How Coaches Can Specialize in Perimenopause and Menopause Care

More than a billion women around the world are living through perimenopause, menopause, or the years that follow, and that share keeps growing. By 2021, women aged 50 and over made up 26% of all women and girls globally, up from 22% a decade earlier. Menopause is one of the largest health transitions on the planet, and a long one. Many women spend years in it.

Support has not kept pace. The World Health Organization notes that menopause is rarely discussed in families, workplaces, or clinics, and that many health workers are not trained to recognize its symptoms, because menopause receives limited attention in professional training. The physical side is starting to get attention. The psychological side, the mood changes, anxiety, sleep loss, and brain fog, has fewer trained people behind it. That is a workforce gap, and coaches are well positioned to help close it.

Coaching is a strong fit for this kind of work. Across studies, coaching reliably improves wellbeing, coping, and a person's ability to set and reach goals. Health and wellness coaching in particular is an established, evidence-based behavioral intervention, built on client-set goals and accountability. Health and wellness coaches and life coaches already help people move through change. Menopause is exactly that kind of change, one that touches sleep, mood, relationships, work, and identity at the same time.

The Menopause Behavioral Health Certification (MBH-C) gives coaches the menopause-specific knowledge and skills to do this work well, within a clear scope and as part of a coordinated care team.

The power of menopause coaching

Different coach framing can effectively specialize in menopause behavioral health. Health and wellness coaching supports the everyday behaviors that shape how a client feels day to day: sleep, movement, nutrition, and stress. Mental health coaching supports emotional wellbeing and coping skills within scope, without diagnosing or treating. Peer coaching draws on shared experience, and for menopause that lived understanding can build trust quickly and ease the isolation many clients feel.

Each of these has a place in menopause support, and the certification speaks to all three. A great deal of durable change happens in this work, in the steady, practical follow-through between medical appointments.

What perimenopause and menopause coaches will be able to do

The MBH-C is built around skill building. By the end, coaches can recognize the common concerns of perimenopause and menopause, screen appropriately, apply evidence-informed techniques, and refer with confidence.

The fifteen modules span the full landscape rather than one symptom, including:

• A medical overview of perimenopause and menopause, so coaches understand the physiology behind what clients describe.

• Mood, anxiety, and depression in midlife, with screening and clear referral points.

• Sleep and insomnia, covered across two modules.

• Coaching for vasomotor symptoms, the hot flashes and night sweats that drive much of the distress.

• Low and no libido, and how desire changes during the transition.

• Pelvic floor health, and nutrition, supplements, and exercise.

• The coaching toolkit itself: CBT coaching and motivational interviewing for the conversations clients find hardest to start.

• Health equity and trauma-informed care.

Scope of practice and when to refer

Scope of practice runs through every module. A coach's role is to support behavioral change, provide education, screen, and refer. Coaches do not diagnose or treat medical or mental health conditions. This is a defined role, and it is where a great deal of lasting change happens.

Referral is a mark of good practice and a skill the program builds deliberately. As a general rule, a coach refers when a concern falls outside their scope, when symptoms point to something that needs diagnosis or medical management, when there is any risk to safety, or when a client is not progressing with the support a coach can offer. Each clinical module names its own red flags, and the sleep modules spell out specific contraindications and when to send a client to a sleep clinic or another provider.

A coach can keep working with a client after a referral. In a team-based model, the coach often continues supporting behavior change and day-to-day wellbeing while a clinician handles diagnosis or treatment, so the client has both kinds of support at the same time.

How the program works

The program has two parts. First, fifteen self-paced video modules completed on the learner's own schedule. Then a six-hour mentorship, delivered as three two-hour sessions built around case studies and peer discussion.

There is no final exam. Progress is confirmed through knowledge checks, which can be retaken until passed, and short reflections after each session. Most learners finish in three to six months, with up to a year to complete.

When reflections are approved, coaches receive a digital certificate, a shareable badge, and the right to use the MBH-C credential. FamilyWell is pursuing continuing education approval through the National Board for Health and Wellness Coaching, which is in progress.

Get started

There is a devastating gap for support of those in the menopause transition, and coaches are well placed to fill it. The MBH-C builds the skills, the menopause-specific knowledge, and the scope and referral judgment to do it well.

References

Alessi, C., Martin, J. L., Fiorentino, L., Fung, C. H., Dzierzewski, J. M., Rodriguez Tapia, J. C., Song, Y., Josephson, K., Jouldjian, S., & Mitchell, M. N. (2016). Cognitive behavioral therapy for insomnia in older veterans using nonclinician sleep coaches: Randomized controlled trial. Journal of the American Geriatrics Society, 64(9), 1830–1838. https://doi.org/10.1111/jgs.14304

Bhaskar, S., Hemavathy, D., & Prasad, S. (2016). Prevalence of chronic insomnia in adult patients and its correlation with medical comorbidities. Journal of Family Medicine and Primary Care, 5(4), 780–784. https://doi.org/10.4103/2249-4863.201153

Carmona, N. E., Millett, G. E., Green, S. M., & Carney, C. E. (2022). Cognitive-behavioral, behavioural and mindfulness-based therapies for insomnia in menopause. Behavioral Sleep Medicine, 21(4), 488–499. https://doi.org/10.1080/15402002.2022.2109640

Drake, C. L., Kalmbach, D. A., Arnedt, J. T., Cheng, P., Tonnu, C. V., Cuamatzi-Castelan, A., & Fellman-Couture, C. (2019). Treating chronic insomnia in postmenopausal women: A randomized clinical trial comparing cognitive-behavioral therapy for insomnia, sleep restriction therapy, and sleep hygiene education. Sleep, 42(2), zsy217. https://doi.org/10.1093/sleep/zsy217

McCurry, S. M., Guthrie, K. A., Morin, C. M., Woods, N. F., Landis, C. A., Ensrud, K. E., Larson, J. C., Joffe, H., Cohen, L. S., Hunt, J. R., Newton, K. M., Otte, J. L., Reed, S. D., Sternfeld, B., Tinker, L. F., & LaCroix, A. Z. (2016). Telephone-based cognitive behavioral therapy for insomnia in perimenopausal and postmenopausal women with vasomotor symptoms: A MsFLASH randomized clinical trial. JAMA Internal Medicine, 176(7), 913–920. https://doi.org/10.1001/jamainternmed.2016.1795

Theeboom, T., Beersma, B., & van Vianen, A. E. M. (2014). Does coaching work? A meta-analysis on the effects of coaching on individual level outcomes in an organizational context. The Journal of Positive Psychology, 9(1), 1–18. https://doi.org/10.1080/17439760.2013.837499

Wolever, R. Q., Simmons, L. A., Sforzo, G. A., Dill, D., Kaye, M., Bechard, E. M., Southard, M. E., Kennedy, M., Vosloo, J., & Yang, N. (2013). A systematic review of the literature on health and wellness coaching: Defining a key behavioral intervention in healthcare. Global Advances in Health and Medicine, 2(4), 38–57. https://doi.org/10.7453/gahmj.2013.042

World Health Organization. (2024, October 16). Menopause. https://www.who.int/news-room/fact-sheets/detail/menopause

Two small verification notes: I filled in the full MsFLASH author list for the McCurry entry from the trial record, so give it a quick check against the journal page. And the Carmona entry resolves to the 2023 version of record even though the in-text hyperlink reads 2022, so if you want strict consistency you could update the in-text year to 2023.