Perimenopause: Why No One Talks About It and How to Reclaim Your Power
Perimenopause is one of the most misunderstood phases in a woman’s life, often leaving women feeling invisible, unprepared, and disconnected from themselves. Learn about the symptoms, the neuroscience behind the transition, why it's taboo, and how to reclaim your confidence and vitality in this powerful new stage of life.
What Is Perimenopause?
Perimenopause marks the transitional period before menopause when a woman’s body begins to shift hormonally, emotionally, and physiologically. It can last anywhere from four to ten years and is characterized by fluctuating estrogen and progesterone levels, leading to a cascade of physical and mental health changes.
Many women feel blindsided by perimenopause. It isn’t a sudden switch but rather a slow, unpredictable process that begins in the late 30s or early 40s, sometimes even earlier. Despite affecting half of the population, perimenopause remains largely undiscussed, leaving women unprepared, isolated, and confused about the changes happening in their bodies.
Signs and Symptoms of Perimenopause
The symptoms of perimenopause can be frustrating, disruptive, and even distressing. Understanding them is the first step to managing this transition with confidence:
— Irregular periods – Cycles become unpredictable, shorter or longer, and periods may be heavier or lighter.
— Hot flashes & night sweats – Sudden waves of heat followed by chills disrupt sleep and daily activities.
— Mood swings & irritability – Fluctuating hormones affect neurotransmitters like serotonin, leading to anxiety, depression, or emotional outbursts.
— Sleep disturbances & fatigue – Hormonal shifts disrupt circadian rhythms, making it difficult to get restful sleep.
— Brain fog & memory issues – Forgetfulness, difficulty concentrating, and a sense of "losing your edge" are common complaints.
— Weight gain & metabolic changes – Slower metabolism and changes in fat distribution often lead to weight gain, particularly around the midsection.
— Vaginal dryness & low libido – Estrogen decline can cause discomfort during sex and a decrease in sexual desire.
— Joint pain & muscle aches – Decreased estrogen levels impact inflammation and connective tissue, leading to stiffness and pain.
These symptoms stem from the brain’s response to declining estrogen. Estrogen plays a crucial role in regulating neurotransmitters like dopamine and serotonin, which control mood, energy levels, and cognitive function. This is why perimenopause can feel like an emotional and physical rollercoaster.
Why Isn’t Perimenopause Talked About? Why Is It So Taboo?
Despite its profound impact, perimenopause remains a whispered topic. Why?
1. Cultural Ageism
Western culture glorifies youth and equates femininity with fertility. As women transition out of their reproductive years, they often feel unseen, undervalued, or dismissed. In contrast, other cultures honor older women as wise matriarchs—an empowering perspective we need to reclaim.
2. Medical Dismissal and Lack of Education
Many doctors fail to recognize perimenopausal symptoms and may misdiagnose women with depression or anxiety, prescribing antidepressants rather than addressing hormonal imbalances. Because menopause education is not a significant part of most medical training, many women are left to navigate this phase alone.
3. Internalized Shame
Women are conditioned to believe that aging diminishes their worth. Conversations about perimenopause are often avoided due to fear of being perceived as "past their prime." This silence perpetuates the cycle of confusion and isolation.
4. Generational Silence
Because previous generations also suffered in silence, there is little intergenerational wisdom about perimenopause. Women often don’t realize they are perimenopausal until they are deep in the throes of symptoms.
The Emotional Toll: Feeling Invisible in a Youth-Obsessed World
One of the most painful aspects of perimenopause is the sense of invisibility. Women who once felt confident and attractive may feel dismissed or unseen, both in professional spaces and personal relationships. The shift can lead to questions like:
— Who am I if I’m no longer young, fertile, or the center of attention?
— How do I maintain my confidence and sexuality through this transition?
— Why do I feel so disconnected from myself and my partner?
These are valid concerns, but they are also deeply rooted in societal messaging rather than biological reality. The truth is that midlife is an opportunity for reinvention, self-rediscovery, and deeper confidence than ever before.
How to Navigate Perimenopause with Strength and Grace
While perimenopause is a natural transition, it doesn’t mean women have to suffer through it. Here’s how to reclaim your vitality and step into this stage with confidence:
1. Support Hormonal Balance Naturally
— Eat for hormonal health – Prioritize whole foods, lean protein, healthy fats, and fiber. Foods rich in phytoestrogens (flaxseeds, soy, legumes) can support estrogen levels.
— Exercise regularly – Strength training and cardiovascular exercise help maintain muscle mass, boost metabolism, and regulate mood.
