What Is a Menopause Coach, and What Do They Do That a GP Doesn’t?

You’ve done the reading. You’ve had the GP appointment, maybe two. Perhaps you’re on HRT and it’s helping, or you’ve decided against it, or you’re still weighing it up. The flushes are better, or they never were the problem.

And something is still wrong. You’re not sleeping the way you did. You snap and then hate yourself for snapping. You don’t quite recognise the woman running your life, and there’s nobody whose job it is to sit down with you and ask what all of this has actually been like.

That gap is where menopause coaching fits. So here is what it is, what it isn’t, and how to tell a good coach from a poor one.

A menopause coach is someone who helps you manage the emotional, practical and lifestyle side of menopause: sleep, stress, mood, identity, relationships and the conversations you need to have. Coaching sits alongside your GP, not instead of them. A coach does not diagnose, prescribe or manage HRT; those decisions belong with your doctor.

What a menopause coach does, and doesn’t

The title covers a wide range of people, so I’ll describe what the work should be, and you can hold anyone offering it to that.

What it is. Structured, regular time with someone who understands this transition, working on the parts a ten-minute appointment can’t reach: the emotional side (anxiety, rage, flatness, grief), the practical side (sleep, food, movement, boundaries, the meeting you’re dreading), and the bigger questions underneath (who am I now, what do I want the next thirty years to look like). Good coaching helps you understand where you are, gives you someone who has properly heard it, and leaves you with a plan.

What it isn’t. It is not medical care. A menopause coach shouldn’t tell you whether to take HRT, which type or what dose, shouldn’t interpret your blood results, and shouldn’t sell you a supplement protocol as a substitute for a doctor. If someone in this role talks you out of seeing your GP, walk away. And it isn’t therapy for everything: if you’re in crisis, or this transition has thrown open something from your past, you need a counsellor or psychotherapist, which is why I think a menopause coach should have counselling training as well.

Coaching, your GP and HRT: how the pieces fit

I’m a counsellor, not a doctor, and the division of labour matters, because the women who do best have both halves in place.

Your GP owns the medicine: diagnosis, HRT and its alternatives, anything that needs investigating, referral to a specialist if your case is complicated. The British Menopause Society keeps a register of menopause specialists, and those are doctors and nurses, not coaches. If you want a better GP conversation, I wrote a whole piece on HRT, your GP and the support in between.

Coaching owns the rest. NICE’s menopause guidance for GPs lists talking therapy, specifically cognitive behavioural therapy, as an option for the low mood, anxiety and sleep problems of menopause, alongside or instead of HRT. That is the medical establishment saying what I see every week: hormones are half the story, and the other half is how you’re living with them.

A woman I worked with last year came to me on HRT that was working, with a marriage that wasn’t. Her flushes had gone and her sleep had come back. What hadn’t come back was any sense of who she was to her husband now that she wasn’t the woman who ran everything, and no ten-minute appointment was going to reach that. That is the work coaching is for, and it was the work that changed her year.

What a session looks like

People imagine either a lecture or a pep talk. It’s neither.

The first session is mostly me listening. Where you are in the transition, using the stages from the pillar guide as a shared reference point. What’s happened medically so far. What’s keeping you awake, literally and otherwise. What you want to be different in three months. I’m not after a symptom list; I’m listening for the thing you haven’t said out loud yet.

From there we work on one or two things at a time, because trying to change everything at once usually means changing nothing. Sleep first, often, because nothing else improves until you’re sleeping. A script for the conversation with your manager, your partner or your mother. Food, since I’m a naturopath and a great deal of midlife exhaustion turns out to be blood sugar rather than hormones. And with many women, grief work: naming what’s ending, properly, so it stops coming out as rage.

Sessions are weekly or fortnightly, in person in Surrey or online anywhere, and I use hypnotherapy where it helps, particularly for sleep and anxiety. You leave each session with something practical to do before the next one.

Who menopause coaching is for

Not everyone needs it, and I’d rather say so than pretend otherwise. If your symptoms are settling and you feel like yourself, read the series, keep your GP in the loop and get on with your life.

