some of it down.

Not all of it. Not yet. But enough to feel a bit lighter. A bit clearer. A bit more like ourselves.

And that? That’s where the shift begins.

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.

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

Women in the menopause transition experience changes across all areas of their lives, from their physical, emotional, cognitive, and social well-being. Women may welcome these some of these changes, finding freedom from past expectations, roles, or responsibilities. Others may experience these changes as loss, resulting in grief.

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

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, and a re-evaluation of life goals and sense of life purpose.

Tangible and Intangible Loss

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.

While every woman’s experience of menopause is unique, complex and deeply personal, 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.

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When we talk about eating disorders, our minds often jump to adolescent girls, diet culture, and disordered relationships with food. But the reality is more complex and more widespread than many of us realise. One demographic still largely missing from the conversation? Midlife women.

Thanks to the trailblazing work of Professor Gemma Sharp and her team, we’re beginning to shed light on the critical intersection of eating disorders and the menopause transition. And what we’re finding is both illuminating and deeply concerning.

A Silent Reawakening in Midlife

It was a spike in referrals from midlife women, many of whom had previously experienced and recovered from eating disorders, that first caught Professor Sharp’s attention. Women were returning to therapy, surprised by a resurgence of old behaviours: binge eating, body dissatisfaction, preoccupation with weight, and restrictive eating patterns.

This wasn’t a coincidence.

Menopause, like puberty and the postpartum period, is a significant hormonal shift. But unlike puberty, its relationship to eating disorders has been under-researched and, more critically, under-recognised in clinical care.

Many women Professor Sharp encountered were unsure if they were even going through menopause. Despite seeking help for disordered eating, few had conversations with their doctors about what was happening hormonally. This gap in care speaks volumes.

Hormones, Sensitivity, and Risk

Emerging research suggests that some women are highly sensitive to changes in estrogen, a key hormone that fluctuates and ultimately declines during perimenopause. For these women, the physiological shift can trigger emotional distress, appetite dysregulation, and an increase in impulsive behaviours, including binge eating or rigid restriction.

In other words, the hormonal landscape of menopause doesn’t cause an eating disorder in itself but it can unearth latent vulnerabilities or exacerbate existing patterns.

Those with a history of high body awareness, or mood sensitivity may be particularly at risk. And while anorexia or bulimia are less commonly reactivated during this life stage, binge eating disorder and OSFED (Other Specified Feeding or Eating Disorders) appear to be far more common.

Why It’s Flying Under the Radar

Many women aren’t seeking help for these issues, not because they aren’t suffering, but because they don’t recognise what they’re experiencing as a ‘problem.’ Disordered eating has been so normalised in our culture, especially in midlife, where weight gain and body changes are often framed as inevitable, that it’s easy to dismiss symptoms as “just what happens” or “a willpower issue.”

And it doesn’t help that most screening tools for eating disorders were designed with young women in mind, usually focusing on restrictive behaviours and low weight. As Professor Sharp emphasised, clinicians need to ask different questions, ones that explore appetite changes, weight fluctuations, body image distress, compensatory behaviours like fasting or over-exercising, and how a woman feels in her body.

Working with Midlife Clients: What Clinicians Should Know

If you’re a psychologist or mental health professional working with women in their 40s, 50s or 60s, here are a few key considerations:

• Trust your instincts. If a client reports changes in their eating habits, weight, or body image, don’t assume it’s minor. Explore gently, with curiosity and compassion.
  
  
• Frame it around quality of life. Many women are more open to discussing how their behaviours affect their wellbeing than to immediately labelling their symptoms as an eating disorder.
  
  
• Use your therapeutic relationship. The connection you’ve built may be more powerful than any specialist referral, though seeking supervision or collaboration can be helpful.
  
