Manifesto from a woman approaching menopause by Karen Abi-Karam, HART Holistic Support

The one thing you can be sure of about the menopause, just like puberty, is the inevitability of it. After all, if I am lucky enough to reach old age, I have to pass through this particular gate. And I wish to do it with a sense of anticipation rather apathy…or dread.

Like most of us, I have weathered a fair few storms in my life. I am stronger now that I have ever been before.

However, if I’m honest, I’ve not been fully aware through most of them. In the majority of cases, I have woken up to the impact of my changing circumstances at some point during the transition. Usually, during a period of intense pain (emotional or physical). In one case, the veil lifted only decades later.

For example, my passage across the threshold into puberty – some 36 years ago – began without any kind of map. Like a newly born fawn, I stumbled through the changes that came my way. With weak legs (sometimes quite literally, from the sheer intensity of my periods), I fell into my twenties with no real grace.

For the most part, I was unaware of the changes that were taking place. Sure, I lived them. But I didn’t understand them. Nor was I prepared for them. I had precious little more than the perfunctory information necessary to drift into adulthood. And I definitely didn’t recognise it for the significant milestone it was.

I wasn’t initiated. I just got older. But I was lucky. I came through, more or less, unscathed. However, knowing what I know now, I realise the whole experience could have been so much richer.

In the years since I’ve noticed the signs of menopause on the horizon, I have chosen to do things differently. I am saddened that I didn’t acknowledge my first bleed. And I am determined to be ready to honour my last.

Thankfully, taboos are being broken. It is becoming more acceptable to talk about menopause and we have just marked World Menopause Day. There are rumblings, like the distant thunder that comes before the refreshing rains. We are slowly losing our obsession with youth. We are beginning to remember that with age comes wisdom, even freedom.

We will all experience things differently so the specific support we need will be equally varied. My holistic training and practice have taught me that we need to attend to the following three things in equal measure. To make my menopause matter, these guide me as I begin the traverse across this unfamiliar landscape:


– How are you feeling about approaching your menopause?
– What support do you need?


– Where and how is your body seeking attention?
– What might help?


– What will being a menopausal woman mean to you?
– How can you honour it?

The answers to these questions will help you decipher the balance of support that will be most beneficial as you make your journey. If you’re not sure, I’ve created a free worksheet to help you find some clarity. Additionally, for those in the UK, I am hosting a one-day mini retreat to offer in person support.

For example, it may be your body that is calling out for more attention right now. In which case you might be looking for more detailed support with the physical changes you are experiencing. Programmes like The Change Plan offer a great resource for those wishing to get a handle on these.

Or it may be that, for now, you feel more drawn to better understand the deeper implications of moving from a woman who bleeds to one who doesn’t. The Red School offers a unique, even spiritual, perspective on connecting with your changing cycle.

Perhaps everyone might do well to consider some kind of celebration. Whether at the first signs of menopause or sometime after your final bleed. Make it a party by all means but be sure to infuse it with some kind of ceremonial observance too. The right celebrant can help you create something meaningful.

Above all else, I hope you are able to see your menopause as more than a collection of symptoms to be managed. Honour it as a coming of age and find your own way to grow older as gracefully (or disgracefully) as you please!


  • Karen Abi-Karam

    Milestone Mentor - working holistically with women who are having to face a major milestone in their lives and want support to rise above the label others are placing on them, so they can become who they were meant to be.

    Inspired to put some shape to the road-map of life’s milestones, I have developed the HART process. This holistic approach is infused through the bespoke 1-2-1 support, group programmes and luxury retreats that I offer. My clients range from pre-teen girls to menopausal women. From those on the threshold of motherhood to those for whom motherhood will never come. I know first-hand that we need outside support if we are to navigate such choppy waters, having traversed many of my own milestones and the labels that came with them. My story saw me seek this help from many different places but I craved somewhere or someone that could support me mind, body and spirit. That’s why I’m committed to consolidating these aspects to guide others to unlock their full potential – using my personal experiences and my 17-year professional background (as a holistic therapist, doula, group facilitator and independent celebrant). Although their situations are diverse, each client feels ready to use this transitional point in their life as an opportunity to learn something about themselves – on an emotional, intellectual, physical and spiritual level. We work together to break old patterns and evolve the way they respond to challenging situations. Just as I did on my own journey, they emerge feeling stronger, calmer and more connected with themselves and others. Ready to life their best life. If you are facing a transition of some kind and know you would value support with that, just email me here to set up a Milestone Meeting. This will be a 90-minute rich conversation, on a call or via video if that's easier than a physical meet. This time is my gift to you and will be dedicated to you sharing your story. Together we will identify where you are on a Milestone Map – and where you want to be. At the end of our time together we will know if I am the right person to help you get there and which HART offering feels the right fit for you. And if not, no problem. You will leave our conversation feeling relieved, re-energised and inspired to move steadily forward. I look forward to 'meeting' you.