Understanding & Supporting Menopause
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In this group by Dr Iya Goubareva combines modern scientific research with ancient traditional wisdom to educate, empower and support women through their menopausal transition.
01/10/2026
Too Complicated to Study: The Real Reason Women's Health Is Decades Behind
If you've said any of this to your doctor — "I don't feel like myself anymore. I'm exhausted. I can't sleep. I can't concentrate. My body has changed. I'm struggling to get through my day." — and if your blood work was normal, you can hear in return -"Well, you're getting older, it becomes difficult for a woman your age." And that's it.
I was reading Dr. Mary Claire Haver's work recently, and one number shocked me: menopause research receives less than 1% of the already-limited budget for women's health research. Less than 1%, for a transition every single woman who lives long enough will go through.
And there's a reason that gap exists. Since the beginning of modern medicine, research has been built around the male body as the default — the standard, the baseline, the "normal" everything else gets measured against. Why? Because women were considered too complicated. Hormones that fluctuate, cycles, pregnancy, menopause — too many variables, too messy to study cleanly. So apparently, for centuries, the solution wasn't to study us properly. It was to just not study us much at all.
Sorry for the inconvenience of being half the planet's population!
Here's what that "inconvenience" actually costs us. The differences between female and male bodies go far beyond reproduction.
Hormones influence:
• Brain
• Bones
• Heart
• Muscles
• The immune system — autoimmune diseases are much more common in women
• The cardiovascular system — heart disease and heart attacks can show up differently
• Pain is experienced and processed differently
• Medications are absorbed and broken down differently
• Metabolism works differently
• The brain and nervous system are shaped by s*x hormones throughout a woman's life
So of course, if our bodies are understudied, what do you expect about perimenopause — a word that only recently became part of our vocabulary?
Perimenopause requires a symptom-based diagnosis rather than a lab-test-based one. There are currently no lab tests that allow for a conclusive diagnosis, so a doctor must rely on their knowledge of the symptoms related to this transition to make the diagnosis. And if doctors aren't educated about these symptoms, they don't have the knowledge to rely on, and so they just dismiss women with condolences.
Of course, changes in the menstrual cycle do occur because of hormone fluctuations, but it isn't always the first symptom, or the only symptom. We're starting to understand that it's actually the brain that is often the first organ affected, way before the menstrual cycle starts to become irregular. The hormones become erratic, and the ability to focus, energy levels, and mood decline.
To this day, doctors are not taught that these symptoms — together with abdominal weight gain, low libido, and fatigue — can be a sign of perimenopause. At this point, the doctor should be talking about lifestyle-based protocols, which do exist but are rarely mentioned.
The general criteria for diagnosing perimenopause is very narrow — irregular periods and hot flashes — and if you don't have those, they almost never discuss the possibility of perimenopause. So women are turned away and dismissed because they don't match that checklist.
If you report depressive thoughts and increased anxiety, you are much more likely to be put on antidepressants before anyone discusses fluctuating hormones. Hormone therapy is actually very effective at stabilizing the hormones that affect mood in perimenopause, and it has fewer side effects than antidepressants.
So please hear this: normal bloodwork doesn't mean nothing is happening. It means the specific things tested were within range. That's not the same as "everything is fine."
Women are underserved in their care by doctors who are under-educated on this. So many doctors are now seeking knowledge beyond their traditional medical training, building a body of real-world evidence — a database of symptoms and treatments that actually work. There are also interactive questionnaires collecting data directly from women, like the ones from Midi Health and Alloy Health, and the information gathered from these can help improve treatment.
We need women to refuse to settle for outdated information being passed off as an acceptable standard of care. Women in menopause deserve more accurate care, more respect, more science.
You know your body. If something feels wrong, say so — clearly, repeatedly, to whoever will listen. We're finally starting to ask the questions that should have been asked all along.