  
• Refer for medical checks. Bloodwork, ECGs, and nutritional assessments are essential, particularly if there’s evidence of restriction or physical depletion. The NEDC provides excellent guidelines on what to request: https://nedc.com.au/assets/NEDC-Resources/NEDC-Resource-GPs.pdf?2025052004
  
  
• Consider MHT (Menopausal Hormone Therapy). While much more research is needed, there’s emerging anecdotal and clinical evidence that hormone therapy may support women experiencing eating issues in midlife, particularly those with mood or appetite dysregulation.
  
  

The Takeaway: Eating Disorders Aren’t Just for the Young

As Professor Sharp so powerfully shared, “All clients eat.” That means eating-related distress is always relevant, regardless of age, body size, or diagnostic label. Menopause is a profound psychological and physiological transition. For many women, it reactivates long-buried patterns around control, identity, body image, and self-worth.

By bringing awareness, empathy, and a willingness to ask the questions, we can help midlife women access the support they need, often for the first time in decades.

Oestrogen plays a pivotal role in the intricate dance of hormones that govern our bodies. Often associated with femininity and reproductive health, this powerful hormone profoundly influences behaviours, particularly in the context of accommodation and servitude, extending its impact far beyond the biological realm.

What is Oestrogen and What is Its Biological Role?

Oestrogen is a primary female sex hormone vital for developing and regulating the female reproductive system and secondary sexual characteristics. It controls the menstrual cycle, maintains bone density, supports heart health, and helps keep skin and hair healthy. Beyond these biological functions, oestrogen is known as the hormone of "mate, date, and procreate," encapsulating its evolutionary role in fostering behaviours that prioritise the needs of others through its influence on mood, cognitive function, and emotional resilience.

The Influence of Oestrogen During Earlier Years

During our younger decades, and especially if motherhood is part of our life journey, many women, driven by oestrogen, find themselves subconsciously prioritising others. With oestrogen driving the hormonal show, we are more inclined to take care of others first, including our children, which may lead to sacrificing personal time and interests. 

In its neuroprotective role, oestrogen helps mothers cope with sleep deprivation and stress, and juggling the multiple balls required of caregiving. However, as oestrogen levels decline, the drive to continuously serve and accommodate others diminishes. This shift can lead to a profound reevaluation of personal desires and roles.

Navigating the Discombobulation: Understanding the Parallel with Adolescence

As oestrogen levels decrease, women often experience a discombobulation similar to adolescence. This transition can be unsettling as the desire to accommodate and serve, deeply ingrained by oestrogen, fades away. 

Women may find themselves questioning long-held roles and expectations, leading to a significant psychological and emotional shift. This phase mirrors the adolescent quest for identity and independence, as women reassess their priorities and seek to redefine their roles and relationships.

Embracing New Desires

With the drop in oestrogen, women may discover that the life they once meticulously curated no longer satisfies them. This isn’t a reflection of a life wrongly lived but an indication that their needs and desires have evolved. 

Realising that they no longer find joy in the same things can be unsettling, but it also offers an opportunity to embrace change. During this phase we might struggle to give ourselves permission to seek new experiences, but it is crucial to acknowledge that "I have changed, I am very different now."

Redefining Autonomy and Generosity

This pivotal moment allows women to redefine what generosity means, moving from a life of servitude through obligation and conditioning, to one of authentic generosity (if the desire to be ‘of service’ exists at all!). 

As the societal expectations of "just being daycare for my grandkids" or preserving the entirety of children's inheritance become less compelling or appealing, women can choose to contribute on their terms, whilst they head off on new experiences or adventures, engaging in activities that genuinely fulfil them.

The decline of oestrogen offers an opportunity to liberate oneself from previously imposed roles, fostering self-discovery and personal growth. Understanding the role of oestrogen in shaping earlier behaviours and acknowledging the freedom its decline offers empowers women to live fuller, more balanced lives. 

At All About Her Centre, we support women through every stage of their hormonal journey, providing guidance and resources to help navigate these transitions with confidence and grace. By embracing the changes in our desires and the realities of our hormonal shifts, we can redefine what it means to give and live generously, on our own terms.

Want to know more about joining us, so you are better equipped to help your midlife clients through this sometimes tricky transition?

