Menopause. Just saying the word can make some women brace themselves for the whirlwind of hot flashes, night sweats, sleepless nights, mood swings, and that ever-present feeling of being “off balance.” For many, the perimenopause and menopause years are like riding an emotional rollercoaster, thrilling at times, but ultimately extremely exhausting.
The good news? You don’t have to just hang on and hope for the ride to end. Techniques drawn from Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT), and Mindfulness Meditation can provide a helpful toolkit for navigating the ups and downs, reducing stress, and even rediscovering a sense of calm and empowerment. They can be used as a non-hormonal treatment for managing menopause symptoms, or alongside hormone treatment.
Cognitive Behavioural Therapy (CBT): Taming the Mind’s Rollercoaster
CBT is all about helping you recognise the thoughts and behaviours that add to your stress and learning ways to change them. When menopause symptoms hit hard, it’s easy to spiral into “catastrophic thinking”: “I can’t cope with this hot flash” or “I’ll never sleep properly again.”
CBT helps you:
Reframe unhelpful thoughts into more realistic and helpful ones.
Develop coping strategies for insomnia, mood swings, and anxiety.
Feel more in control of your emotions and reactions.
You can think of CBT as your mental toolkit for problem-solving during the menopause ride, giving you practical ways to calm the storm when your mind wants to take the wheel.
““The greatest weapon against stress is our ability to choose one thought over another.””
Daily CBT Exercise: Thought Check-In
This exercise helps you notice unhelpful thoughts that can provoke anxiety, lower self-esteem, or drag down your mood. The aim is to reframe these thoughts, creating more calming, energising, or uplifting emotions.
When you begin to notice these thoughts, you may realise that certain patterns or recurring worries keep coming up. By practising this exercise regularly, you’ll gradually develop more helpful ways of thinking and train yourself to replace unhelpful thoughts with ones that support your wellbeing. Over time, this gives you a sense of control, reduces catastrophic thinking, and helps calm your mind.
How to do it:
Pause during the day when you feel stressed or overwhelmed, for example, during a hot flash, mood swing, or moment of worry.
Write down the thought running through your mind: e.g., “Oh no, I can’t cope with this.”
Ask yourself: “Is this thought 100% true? Could there be another, more balanced way to see this?”, “Everyone is looking at me” or “I am out of control
Reframe it with a supportive alternative: For example:
“Oh no I can’t cope with this” could be reframed as “Let’s see how well I can deal with this one, one flush at a time”
“Everyone is looking at me” could be written differently as ‘I will notice my flushes more than other people, they may not notice’
“I am out of control” could become ‘There are things I can do to take control’ ‘They will go on for ever’ ‘They will gradually reduce over time’
Acceptance and Commitment Therapy (ACT): Finding Peace with What You Can’t Control
ACT is an excellent “therapy friend” of CBT., as it gives a framework to work with the bits we can’t change, the parts of going through any stage of the menopause that we can’t really control a great deal.
Sometimes, the more we fight menopause symptoms, the worse they feel. ACT flips the script. It’s about accepting what’s beyond your control and focusing your energy onto what truly matters to you.
““You can’t stop the waves, but you can learn to surf.” ”
With ACT, you can:
Leant to acknowledge, notoce and accept hot flashes, fatigue, and mood swings without battling and struggling with them.
Stay engaged in life despite discomfort, anchored by your personal values.
Cultivate resilience, finding meaning and purpose even on difficult days.
In other words, ACT teaches you to ride the rollercoaster with open eyes and a sense of agency, knowing the ride is temporary but your life is ongoing.
Daily ACT Exercise: Values Pause
Here is an exercise that aims to help you stay grounded in what really matters, even when menopausal symptoms feel overwhelming. By focusing on your values, you can take purposeful action instead of being driven by discomfort or stress.
When symptoms show up, it’s easy to get caught up in frustration or worry. Practising this exercise daily encourages acceptance, resilience, and mindful engagement with life. It reminds you that while you may not control every symptom, you can choose how you respond.
How to do it:
Take a moment to reflect on your core values, the things that matter most to you (e.g., family connection, creativity, self-care, kindness, thoughtfulness).
Ask yourself: “What is one small action I can take today that aligns with these values, even if I’m not feeling 100%?”
Take that action — it could be a short walk, calling a friend, journaling, or practising a kind gesture for yourself or someone else.
Notice how connecting with your values shifts your focus from symptoms to meaningful, empowering action.
Mindfulness Meditation: A Breath of Calm Amidst the Storm
Mindfulness is another therapy that can be interweaved into your helpful toolbox of approaches for menopause, and used alongside CBT and ACT. Mindfulness is about creating space between you and your emotions, noticing sensations without judgment, and finding moments of calm in a hectic world. For menopause, this can be transformative.
““Mindfulness means paying attention in a particular way: on purpose, in the present moment, and non-judgmentally.” ”
Mindfulness can help you:
Ground yourself during hot flashes or emotional swings.
Step back from overwhelming thoughts and worries.
Feel gratitude for your body and the natural process of life.
Reconnect with yourself, fostering empowerment instead of frustration.
Even a few minutes a day of mindful breathing or a body scan can reduce stress, enhance emotional balance, and remind you that menopause is a normal stage of life — not an illness.
Daily Mindfulness Exercise: 3-Minute Body Scan
This exercise helps you ground yourself in the present moment, creating space from overwhelming thoughts or emotions. Mindfulness nurtures calm, awareness, and self-compassion during the often turbulent menopause years.
Even just a few minutes a day can help you step back from stress, create a feeling of having more room to really breathe and shift perspective and reconnect with your body, and foster a sense of calm and acceptance.
How to do it:
Sit comfortably and close your eyes. Some people like to rest their hands on their chest or tummy (or one hand on each) while doing this.
Take three slow, deep breaths, noticing how your chest and abdomen move.
Slowly scan your body from head to toe, paying attention to sensations without judgment. just notice. If tension, discomfort, or heat appear, simply observe it.
Finish with a deep breath and a gentle acknowledgement: “I am here. I am safe, I am okay.”
Bringing It All Together
Imagine combining CBT, ACT, and mindfulness like a three-part survival kit for menopause:
CBT gives you the practical tools to manage your thoughts and behaviours.
ACT teaches acceptance and resilience, keeping you aligned with your values.
Mindfulness creates calm, perspective, and appreciation for the present moment.
Together, they don’t just reduce stress — they help you feel grounded, empowered, and connected to your body during a time that can often feel overwhelming.
Menopause may be a rollercoaster, but with the right strategies, you can ride it with calm, clarity, and even a sense of wonder. Because while the symptoms can be challenging, this stage of life is also a reminder of the incredible, natural rhythms of the human body, and of your own resilience.
You are not alone. We can help.
At My Therapist Online (MTO), we have specially trained CBT, ACT, and Mindfulness therapists who understand the unique challenges of menopause. They can work with you to create a tailored approach, supporting you in navigating the trickier symptoms and emotional experiences that this stage of life can bring.
Whether it’s managing hot flashes, mood swings, anxiety, or simply finding a sense of balance and calm, our therapists are here to help you feel empowered, supported, and in control.
Get in touch today to explore how a personalised therapy plan can help you ride the menopause rollercoaster with more ease, clarity, and confidence.