If you want to go deeper, these are doctors doing real, evidence-based work in this space and worth following: Dr. Mary Claire Haver, Dr. Kelly Casperson, Dr. Lauren Streicher, Dr. Rachel Rubin, Dr. Avrum Bluming, Dr. Carol Tavris, Dr. Sharon Malone, Dr. Corinne Menn, Dr. Suzanne Gilberg-Lenz, and Dr. Rocio Salas-Whalen.
10/09/2026
What Happens to Your Brain During Perimenopause—and What You Can Do About It
Have you ever walked into a room and forgotten why you were there? Struggled to find the right word? Forgotten names, appointments or where you left your keys?
If so, you're not alone.
Many women worry they're "losing their memory" during perimenopause, but in most cases that's not what's happening.
During perimenopause, estrogen doesn't simply decline—it fluctuates dramatically. These hormonal ups and downs cause your brain to constantly adapt and remodel itself.
Why does that matter?
Because estrogen supports many of the brain functions we rely on every day, including:
- Memory formation
- Focus and concentration
- Planning and decision-making (executive function)
- Mental processing speed
- Communication between brain cells
- The brain's ability to produce and use energy efficiently
When estrogen is fluctuating, it's completely normal to feel like your brain is a little "offline."
But hormones aren't the whole story.
Brain fog is often made worse by:
- Poor sleep (especially from night sweats or insomnia)
- Chronic stress
- Anxiety
- Insulin resistance and blood sugar swings
- Inflammation
- Thyroid disorders
- Low iron
- Vitamin B12 deficiency
- Vitamin D deficiency
The good news? For most women, brain fog is temporary—and there is a lot you can do to support your brain.
Here I go sounding like a broken record... but the simple lifestyle changes I talk about all the time really can have a profound effect.
😴 Prioritize sleep. If I had to pick just one thing, this would be it. Sleep is when your brain consolidates memories, clears away waste products and essentially "resets" for the next day. Even one poor night's sleep can make brain fog noticeably worse. In fact, the very first post I shared in this group was about sleep, so if you haven't read it yet, I highly recommend starting there.
💪 Move your body every day—but don't skip strength training. A daily walk increases blood flow to the brain, delivering the oxygen and nutrients it needs to function at its best. Strength training goes a step further. It stimulates the release of special proteins from your muscles, along with a natural "brain fertilizer" that helps brain cells grow, form new connections and repair themselves. This supports memory, learning and mental sharpness. Building muscle also improves insulin sensitivity, helping keep blood sugar stable and reducing the energy crashes that can make brain fog even worse.
🥩 Eat enough protein. Your brain needs protein to make the chemical messengers that allow brain cells to communicate. Protein also helps keep your blood sugar stable, preventing the highs and lows that can make brain fog worse.
🫒 Follow a Mediterranean-style eating pattern. Rich in vegetables, olive oil, legumes, nuts, fish and berries, this way of eating helps reduce inflammation and provides the nutrients your brain needs to stay healthy.
🧘 Manage stress. Ongoing stress keeps cortisol levels high, which can interfere with memory, focus and concentration over time.
📚 Keep your brain active. Learning a new skill, reading, playing music, doing puzzles or simply having meaningful conversations all help keep your brain adaptable and resilient.
🌿Herbs that can help
- Rosemary – Can help improve memory, alertness and mental clarity. Even the aroma of rosemary has been linked to better attention and recall.
- Sage (Salvia officinalis) – Traditionally used to support memory and concentration.
- Bacopa (Bacopa monnieri) – Can help improve memory, learning and processing speed. It usually takes several weeks of consistent use before you notice the benefits.
What if you're doing all of this and you're still struggling?
If brain fog is still affecting your daily life, speak with your doctor. Together, you can explore whether something else is contributing.
Your doctor may recommend:
- Blood tests to check for thyroid disorders, iron deficiency, vitamin B12 deficiency, vitamin D deficiency, diabetes or insulin resistance.
- Treatment for anxiety or depression, both of which can have a major impact on memory, focus and concentration.