Learn more       Book a chat with Kirstin Bouse

At All About Here Centre for Menopause, here’s what we stand for (and how we’re saying NO to the MENO STATUS QUO)

💪  YES to the bio-psycho-socio-cultural approach and NO to the ‘one size fits all’ approach 

At All About Her, we support our midlife women clients and growing team of menopause-aware and educated health practitioners through a biopsychosociocultural model of support.

Instead of a more conventional “slap a HT patch on it and that’s all you’ll ever need” menopause model, we understand the importance of offering holistic support that takes into account an individual’s entire picture of biological, psychological, social and cultural influences on the menopause transition. HT can absolutely be part of a holistic approach, but it is seldom all that is required to give true support.

Midlife is often where life stressors like ageing parents, parenting teenangers, increased career stress or responsibility, relationship rupture, other health issues and lifestyle habits that haven’t been quite so supportive of your wellbeing, can collide with the already tricky landscape of menopause. We make sure to consider the whole picture, not just a teeny part! 

💪 YES to multidisciplinary, holistic support and NO to the one dimensional ‘cures’

Understanding that medical treatments for menopause like Hormone Therapy are not a “magic pill” is important. Whilst a proportion of menopausal individuals describe HT as life-changing, the vast majority report that HT has reduced their symptoms to a ‘more manageable level'. 

Yes - HT CAN be a miracle worker (for some). For others, it ‘helps a bit’. Others choose not to take it. Others can’t. EIther way, sometimes symptoms aren't fully resolved and there are other avenues that can also support ovary owners through this transition.

At All About Here, we don’t offer a one-size-fits-all “cure”. And we certainly don’t want people to feel there’s something wrong with them, if one approach (whatever that approach might be) doesn’t work at all, or only partially relieves troublesome symptoms. 

Instead, we support individuals through this significant time of transition with a holistic approach that honours what is most important to them/you AND recognises that perimenopause is not just a physical, but also a psychological and emotional Rite of Passage. 

💪 YES to ever-evolving care solutions and NO to ‘one and done’ 

Symptoms evolve and change during the menopause experience, meaning that folk who have or have had ovaries, have different needs as they navigate this transition. Menopause isn't a single event; it's a dynamic process that requires ongoing, adaptive care.

Rather than a “one and done” set and forget approach to care, At All About Her, we understand that women bring their histories, current circumstances, and unique health patterns to the menopause transition. This means that what works for one woman may not work for another, and even for the same woman, her needs may change over time.

We prioritise evolving care solutions, which means we regularly reassess, provide personalised treatment plans, offer a multidisciplinary holistic approach and collaborative care across disciplines. 

💪 YES to whole-human, collaborative care and NO to misinformed care, ‘incomplete’ care or lack of care

Far too many women are met with cold, uneducated or unsupportive opinions - and even misinformation and diagnosis when seeking support for life-impacting menopause symptoms. Worse still, there’s still practitioners out there only giving part of the picture, thinking the ‘power to know what’s best’ lies in their hands, and not the individual seeking care.

At All About Her, we believe menopause education is vital for health professionals. Understanding the complexities of menopause allows us to provide better collaborative and fully informed care and support for women during this significant life transition.

Our growing team of health professionals are often people who, like our founder Kirstin Bouse, became fired up when their own struggles to find adequate support in their own menopause transition highlighted the glaring gaps in our current conventional approach. Our practitioners are inspired and committed to providing real, holistic, up-to-date (and never misinformed!) advice. 

We believe women in midlife [including YOUR clients and patients] deserve to be SEEN, HEARD, ACKNOWLEDGED and offered real, evidence-backed, holistic treatment and support options. Ones that don’t leave them even more stressed than when they walked into your office!

Download your FREE copy of A Paradigm-Shifting Approach to Perimenopause & Beyond Guide

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And learn how to become a Heart-Driven, Meno-Aware Health Professional, because your midlife clients DESERVE to be seen, heard and truly supported and you DESERVE the evidence-backed education and experienced community support to provide this support with confidence!