What to Expect When You're...Perimenopausal
Written by Erica Langer, PsyD - Clinical psychologist at The Centered Space
Everyone knows that children mature through a process of puberty called adolescence. During the pre-teen years, girls are flooded with information about bodily changes through health education class, magazines and interactions with peers. Parents know to expect the changes and to tell their children what is going to happen. Although one can never be fully prepared for puberty, at least we are told what to expect!
I’m an adult, my body should be done changing, right? Think again.
Fast forward a few decades. You're in your 40s. With the exception of an annual GYN appointment and maybe a mammogram, reproductive health often receives little attention. Just like every child goes through adolescence, every woman goes through perimenopause and menopause. It is also a predictable and normal time in a woman’s life, when being aware and prepared is helpful, just like it was as a child.
So when does perimenopause start? What about menopause? Is there anything I can do to deal with hot flashes? Spotting? Other bodily changes? When it comes to menopause, there is a lot of mystery and many unanswered questions. Other times, we may hear unhelpful advice, including “there’s nothing to do about it” and since it’s normal, I guess it’s fine.
There is a difference between normal and fine
Just because adolescence is normal, we don’t expect everything to go great for teens. We support them with therapy, education, sometimes medications and hormonal support. The same should be true of perimenopause and menopause - support, therapy, hormonal support and possibly medications can and should be on offer at this time, without stigma.
As a Clinical Psychologist, I work with patients struggling with anxiety in the face of uncertainty. For women in their 40s, it often relates to menopause. It is hard not having answers, especially when the unknown lies within our bodies. If you are struggling to adapt to this new life phase, you are not alone.
Below are some ways a therapist specialized in perimenopause can help:
Mood and Anxiety Symptoms: Up to 50% of women experience irritability, low energy and difficulty concentrating, among other mood symptoms. Anxiety may also worsen or present for the first time due to fluctuating hormones. A therapist can help you gain insight and provide tools to cope with symptoms.
Sleep: Sleep difficulties are often reported during perimenopause, including difficulty falling asleep, staying asleep and poor sleep quality. A therapist can make suggestions and teach relaxation exercises and breathing techniques. CBT for Insomnia (CBT-I) can be helpful for sleep.
Hot flashes: Hot flashes can become more manageable by identifying triggers and making small changes. A goal of therapy might be to increase physical comfort as you adapt or deal with medical changes in your body.
Other bodily changes: Addressing weight changes, appearance-based concerns and sexual health all have psychological components to be addressed in therapy, along with the medical treatment that may also be of benefit.
Advocating for yourself and your health: Therapeutic discussion may focus on how to talk to your medical doctor, including what questions to ask, and any barriers to treatment.