- Hormone replacement therapy (HRT), if it's appropriate for you. While HRT isn't prescribed specifically for brain fog, many women notice clearer thinking as hormone levels become more stable and other menopausal symptoms improve.
The most important thing to remember is this:
Perimenopause isn't your body asking you to do more—it's asking you to do things differently.
Support your body, support your brain.
Slow down when you need to.
Sit quietly for a few minutes. Listen to the birds.
Feel the sun on your face. Breathe in the fresh air. Some of your best thinking doesn't happen when you're rushing from one task to the next—it happens in moments of stillness.
Give your body the support it is asking for, and it will take care of you in return. 💚
22/08/2026
My Dear Beautiful Ladies — Give Your Body a Break
In this post, I want to make a simple call to every woman reading this: give your body a break.
As you enter perimenopause, your body is going through a serious hormonal shift — and it doesn't just affect one thing, it touches nearly every system you have:
- Your nervous system (mood, anxiety, emotional regulation)
- Your sleep and circadian rhythm
- Your metabolism and how you process food and store fat
- Your musculoskeletal system (joints, muscle recovery, bone density)
- Your cardiovascular system
- Your cognitive function (focus, memory, mental clarity)
- Your skin and connective tissue
- Your digestive system
- Your stress response and cortisol regulation
That's not a small list. And here's the problem: many of us don't even realize we're in perimenopause when this starts. So instead of slowing down, we do the opposite — we push exercise harder, drink more coffee, cut calories, and keep pushing, expecting our body to respond the way it always has.
I did the same thing, but my story is a little more tangled than that. I was going through a real, serious grief at the time — I had lost my father. So for a long while, I believed everything I was feeling was grief, and only grief. It made sense. It fit. I had no reason to think anything else was happening underneath it.
My sleep was badly affected. I was tired constantly. I developed IBS out of nowhere. I couldn't exercise the way I used to. And I could no longer fast — I had to eat every four hours or I'd feel awful. But all of that could just as easily be grief. Grief does that to a body too. I didn't have hot flashes either, which is part of why it took me so long to even consider perimenopause — I thought that was the sign you were supposed to look for.
Then suddenly my breasts became tender and grew two sizes, seemingly overnight, and that's when it hit me: this wasn't grief anymore. That had nothing to do with losing my father, and I knew it.
And when I realized it was perimenopause, another wave of grief hit me — a different one this time. I thought, is this my new reality now? I thought I might never feel like myself again. I thought I might never be able to exercise the way I used to. I had gained weight, and it felt like life, as I knew it, was simply over — like I'd been pushed into some "old" phase of life I wasn't ready for.
Grief has its own shape, and perimenopause has its own shape, and for a long time I genuinely couldn't tell where one ended and the other began. Both were real. Neither cancelled out the other.
What actually helped was the opposite of pushing. I became still. I started listening to my body instead of fighting it, and the message was simple: relax. Give me time. Let me do what I need to do.
So I stopped resistance training, temporarily, and replaced it with tai chi and yoga. I stopped forcing myself through days with coffee and napped when I could. My brain fog and fatigue were severe enough to affect my work, so I took real time off — no TV, no reading, nothing to consume or perform. Just myself, my garden, my cats. I honored the need to eat every four hours without questioning it. In the evenings, I did small, genuine things for myself — foot massages, relaxing music, candles I used to save only for special occasions, face masks, face yoga, stillness with no stimulation at all.
And slowly, my body started to respond. I eased back into exercise, gently, on its terms rather than mine. The fog started to lift. I started to feel like a version of myself again — not the old one, but a real one.
If you're carrying grief and this transition at the same time, please know both are allowed to be true, and you don't have to untangle them alone or all at once. I was grieving, and I was changing, and my body was asking for something I hadn't learned to give it yet: rest, without needing to earn it.
