If you know me, you know I’m big on talking all things perimenopause these days. I’m passionate about dismantling the stigma, having real conversations and supporting women in getting the care they deserve. After all, you can not separate out our physical, emotional, social and spiritual wellness.

This week is the third and final blog post in my series about navigating the perimenopause transition.

We’ve talked about what perimenopause is and isn’t, and also taken a deep dive into what it means to claim perimenopause as a rite of passage in our culture that has minimized and/or hyper-medicalized it.

In this post we’ll explore how we can care for ourselves and each other in such a vulnerable time and also how to form an integrative care team so you can get the physical, emotional and spiritual support you need and deserve.

First, a recap …

Perimenopause 101

Women spend on average 40 years following their body’s cycles and unique hormonal flows until menstruation fully stops. When we enter perimenopause, our bodies, minds and souls begin preparation for the end of our “reproductive years” and for a new chapter to begin. This is huge.

Here, we leave the known and enter an in-between space where we may stay for up to a decade. Perimenopause quite literally means: “around menopause.” It’s a time that may be shrouded in uncomfortable symptoms including hot flashes, insomnia, changes in mood, lethargy, heart palpitations, sexual pain, brain fog and so on. Many women also experience feelings of shame/discomfort with getting older, as well as grief, irritability and feelings of isolation. Fact: women in perimenopause (an in periods of hormonal flux) are at higher risk of experiencing mental health challenges.

This is why it is important to talk about what’s happening, seek community and work with providers who center the perimenopausal experience rather than treating it as an afterthought. Unfortunately the latter is commonplace.

5 Ways to Cultivate Wellness During Perimenopause

For those of us who have had difficulty prioritizing our own wellbeing, perimenopause may be a much needed ‘come-to-Jesus-moment.’ Between the physical and emotional health challenges and the existential crunch there’s no longer room to play around. Here, in midlife, is where we get serious about prioritizing our own wellbeing. Fiercely. Unapologetically.

Let’s talk about how we get started.

Practice Self-Compassion - Many women report feeling like there’s something wrong with them or they’re broken when perimenopause symptoms begin flaring up. Recognize this line of thinking for what it is: negative self-talk fueled by productivity culture (aka patriarchy and capitalism.) How do we soften the tone here? With compassion. Perimenopause is no joke. It’s a radical transformation on all levels. Practice talking to yourself like you would a friend and see how it feels.
Educate Yourself - I know it’s a cliche, but it’s also truth: knowledge is power … also, it eases anxiety. Perimenopause and menopause are having a moment right now in the media (thank you Gen X) and numerous books have been published of late explaining what’s happening, why it’s happening and how we can work with the constellation of symptoms. Two of my favorite books are included here, but keep in mind there are many more out there, as well as podcasts and recent articles. Dr. Lara Briden, ND, includes tips to talk with your doctor about perimenopause in her book Hormone Repair Manual: Every Woman’s Guide to Hormones after 40. Overall, this is one of the most helpful books I’ve read on perimenopause and menopause, as is The Menopause Brain by Dr. Lisa Mosconi PhD.
Communicate Your Needs and Requests - In the best of times many women hesitate to share their feelings and ask for what they need. Couch that hurdle with the cultural stigma of perimenopause, and communicating our feelings, needs, boundaries and requests becomes even more challenging and even more necessary - both personally and in professional settings. Start here with the folks closest to you who you feel safe with and go from there. As with all of these steps, you may need and/or want professional support in navigating your new landscape.
Find Community - Yes, please! Again, breaking down the stigmas and actually talking to other women who are going through and have made it through the perimenopause transition is essential. You may make these connections in your existing community or you may want a designated space to explore your experience and reciprocate support. Perimenopause support groups exist for this reason.
Create Your Personalized Toolkit - Exercise, sleep, nutrition and stress reduction are building blocks of a solid self-care plan, especially during challenging times. They really make a difference. Alone or with the help of a therapist, take some time to think about supportive practices to integrate into your routine.
You may also want to consider what tools may be helpful with alleviating symptoms in the moment. We’ve seen an uptick in products designed to ease many perimenopause symptoms including cooling sheets for night sweats, cooling mists for hot flashes and intensive creams for dry skin due to hormonal flux. In turn, the market has also been flooded with supplements that may or may not be helpful, so on this front I really suggest working with your healthcare providers. Keep reading to learn more about finding specialized care providers to support you….

Building Your Integrative Care Team

First thing’s first. If you suspect you’re in perimenopause don’t hesitate to talk with a medical professional you trust - whether that’s a traditional MD or a naturopathic physician.

If your first point of contact is your psychotherapist, you can discuss together if you want to seek out medical consultation and if so, how best to move forward.

While some women have clear symptoms many others just describe feeling “off” or “not themselves.” Trust yourself in this process.

If you’re not sure where to start with finding a medical provider, you may consider the following:

Ask for referrals from friends, family or other providers you trust.
Check the North American Menopause Society web site for specialized providers and also do your due diligence in researching the training of any doctor you choose. Not all primary care doctors of even gynecologists have specialized trainings in hormonal care.
When you’ve compiled your list of names, remember you have the option of interviewing providers before you commit to working with them. Yes, you heard me right! I regularly encourage my clients to make a list of questions ahead of time and find out more about a provider’s knowledge and approach. Trust your gut! Do you feeling comfortable? Heard? at Ease?
Also know, that depending on your unique experience your primary provider may suggest other treatment modalities such as acupuncture, exercise, pelvic floor PT, reproductive psychiatry, herbalism, psychotherapy and so on. You may also be interested in a treatment modality that they have not named. Don’t be afraid to bring it up! This is your wellness we’re talking about.
In my own practice, I work closely with my client’s other providers to ensure continuity in care. In my opinion, this is best practice.

Closing Thoughts

I am so excited to share this third, of three blog posts, in my series about perimenopause and mental health.

As well, I’m excited to announce my new speciality offering supporting women navigating perimenopause and midlife transition. I have a few spots open for individual therapy clients opening in May 2024. If you are in need of support, please don’t hesitate to reach out.

I am also enrolling for a community support group for women navigating perimenopause, also beginning May 2024. The information is below.

Please remember, with scaffolding in place, perimenopause can be more than a time of discomfort. It can be a time of reckoning and reconciliation. A time for women to care for themselves fiercely and support each other with just as much care. It is a time of infinite possibility and transformation.

Remember, here’s where we get to write our new narrative, both individually and collectively. It’s choose your own adventure time.

Let’s move forward educated, confident and cared for.