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5 Tips for Women in the Throes of Perimenopause

“The menopausal transition is actually a profound developmental stage in which unfinished business from the past comes up once again for resolution and healing, so that we can free ourselves from the outmoded beliefs and behaviors of our past. All the issues that weren’t resolved during puberty and early adulthood—such as body image, relationships, vocation, fear of aging, and self-esteem issues—now arise once more to be healed and completed.” – Christiane Northrup, MD 


We’ve heard of the tumultuous transition called adolescence, which for both boys and girls brings about rapid hormonal fluctuations leading to maturity to a full grown adult. Yet our society in general does not acknowledge with great attention the other end of a woman’s reproductive years, called perimenopause. This stage is basically the 10-15 years in a woman’s life before menopause occurs (menopause is the ceasing of menstrual periods). In essence, a woman could enter perimenopause any time between age 35-51, the latter being the average age of menopause. It is also possible for a woman to be both pregnant and technically in perimenopause at the same time. Wow, that’s a lot of hormones going on.

So, what happens when a woman experiences perimenopause and what can you do?:

  1. Many women can experience “mood instability”, hot sweats, fatigue, and irritability due to rapid hormonal fluctuations. Just as a woman experiences hormonal shifts during adolescence, so too she will undergo just as many hormonal ups and downs as she did as a teen (Northrup, 2010). Although perimenopause is nothing to fear, it’s important to be prepared for potential shifts and changes both biochemically and emotionally.
  2. Estrogen and progesterone fluctuations impact the levels of neurotransmitters that regulate mood health (like serotonin). If a woman has experienced a reproductive life event concurrently with depression and/or anxiety (i.e. menstruation, pregnancy, childbirth, breastfeeding/weaning, fertility treatments, traumatic birth, etc) she could be more prone to depression/anxiety during perimenopause (Bender, 1999). Dips in progesterone in particular seem to create more of a vulnerability towards depression/anxiety in some women (Pick, 2014).
  3. Just as the pillars of self-care are important in other times of a woman’s life, so too is it doubly important to practice the following: good sleep hygiene, good nutrition, exercise and managing stress (i.e meditation,  mindfulness based practices such as yoga and hiking).
  4. Being that this transitional period can bring up many emotions related to lifecycle transitions, it’s often the perfect time for women to revisit/establish with a psychotherapist. In midlife, a woman may be mourning the loss of opportunities lost (ending of fertility), a career change, body changes, aging parents, and launching children. At the same time, she may be excited to begin a new chapter of change with a career shift, more time for her personal pursuits and goals outside of active mothering, perhaps more time with her partner as her children become increasingly independent. It’s an opportunity to harness newfound creativity as the second stage of life ensues (Northrup, 2010).
  5. It’s always a good idea to connect with your healthcare practitioner to address hormone support, healthy lifestyle habits, and emotional well-being. Having a consultation with a medical professional will be helpful to ascertain if you might benefit from hormone support, antidepressant medication, and/or holistic interventions (Pick, 2014). Just as any time in your life is important to engage in self-care, so especially is this vulnerable time an opportunity to feel optimal in all facets of health.


Reading Materials on Perimenopause:

The Menopausal Years: The Wise Woman Way, by Susan Weed
The New Natural Alternatives to HRT, by Marilyn Glenville
Homeopathy for Menopause, by Beth MacEoin
What Your Doctor May Not Tell You About Menopause by Dr. John Lee and Virginia Hopkins
Dr. Susan Love’s Hormone Book by Susan Love
Women’s Bodies, Women’s Wisdom by Christiane Northrup, MD
The Wisdom of Menopause by Christiane Northrup, MD
The Power of Perimenopause  by Stephanie DeGraff Bender, M.A.
Self-Nurture by Alice Domar, PhD
The Silent Passage by Gail Sheehy

Is It Me or My Hormones?: The Good, The Bad, The Ugly About PMS, Perimenopause, and All the Crazy Things that Occur with Hormone Imbalance by Marcelle Pick.

For excellent resources/warmline support for women’s reproductive mental health (and pregnant/parenting families), check out Postpartum Support International at

5 Tips for Women in the Throes of Perimenopause

Andrea Schneider, MSW, LCSW

Andrea Schneider, MSW, LCSW is a licensed clinical social worker in private practice in the San Francisco Bay Area. She is currently the Lead Counselor at Cal State Maritime Academy, where she counsels college students and leads Counseling and Psychological Services (CAPS) at the integrated Student Health Center. In her private practice, Andrea provides psychotherapy for individuals experiencing trauma and loss. She is also a writer, educator, and podcaster. Website:

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APA Reference
Schneider, A. (2019). 5 Tips for Women in the Throes of Perimenopause. Psych Central. Retrieved on July 12, 2020, from


Last updated: 26 Feb 2019
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