Here's the thing about pushing through brain fog, stress, and poor sleep: it doesn't work. Your body performs worse the harder you push it in that state, which only stresses you out more, which makes everything worse again. It becomes a loop that feeds itself. Stillness isn't the opposite of getting things done — it's actually what breaks that loop. Your brain needs quiet to sort itself out. Solutions rarely show up while you're pushing; they show up in the stillness, once your body finally feels safe enough to stop bracing and start working things out.
If any of this sounds familiar — the exhaustion, the fog, the feeling that your body has quietly changed the rules on you — this season simply asks something different of us than the ones before it did. My gentle challenge to you this week: pick one thing to stop pushing, and one thing to actually rest. Notice what happens. And if you ever want support figuring out what your body is asking for, I'm here. 💛
03/08/2026
💪Why Building Muscle Is Essential During Perimenopause
Building muscle during perimenopause isn't just about looking stronger—it's one of the best things you can do for your long-term health. As estrogen levels decline, women naturally lose muscle and bone mass while becoming more prone to insulin resistance, abdominal weight gain, and reduced mobility. Strength training, combined with adequate protein, can help counter many of these changes and improve overall well-being.
The Benefits of Building Muscle
1. Protects your bones – Resistance training strengthens bones, helping prevent osteoporosis and reducing fracture risk.
2. Improves insulin sensitivity – Muscle helps remove glucose from the bloodstream, lowering the risk of insulin resistance and type 2 diabetes.
3. Supports a healthy metabolism – Preserving muscle helps maintain your resting metabolic rate and makes weight management easier.
4. Reduces abdominal fat – Strength training helps reduce harmful visceral fat, which tends to increase during perimenopause.
5. Promotes heart health – Better blood sugar control, healthier cholesterol, and lower blood pressure all contribute to a healthier heart.
6. Supports healthy joints – Strong muscles stabilize joints, reducing strain and improving movement.
7. Maintains everyday strength – Carrying groceries, climbing stairs, lifting luggage, and getting off the floor all become easier.
8. Prevents frailty – More muscle helps maintain independence and improves recovery from illness or injury as you age.
9. Improves balance – Greater strength and coordination reduce the risk of falls and fractures.
10. Supports hormonal health – Regular resistance training can improve energy levels and help ease some menopausal symptoms.
11. Supports brain health – Strength training has been linked to better memory, cognitive function, and healthy brain aging.
12. Boosts mood and sleep – It can reduce symptoms of anxiety and depression while improving sleep quality.
13. Provides a protein reserve – Muscle serves as a valuable reserve of amino acids to support healing and immune function during illness or injury.
14. Improves quality of life – Feeling stronger makes it easier to stay active, independent, and confident throughout midlife and beyond.
Don't Forget the Building Blocks: Protein
Exercise provides the stimulus for muscle growth, but protein provides the building materials. Without enough protein, your body can't efficiently repair and build muscle, no matter how hard you train.
Aim for at least 100 grams of protein per day, spread across your meals. Prioritize high-quality protein sources such as lean meat, fish, eggs, dairy, soy, legumes, and other protein-rich foods.
New to Strength Training?
It's never too late to start, and you don't have to spend hours in the gym to see results.
- Aim for 2–3 strength training sessions per week, allowing a day of recovery between sessions.
- Focus on simple, full-body exercises that work the major muscle groups, such as squats, lunges, rows, presses, and deadlifts—or their beginner-friendly variations.
- Start with body weight, resistance bands, or light dumbbells, and gradually increase the weight as you get stronger.
- Good technique is more important than lifting heavy. If possible, work with a qualified trainer for a few sessions to learn proper form.
- Consistency beats intensity. Two or three well-planned workouts every week will deliver far greater results than occasional hard workouts.
Remember, you don't have to become a bodybuilder. The goal is simply to build and maintain enough muscle to support your bones, metabolism, and overall health for decades to come.
Simple WEIGHT LOSS Checklist for Perimenopausal Women
- Prioritise sleep and manage stress. This is the foundation.