— Reduce stress – Chronic stress exacerbates hormonal imbalances. Somatic therapy, breathwork, and mindfulness practices help regulate cortisol levels.
2. Prioritize Sleep
— Establish a bedtime routine and reduce screen time before bed.
— Consider magnesium, melatonin, or adaptogenic herbs to improve sleep quality.
— Address night sweats with moisture-wicking sheets or a cooling pillow.
3. Explore Hormone Replacement Therapy (HRT)
HRT can be a game-changer for many women. While it’s not for everyone, it can significantly improve mood, sleep, and overall quality of life. Discuss with a healthcare provider whether it’s a good fit for you.
4. Reignite Sexuality and Intimacy
— Use vaginal moisturizers or low-dose estrogen creams for dryness.
— Explore new ways to connect with your partner, including mindfulness-based intimacy practices.
—Address body image concerns with self-compassion and body-positive movement practices.
5. Seek Professional Support
Embodied Wellness and Recovery specializes in somatic therapy, relationship coaching, and holistic mental health care for women navigating perimenopause. Our approach integrates neuroscience, trauma-informed care, and evidence-based therapies to help women feel empowered rather than diminished by this transition.
How Somatic Therapy Supports Women in Perimenopause & Menopause
Somatic therapy and Somatic Experiencing (SE) help regulate the nervous system, reduce stress and anxiety, and improve sleep, mood, and libido—key concerns during perimenopause and menopause. By addressing hormonal changes, emotional shifts, and body discomfort, somatic therapy offers a holistic, natural approach to easing symptoms.
1. Reducing Anxiety, Irritability & Mood Swings
Estrogen and progesterone fluctuations can cause stress, mood swings, and irritability. Many women feel overwhelmed or emotionally reactive as their nervous system struggles to adapt.
How Somatic Therapy Helps:
— Breathwork & grounding techniques calm stress responses.
— Vagal toning exercises (humming, gentle movement) reduce fight-or-flight activation.
—Body awareness practices ease emotional dysregulation.
2. Improving Sleep & Reducing Night Sweats
Insomnia, night sweats, and cortisol spikes are common in menopause, leading to fatigue and brain fog.
— Progressive relaxation & body scanning improve sleep quality.
— Breathwork techniques lower cortisol and body temperature.
— Somatic tracking helps women tune into sleep cues.
3. Managing Hot Flashes & Temperature Sensitivity
Hot flashes trigger stress and discomfort, making women feel out of control.
— Breathing & cooling techniques lessen hot flash intensity.
— Self-soothing touch & sensory regulation improve resilience.
4. Healing Emotional & Identity Shifts
Menopause brings grief, self-worth challenges, and identity shifts, impacting mental health and confidence.
How Somatic Therapy Helps:
— Body-based self-compassion exercises reframe aging positively.
— Releasing stored trauma eases emotional stress.
—Mindful movement & sensory attunement boost body confidence.
5. Boosting Libido & Sexual Wellness
Hormonal changes, vaginal dryness, and stress can lower libido and sexual satisfaction.
Somatic Practices for Sexual Health:
— Sensory awareness & pelvic release exercises improve comfort.
— Mindfulness-based touch & breathwork reconnects women with pleasure.
Somatic Therapy: A Natural, Holistic Solution
Somatic therapy helps women move through perimenopause and menopause naturally, reducing stress, sleep problems, mood swings, and low libido while promoting body confidence and emotional resilience.
Perimenopause as a Gateway to Power and Confidence
Perimenopause is not an end—it’s an evolution. With knowledge, support, and the right strategies, this stage can be the most powerful and fulfilling chapter of your life. Instead of shrinking into invisibility, step forward into your wisdom, strength, and self-assurance.
If you’re struggling with the emotional, physical, or relational challenges of perimenopause, Embodied Wellness and Recovery is here to help. Let’s change the narrative—perimenopause is not a loss but a gateway to the most vibrant, self-assured version of you. Reach out today to schedule a free 20-minute consultation with our team of top-rated therapists or coaches to discuss whether Embodied Wellness and Recovery could be an ideal fit for your mental needs, supporting you through this unique phase of life with compassion and attunement.
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References
Maki, P. M., & Henderson, V. W. (2022). Hormones and the aging brain: Impact on cognition and mood. Journal of Women’s Health, 31(3), 275-284.
North American Menopause Society. (2023). The 2023 position statement on hormone therapy. Menopause, 30(1), 1-20.
Fisher, W. A., & Alexander, J. L. (2021). Sexual health during perimenopause and menopause: Challenges and interventions. Journal of Women’s Health, 30(12), 1500-1512.
