Written by: Stephanie Smith
What Is Perimenopause – and Why Does It Matter?
Perimenopause is more than a hormonal shift, it’s a profound life transition that can leave many women grappling with anxiety, identity loss, and a sense that something is “off.” While the menopause often gets the attention, the years leading up to it, perimenopause, can be even harder.
One in four women will experience severe perimenopausal symptoms, with fatigue, mood swings, and brain fog disrupting daily life (Walker et al., 2022). Many women say they pull away from friends, struggle at work, or feel disconnected from their body or relationships. These changes affect more than just the body, they strongly affect mental health, and sadly, they’re often misunderstood or ignored.
Mental Health and the Role of Support Systems
Anxiety and depression are common during this stage. A study of over 800 women, found that those with less family support had worse sleep, more anxiety, and higher depression (Liang et al., 2025).
From a counselling view, this shows how important it is to look at more than just hormones. We also need to talk about stress, family life, and burnout. Therapy that includes mindfulness or relationship support can help women feel more grounded.
The Pressure of Perfection: Gender Norms and Identity Shifts
This isn’t just about hormones, it’s about culture too. Pérez et al. (2025) found that women who strongly conformed to gender norms around thinness and domesticity faced greater psychological risk. As our bodies and roles change, it’s common to feel lost or to grieve the past.
In therapy, we can name and challenge these beliefs from society. Narrative counselling helps women tell their own story in a new way, one that shows their strength and values what matters to them.
Sexual Health and Self-Esteem in Midlife
Sexuality often gets left out when we talk about women’s health, but it matters a lot for self-worth and relationships. Saleh et al. (2024) found that depression and anxiety lowered sexual desire and satisfaction in perimenopausal women. Many women feel shame, guilt, or confusion about these changes, and don’t know who to talk to.
Counselling is a safe place to talk about sex, body changes, and closeness. Together, we can explore what feels good and help rebuild confidence.
How Counselling Can Help
I don’t see this time as a crisis, I see it as a chance to grow. Whether it’s through mindfulness, support, or finding your strengths, counselling can help you feel more like yourself again.
We don’t just look at symptoms, we’ll look at your story and lived experiences. Therapy gives space to feel heard, respected, and supported through this stage of life. This isn’t something you need to just “get over.” You deserve to be seen, heard, and cared for.
You Don’t Have to Navigate This Alone
If you’re feel overwhelmed or like you’ve lost your spark, you’re not alone. I work with women going through perimenopause, identity changes, anxiety, and more. As a practicum counsellor completing my Master of Arts in Counselling Psychology, I offer reduced-cost counselling to help you through this stage. Together we can help you feel more grounded, connected, and hopeful.
I would be honoured to walk alongside you.
Click here to book a session or learn more about me.
or email me directly at stephsmith.counselling@gmail.com
References:
Liang, N., Ren, J., Zhao, J., Liu, X., & Zheng, H. (2025). Impact of family care on sleep quality in perimenopausal women: mediating roles of anxiety and depression. BMC Women’s Health, 25(1), 19. https://doi.org/10.1186/s12905-025-03551-3
Pérez, I., Cárdaba-García, R. M., Velasco-Gonzalez, V., Cárdaba-García, I., Durantez-Fernández, C., Muñoz-del Caz, A., Soto-Cámara, R., Aparicio-García, M. E., Madrigal, M., & Pérez-Pérez, L. (2025). Conformity to female gender norms and its influence on psychological risk in Spanish climacteric women: A descriptive study. Sexes, 6(1), 10. https://doi.org/10.3390/sexes6010010
Saleh, S. A., Almadani, N., Mahfouz, R., Nofal, H. A., El-Rafey, D. S., & Seleem, D. A. (2024). Exploring the intersection of depression, anxiety, and sexual health in perimenopausal women. International Journal of Women’s Health, 16, 1315–1327. https://doi.org/10.2147/IJWH.S464129
Walker, N., Jervis, J., Keeling, J., & Finney, A. (2022). Helping women through the perimenopause. Practice Nurse, 52(2), 26–29.