Poor sleep and chronic stress increase cortisol (the stress hormone), which can make losing fat—especially around the abdomen—more difficult during perimenopause. Belly fat is particularly responsive to cortisol, so improving sleep and reducing stress should come before focusing on diet or exercise.
- Eat enough protein.
Aim for at least 100 g of protein per day. Protein helps preserve and build muscle, keeps you feeling fuller for longer, and supports a healthy metabolism.
- Reduce refined carbohydrates. Cut back on foods such as sugary drinks, sweets, pastries, white bread and other highly processed carbohydrates. Instead, choose whole grains, vegetables, fruit and other high-fibre foods.
- Create a modest calorie deficit. You don't need to starve yourself, but consistently eating slightly fewer calories than you burn is essential for fat loss.
- Do not eat late at night. Finish your last meal 3–4 hours before bedtime. This will improve your sleep and promote weight loss.
- Try intermittent fasting. Start with a 12-hour overnight fast, which is often easy to achieve while sleeping. As your body adapts, gradually increase your fasting window to 14, 16 or even 18 hours, depending on what feels sustainable for you.
- Stay hydrated. Drink at least 2 litres of water per day. Thirst is often mistaken for hunger, so staying well hydrated may help reduce unnecessary snacking and support weight loss.
- Exercise regularly.
- Cardio burns calories and improves heart health.
- Strength training is essential because muscle tissue burns more energy than fat tissue, even at rest. As we age—and especially during perimenopause—we naturally lose muscle unless we actively maintain it. Building and preserving muscle helps keep your metabolism higher, improves strength and mobility, supports bone health, and makes it easier to maintain a healthy weight long term.
Remember: Consistency is the key to long-term weight loss and lasting results. 💪❤️
Finally, more women are talking about perimenopause. When it hit me, I had no idea what was going on. My sleep was badly affected, my digestive system was all over the place, I was exhausted, my body was refusing exercise, and I felt like I had early-onset Alzheimer's. Then my breasts suddenly grew seemingly overnight, and that's when I understood this was a hormonal shift. Looking back now, I think it actually started a year earlier.
Even being in the medical profession, I thought I'd get some hot flashes, maybe some mood swings, and my period would stop. I had no idea how drastically this could impact my life. I think that's because menopause has long been a taboo subject — women were labeled as "old," so we didn't talk about it, and there simply wasn't enough research into women's health. We were studied as if our biology were the same as men's, when it's completely different.
So, my dear ladies, let's start talking about this and sharing our experiences with each other, along with practical advice.
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29/07/2026
Why You're Suddenly Puffy in Perimenopause (And What Actually Helps)
If you've noticed your face looks swollen some mornings, your rings don't fit, or your weight jumps a few kilos overnight for no reason — you're not imagining it, and you haven't suddenly "gained fat." It's fluid, and it's driven by hormones.
As oestrogen and progesterone start fluctuating unpredictably in perimenopause, your body becomes far more sensitive to things it used to handle just fine — salt, poor sleep, stress, alcohol, certain foods. The trigger isn't new. Your tolerance for it has simply dropped.
The good news: you don't need to fix everything at once. A few consistent habits make the biggest difference.
What actually helps:
🛌 Focus on sleep quality, not just hours or timing.
It's not about going to bed at a certain time — you can be in bed by 9pm and still toss and turn all night. Deep, uninterrupted sleep is what regulates the hormones behind fluid retention. (I've written a full post on improving sleep quality — worth a read if this is a big factor for you.)
🥗 Pay attention to diet, not just salt.
Salt matters, but so do foods that trigger inflammation or sensitivity in your own body — dairy is a common one for many women, along with refined carbs and sugar, especially in the evening. You don't need to overhaul everything; just start noticing which foods leave you puffier the next day.
🚶 Move your body daily.
Your lymphatic system has no pump of its own — it relies on movement to circulate fluid. Walking, stretching, jumping or shaking your body, lymphatic self-massage and even deep breathing are all genuinely effective ways to help drain excess fluid.