Coaching earns its place when the medical side is handled, or handled as well as it’s going to be, and you still feel lost. When you’re two years in and everyone assumes you’re fine. When you’re asking whether menopause has changed who you are. When the empty nest, ageing parents and menopause have arrived in the same eighteen months. When you’re doing your job with half your old confidence and nobody has noticed except you.

It is also for the women who’ve been told, correctly, that everything is normal, and who need someone to take seriously the fact that nothing feels normal. Both of those things can be true at once, and coaching makes room for both.

How to choose one

Here’s the part nobody advertising the service wants you to know: menopause coach is not a regulated or protected title in the UK. Anyone can use it, after a weekend course or no course at all. That doesn’t make the good ones less valuable, but it does mean the questions you ask before choosing one matter more.

Ask what they were before they were a menopause coach. Nurse, counsellor, nutritionist, personal trainer, someone who had a hard menopause and wants to help. All can be worthwhile, but they are very different offers, and the training underneath the title is what you’re paying for.

Look for counselling accreditation. Membership of a body such as the BACP, UKCP or the National Counselling and Psychotherapy Society means a code of ethics, supervision and a complaints route, and several of those registers are accredited by the Professional Standards Authority. A coaching certificate alone gives you none of that.

Ask about grief training. So much of menopause is loss, and I have watched well-meaning coaches try to positive-think a woman out of mourning. Someone who understands how grief actually moves will not do that to you.

Check the boundaries with medical care. A good coach asks whether you’ve seen your GP and encourages it. A poor one positions themselves as the alternative. Any hint of “doctors don’t understand, but I do” is your cue to leave.

Notice how the first call feels. Most reputable practitioners offer a free introductory conversation. You should come away feeling heard, not sold to.

My own approach, plainly

I’m a psychotherapeutic counsellor, a hypnotherapist and a naturopath, and grief has been my specialism for years: I wrote the 12 Stages of Grief series and I run grief circles. Menopause coaching, for me, is those skills applied to one particular transition. I work in person in Surrey and online with women anywhere.

What I don’t do is medicine. I won’t tell you what to take, and I will ask whether your GP is in the picture. What I will do is work with the whole of it: the body, the sleep, the food, the anger, and the grief for the woman you used to be, which the people around you rarely notice.

Frequently asked questions

Is there such a thing as a menopause coach?

Yes, though the title means different things depending on who holds it. Some are nurses or former clinicians, some are counsellors, some are nutritionists or fitness professionals, and some have completed a short course and nothing else. The work itself is real: supporting the emotional, practical and lifestyle side of menopause alongside medical care. Because the title is unregulated in the UK, ask what someone trained in before they added “menopause coach” to it.

What qualifications do I need to be a menopause coach?

Legally, none. It is not a protected title in the UK, and training courses range from a weekend to a year with no single recognised standard. To do it well you need a substantial underlying qualification (counselling, coaching, nursing or nutrition) with a professional body, supervision and insurance, plus a clear understanding of where coaching stops and medicine begins. If you’re choosing a coach rather than becoming one, those are exactly the things to ask about.

How to reduce cortisol in menopause?

Cortisol is your main stress hormone, and it rises with poor sleep, worry and, many women find, the general upheaval of menopause. No supplement or “cortisol detox” has been shown to reset it, and home saliva kits are of limited use. What helps is unglamorous: consistent sleep, morning daylight, movement you’ll actually do, less caffeine and alcohol, and steadier blood sugar, which I cover in sugar dependency and your brain. If you have unexplained weight gain, high blood pressure or exhaustion that won’t shift, see your GP.

Helping women through the whole of this transition, the medical conversation, the practical rebuilding and the grief in between, is what I do. If you’ve read this far and recognised yourself, book a free discovery call here. This completes the series; start again from The Stages of Menopause: A UK Guide by Age.

This article is part of The Menopause Journey, an eight-part series.
Previous: part 7