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Many women don’t initially connect the dots between perimenopause and the physical, emotional and mental changes they’re experiencing. The confusion, compounded by a lack of validation, can leave us wondering if we’re losing our minds. But these shifts are often part of a natural life transition – one that deserves attention, support and understanding. We explore the emotional and physical impact of perimenopause and menopause, while highlighting ways to navigate this complex phase.

Menopause is a natural stage in every woman’s life that marks the end of her reproductive years. However, before reaching menopause, women often experience perimenopause, a period of hormonal shifts that can last several years.  The average age for the start of perimenopause is around 40 to 45, but it can begin as early as your late 30s, and each case is different. It culminates in menopause when you’ve gone 12 months without a period.

Common and lesser-known symptoms

As estrogen and progesterone levels decline, women may experience a wide range of symptoms. Symptoms may include:

• Hot flashes and night sweats
• Sleep disturbances
• Mood swings, irritability or depression
• Brain fog and difficulty concentrating
• Low energy and motivation
• Reduced libido or pain during sex
• Joint pain or stiffness
• Negative body image due to weight gain or changes in skin and hair
• Digestive issues like bloating or constipation
• Cardiovascular changes, including increased risk of heart disease

Each woman’s experience is unique – some women go through this period with minimal disruption (and may feel relieved to no longer worry about periods or getting pregnant); for others, the menopausal transition can feel deeply disruptive.

The emotional impact of menopause

A study published in the British Journal of Occupational Therapy highlights a significant gap in understanding and awareness among healthcare providers when it comes to menopause. Many women are left in the dark, without adequate support or education, and this lack of knowledge can lead to ongoing uncertainty, affecting a woman’s confidence, self-esteem and mental health. Not understanding what’s happening to her body can leave her feeling isolated and questioning her identity in various roles – whether at work, as a mother or in her personal relationships.

But this transition can also be a powerful gateway into a new phase of life. Many women report feeling more grounded, assertive and in touch with their values. Freed from the hormonal fluctuations of a monthly cycle and the pressure of fertility, some find a renewed sense of freedom, creativity and purpose.

Support comes in many forms

There is no one-size-fits-all solution for navigating perimenopause and menopause. For some women, medical options such as Hormone Replacement Therapy (HRT) can be life-changing, especially when symptoms are severe or disruptive. HRT has evolved significantly in recent years, and talking to a trusted healthcare provider can help you explore whether it’s a good fit. Others find support through holistic and lifestyle-based approaches, or a combination of both.

Occupational Therapy (OT) also offers powerful tools for women navigating menopause, particularly when symptoms impact daily routines or quality of life. OT can support you to: 1) understand the impact of symptoms on daily function; 2) develop strategies to manage symptoms; and 3) maintain and enhance participation in meaningful roles.

You’re not alone

If you are navigating perimenopause or menopause, know that you don’t have to do it in silence – or alone. By seeking guidance from healthcare professionals, you can better understand your symptoms, access appropriate treatment, and find strategies that work for your life. Support might also come in the form of therapy, online communities and trusted friends.

This may be a time of change, but it’s also a time of possibility. With the right tools, this can be a season of reconnection with yourself.

PHOTO: Johannes Plenio

With thanks to Occupational Therapist Hollie Karr for her contribution to this article.

AUTHOR BIO
Hollie Karr is an Occupational Therapist with over 20 years of experience in holistic wellness and preventative care. She is the founder of Total Body OT, LLC, and offers telehealth services specializing in chronic condition management, including heart disease, diabetes, ADHD, tic disorders and menopause. Hollie is dedicated to helping clients overcome barriers to meaningful engagement in daily routines and life roles. You can email her on hollietotalbodyot@gmail.com/ or find her on LinkedIn and Psychology Today.