☕🍺 Notice your own response to coffee and alcohol.
Both affect cortisol, sleep, and hydration differently from person to person. Coffee is technically a mild diuretic, but for some women it raises stress hormones enough to cause next-day puffiness instead. 🍷Alcohol's main issue is usually the rebound — disrupted sleep and inflammation the next day. Track your own pattern rather than assuming either is automatically "bad."
🧘 Lower your stress load where you can.
Chronic stress keeps cortisol elevated, and that alone drives fluid retention. Even short daily downtime — a walk, a few quiet minutes, journaling — helps regulate this over time.
⏳ Give it weeks, not days.
If you cut out one thing for two days and expect the swelling to vanish, you'll be disappointed. Your body needs consistency over several weeks to reset — sleep, movement, stress, and food all matter together, not any single "fix."
When to see a doctor:
Most of this is normal hormonal fluctuation. But get checked if swelling is severe, one-sided, or comes with shortness of breath, chest pain, or rapid weight gain over a few days — and it's worth ruling out thyroid issues too, since they become more common in midlife.
Start here: you don't need to tackle all of this at once.
Pick just one area this week — sleep, movement, or one food you suspect is triggering you — and give it real attention before adding anything else. Small, consistent changes will tell you more about your own body than any list ever will.
The bottom line: your body is changing, but these changes aren't something you have to just live with. Your hormones are shifting, and that means your habits need to shift with them too — you just need to accommodate to this transition. Pay attention to how your body responds to small changes, and remember: you're not alone in this. 💛
🫨😢😡🤯The Emotional Symptoms of Perimenopause
Take a few minutes to read this—you deserve this information.
Having covered the vasomotor symptoms, it's time to move on to what I consider one of the most important aspects of perimenopause: the emotional symptoms.
For many women, these are the symptoms that have the greatest impact on everyday life. Anxiety, irritability, low mood, loss of motivation and feeling overwhelmed can affect relationships, work and self-confidence. Many women say, "I just don't feel like myself anymore."
The first thing I want you to know is this: these changes are real, they have a biological basis, and they're a normal part of the hormonal changes taking place during perimenopause.
Most people think of estrogen as a reproductive hormone, but it does far more than regulate the menstrual cycle. It also plays an important role in helping the brain function smoothly. Think of estrogen as the conductor of an orchestra. When the conductor steps away, the musicians can still play, but they're no longer perfectly in sync. During perimenopause, as estrogen levels fluctuate, the brain has to constantly readjust. That's why emotions can suddenly feel more intense, stress becomes harder to manage, and you may not feel quite like yourself.
The good news is that we now understand much more about why this happens than we did even 20 years ago. More importantly, there are many evidence-based ways to support your brain during this transition.
1. Anxiety, Feeling Overwhelmed & Panic Attacks
What's actually happening?
Your brain has a built-in stress response system, and estrogen helps keep it balanced.
As estrogen begins to fluctuate, that system becomes more sensitive. Think of it like a smoke alarm that's become overly sensitive—it still works exactly as it should, but now it goes off when you're only making toast.
That's why situations you once handled with ease may suddenly feel overwhelming. Your heart may race more easily, your mind may jump to worst-case scenarios, and it can become much harder to switch off and relax.
For some women this shows up as constant worrying, for others as panic attacks, and for many it's simply the feeling of being overwhelmed by everyday life.
2. Irritability, Anger & Rage
What's actually happening?
Many women notice they have much less patience than they used to. They snap more easily, become frustrated over small things or react more strongly than they normally would.
This happens because estrogen also helps regulate the part of the brain responsible for emotional control. During perimenopause, those control systems become less efficient, while the brain's emotional centre becomes more reactive.
Imagine driving a car where the accelerator has become more sensitive and the brakes aren't quite as responsive. You'll still reach your destination, but it takes much more effort to stay in control.
3. Low Mood, Depression & Crying More Easily
What's actually happening?
Estrogen supports several of the brain's systems that help regulate mood.
