The meaning of menopause in the consulting room and psychoanalytic thinking on a menopause life stage

Menopause is increasingly recognised as a significant psychological as well as biological transition, yet its meaning within psychodynamic psychotherapy remains underexplored. This study examines menopause as a midlife transition involving identity, loss, and changes in the body, drawing on psychoanalytic thinking and qualitative research. Using Reflexive Thematic Analysis, semi-structured interviews were conducted with four psychodynamic and psychoanalytic clinicians to explore their experiences of working with clients in relation to menopause. The analysis identified key themes including loss and mourning, the relationship between body and psyche, the loss of fertility, and the role of client and therapist defences. Particular attention is given to transference and countertransference as central mechanisms through which menopausal experience is communicated, understood, and worked with in the therapeutic relationship. Findings suggest that menopause may involve a process of identity reorganisation shaped by unconscious processes, embodied experience, and symbolic meaning. For some clients, menopause reactivates earlier developmental conflicts, while for therapists, countertransference responses may provide important clinical insight. The study highlights the importance of attending to menopause within psychodynamic practice and contributes to a developing understanding of women’s mental health in midlife. This research offers a psychodynamic framework for understanding menopause as a complex psychological and developmental transition, with implications for clinical practice, training, and future research.