Women’s Health

Being a woman means living through changes in your body that can affect far more than your body. Yet we are often remarkably unprepared for how those changes might make us feel.

Periods. Fertility. Pregnancy. Motherhood. Miscarriage. Menopause. We tend to talk about these things medically, as though they happen to the body while the rest of us carries on untouched. But our physical and emotional lives are not that easily separated. Changes in hormones, fertility, pregnancy or our bodies can affect how we feel about ourselves, our relationships, sex, work, confidence and even who we think we are. Sometimes there is a clear beginning. An IVF cycle, a difficult birth, a miscarriage or the arrival of menopause. At other times, you simply notice that you don't feel quite like yourself anymore. And because so many of these experiences are described as a normal part of being a woman, there can be an expectation that we should simply get on with them.

When your body starts to feel unfamiliar

There are times in a woman’s life when the relationship she has with her body can change in ways she wasn’t expecting. Periods can bring pain, anxiety or shifts in mood. Pregnancy and birth can alter how a woman feels physically, emotionally and sexually, sometimes leaving her feeling lost. Then perimenopause and menopause can bring another period of change, affecting sleep, mood, concentration, confidence and desire, often at a time when life is already particularly full. What happens to our bodies can change how we feel about ourselves too. These experiences can touch everything from confidence and relationships to sex, work and our sense of who we are.

You can be grateful for what your body has done and still dislike how it has changed. You can believe passionately that women shouldn't be judged by their appearance and still feel distressed by your own. You can know intellectually that ageing is normal while privately finding the experience of it surprisingly difficult. These contradictions don't make you vain or ungrateful. They make you human.

When getting pregnant becomes the thing everything revolves around

Few experiences demonstrate the gap between what we imagine and what actually happens quite like trying to have a baby. For some women, pregnancy happens easily. For others, something that once seemed like a simple future decision becomes months or years of appointments, tests, waiting, disappointment and fertility treatment.

IVF can create its own strange rhythm of hope and fear. You may become intensely aware of dates, numbers and physical sensations. Friends announcing pregnancies can leave you simultaneously happy for them and devastated for yourself. Sex can stop feeling spontaneous and become attached to timing, treatment and outcome. There can also be grief that isn't always recognised as grief. The loss of a pregnancy. The loss of an embryo. The loss of another unsuccessful cycle. Sometimes it is the gradual loss of the future you had always assumed would happen.

Therapy cannot change the outcome of fertility treatment, but it can give you somewhere to put all of the feelings surrounding it without having to protect anybody else from them.

Motherhood can be wonderful and still be difficult

There is an enormous amount of pressure surrounding how women are supposed to feel about becoming mothers. You are meant to be exhausted but grateful. Overwhelmed but happy. Changed completely by motherhood while somehow remaining recognisably yourself. Real life is usually much messier.

Pregnancy and the period after birth can bring anxiety, low mood, intrusive thoughts, changes in identity and complicated feelings about your body or your relationship. A difficult pregnancy or birth can also leave women trying to make sense of an experience that felt frightening, painful or out of their control. And even when everything has gone relatively ‘smoothly’, becoming responsible for another human being can change the way you see yourself. You can adore your baby and miss your old life. You can feel enormously lucky and incredibly lonely. You can want to be a mother and still wonder where the woman you were before motherhood has gone.

More than one thing can be true at once.

Then there is menopause

For many women, perimenopause and menopause arrive at an already complicated point in life.

Children may need you differently or be beginning to leave home. Parents may be ageing. Relationships may be changing. Careers may be demanding more or perhaps suddenly matter less than they once did. Then your body starts changing too. Some women experience anxiety, irritability, low mood, disrupted sleep, problems with concentration or a loss of confidence that feels completely unlike them. Sex and desire may change. Your relationship with your body may shift. You may find yourself questioning decisions, relationships or the shape of the life you've built.

Not every difficult feeling during this period is caused by hormones, just as not every emotional response should be treated purely as a psychological problem. Appropriate medical support matters. But therapy can provide somewhere to explore the emotional and psychological experience alongside whatever physical care you need. Sometimes the question isn't simply what is happening to my body? It is who am I becoming now?

Women's bodies carry a lot of expectation

From a remarkably young age, women receive messages about what their bodies should look like, what they should do and when they should do it. We should develop at the right time, be attractive but not too concerned with being attractive, have children but not too early, or too late, recover from pregnancy, age gracefully and somehow maintain a comfortable relationship with a body that changes throughout all of it. It isn't surprising that body image can become complicated.

For some women, difficulties around eating, appearance, sex or self worth have been present for years. For others, they emerge around a particular life stage. Fertility treatment can make the body feel clinical. Pregnancy can make it feel public. Illness can make it feel unreliable. Menopause and ageing can bring an unexpected sense of invisibility or loss.

Therapy gives us somewhere to explore what our bodies have come to mean to us, rather than simply telling ourselves we ought to feel differently about them.

How can therapy help?

Women's health isn't one psychological issue and there isn't one kind of therapy that every woman needs. Sometimes the work is about anxiety or low mood. Sometimes it is grief, trauma, relationships, identity, body image or the emotional impact of fertility treatment, pregnancy, motherhood or menopause. Often several of these things are happening at once.

Therapy offers a place where you don't have to minimise an experience because it is common or feel guilty because somebody else has it worse. We can look at what is happening now, the experiences that may have shaped how you respond and what you need at this particular point in your life. There are also times when psychological support should sit alongside medical care rather than replace it. Changes in mood, sleep, menstrual health, pregnancy or menopause can have physical as well as emotional causes, and it is important that these are properly assessed where appropriate.

The aim isn't to teach you how to cope quietly with everything being a woman can ask of you. It is to give you somewhere to understand what is happening to you, what you need and how you want to move through the next part of your life with a little more space for yourself.