As hormone levels fluctuate, these systems don't communicate as efficiently. Some women find themselves crying much more easily, others lose interest in activities they once enjoyed, while some develop symptoms of depression.
It's important to remember that feeling low from time to time is different from clinical depression. If low mood is persistent, affects your daily life or is accompanied by feelings of hopelessness, it's important to seek professional help.
4. Loss of Motivation, Confidence & Enjoyment
What's actually happening?
Many women say,
"I know exactly what I need to do... I just can't seem to get started."
This is another common effect of fluctuating hormones.
Estrogen helps support the brain's motivation and reward system. During perimenopause, everyday tasks can require more mental effort, and activities that once felt enjoyable may not bring the same sense of satisfaction.
That doesn't mean you've suddenly become lazy or lost your ambition. Your brain is adapting to a different hormonal environment.
**Treatment Approaches**
Because every woman's experience is different, treatment should always be tailored to your individual symptoms and needs.
Lifestyle
Looking after your overall health won't stop the hormonal changes of perimenopause, but it can help reduce the intensity of symptoms and support your brain through this transition.
- Exercise most days of the week. A combination of walking or other aerobic exercise with strength training provides the greatest benefits.
- Eat a balanced diet rich in colourful vegetables, fruit, whole grains, beans, lentils, nuts and seeds.
- Choose healthy fats, including oily fish such as salmon, sardines, mackerel and trout, as well as nuts, seeds, avocados and extra virgin olive oil in salads. These foods provide healthy fats that support brain health.
- Eat enough protein throughout the day to help maintain energy and muscle health.
- Limit highly processed foods, excess sugar and alcohol, which may worsen mood, sleep and energy levels.
- Aim for 7–9 hours of quality sleep each night.
- Spend time outdoors every day, especially in the morning, to help regulate your body clock and support mood.
- Stay connected with family and friends and make time for activities that bring you joy.
Complementary approaches
Some women also find benefit from complementary therapies, particularly when used alongside healthy lifestyle habits and medical treatment where needed.
These may include:
- Yoga, mindfulness and meditation.
- Breathing exercises.
- Acupuncture, which some studies suggest may help with anxiety, sleep disturbances and hot flashes.
- Massage or gentle self-massage to ease muscle tension and promote relaxation.
- Herbal infusions such as chamomile, lemon balm or passionflower, which some women find calming. Remember that herbal products can interact with medications, so always discuss regular use with your healthcare professional.
- Spending time in nature.
- Spending time with pets, which has been shown to reduce stress and improve emotional wellbeing for many people.
**Medical treatments**
Hormone replacement therapy (HRT) is often the first treatment considered when emotional symptoms occur alongside other symptoms of perimenopause, such as hot flashes, night sweats or disturbed sleep. By replacing the hormones that are declining, HRT can help stabilise mood and reduce anxiety for many women.
If HRT isn't suitable, or if anxiety or depression are more severe, your doctor may recommend antidepressant medications such as Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Noradrenaline Reuptake Inhibitors (SNRIs).
These medications help improve communication between brain cells involved in regulating mood and anxiety. Some can also reduce hot flashes.
Cognitive Behavioural Therapy (CBT), a structured form of talking therapy that helps you recognise unhelpful thought patterns and develop practical strategies to manage anxiety, stress and low mood. It is particularly effective for anxiety and can be used on its own or alongside HRT or medication.
Everything is connected. That's why the most effective approach is to support your body as a whole rather than trying to treat one symptom at a time.
Poor sleep can increase anxiety.
Anxiety can make you more irritable.
Low mood can reduce motivation.
Hot flashes can disturb sleep, making everything else feel more difficult.
Every woman's journey is different, and there is no right or wrong way to experience perimenopause. The more you understand your body, the better you can support it through this transition.
Be kind to yourself. Be kind to your body, and your body will often return that kindness. It's working hard to adapt during this transition, so nourish it, support it and give it the patience it deserves. 💛
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