Perimenopause: The Hormonal Rollercoaster You Didn’t Sign Up For (And How Therapy Can Help You Hang On)

Perimenopause can feel like someone’s turned the dial on life’s treadmill up a few notches without warning. One day you're jogging along just fine, and the next, you're wondering why everything feels like it has hit a new level of hard.

If you’ve been waking up feeling like you ran a marathon in your sleep—or standing in the kitchen, staring at an empty coffee pot, convinced you already hit the brew button—you’re not alone.

Welcome to perimenopause.

It’s like your body decided to throw a surprise party, except the guests are exhaustion, brain fog, mood swings, and the occasional night sweat that makes you wonder if you unknowingly ran a fever overnight. And the worst part? No one gave you an instruction manual for this phase of life.

Perimenopause is the transition leading up to menopause, where your body starts making significant hormonal shifts. And while we often hear about menopause itself, perimenopause can last anywhere from a few years to over a decade (yes, really). It’s basically puberty’s chaotic sequel—but this time, with a mortgage, responsibilities, and zero patience for nonsense.

What You Might Be Experiencing

The tricky part about perimenopause is that it doesn’t look the same for everyone. One day, you might feel totally fine, and the next, you’re wondering why your energy has plummeted, why you’re crying over a cereal commercial, or why you suddenly forgot the name of your neighbor’s dog (the same dog you’ve been petting for five years).

Some of the most common symptoms include:

The Nighttime Inferno (a.k.a. Hot Flashes & Sleep Disruptions)

If you’ve ever woken up drenched in sweat like you just finished a spin class in your sleep, that’s a hot flash. Or maybe you’re playing the nighttime thermostat game—blankets on, blankets off, feet out, feet in—only to wake up feeling like you barely slept at all.

Mood Swings That Keep You Guessing

One minute, you’re laughing at a meme, and the next, you’re irrationally furious because someone put the cereal box back in the pantry… empty. Your emotions may feel completely out of sync with reality, and no, it’s not all in your head—hormonal shifts can seriously impact your mood and anxiety levels.

Brain Fog: The Great Vanishing Act

Ever find yourself staring at your phone, wondering why you picked it up in the first place? Or leaving the house without your keys, your to-do list, or even your shoes? That’s brain fog. It can make simple tasks feel like solving a complicated riddle, and it’s one of the most frustrating aspects of perimenopause.

Energy Levels That Make No Sense

Some days, you wake up ready to conquer the world. Other days, the idea of walking to the mailbox feels like a full-body workout. Fatigue can hit hard, even when you’re getting enough sleep (or at least trying to).

And these are just a few highlights. Perimenopause can also bring joint pain, headaches, irregular cycles, and even changes in how you process stress.

If it feels overwhelming, that’s because… it is overwhelming. But you don’t have to just “push through it.” Therapy can help.

How Psychotherapy Can Help You Regain Control

Perimenopause isn’t just a physical experience—it affects your emotions, your self-perception, and even your relationships. While medical options like hormone therapy or lifestyle changes can help, psychotherapy plays a crucial role in navigating this transition. Here’s how:

Understanding What’s Happening

One of the most reassuring things therapy can offer is clarity. A therapist can help you understand the biological cacophony behind these symptoms, providing reassurance that, yes, it’s not all in your head—it’s very much in your body, and it's manageable

Emotional Balance & Coping Strategies

If your moods feel like they have a mind of their own, therapy can provide tools to regulate emotions, manage anxiety, and keep frustration from taking over.

Adapting to Change

Perimenopause can feel like an identity shift. You might not feel like “yourself,” and that can be unsettling. Therapy provides space to process those feelings, reconnect with what matters to you, and rediscover joy—even in the midst of unpredictable symptoms.

Practical Tools for Daily Life

Whether it’s working through brain fog, managing stress, or creating new habits to boost energy, therapy offers strategies tailored to you. The goal isn’t just to survive perimenopause—it’s to find ways to thrive through it.

Processing Stuck Emotions: Why Perimenopause Can Resurface Old Wounds

Perimenopause has a way of bringing old, unresolved emotions to the surface. If you’re suddenly feeling deeply sad, more irritable than usual, or even struggling with emotions you thought you had already worked through—there’s a reason.

Hormonal shifts don’t just impact mood; they can lower the barriers you’ve unconsciously put up around past experiences. You might find yourself grieving losses you never fully processed, feeling anger you had previously swallowed, or struggling with anxieties that seem to come out of nowhere.

This is where psychotherapy becomes a game changer.

A therapist can help you:

Identify and process emotions that have been stuck in your body for years (or even decades).
Use somatic techniques to release emotional tension stored physically (think jaw clenching, shoulder tightness, or gut issues).
Reframe past experiences so they don’t feel as overwhelming when they resurface.
Build nervous system regulation skills to help you feel more balanced when emotions hit unexpectedly.

Perimenopause is not just about hormone changes—it’s an invitation to heal parts of yourself that may have been ignored. And while that might sound daunting, it can also be deeply liberating.

This Is a Season, Not the End of the Road

Perimenopause can make you feel like you’re losing control of your body, your emotions, and even your daily routine. But the truth is, you’re not broken—you’re changing. And with the right support, those changes don’t have to feel so overwhelming.

It’s okay to ask for help. Whether that’s through therapy, medical care, or just giving yourself permission to slow down when needed, you don’t have to figure this all out on your own.

So, if today feels tough, know that you’re not alone in this. There’s a path forward, and support is out there—hot flashes, brain fog, and all.

And if nothing else, at least there’s always a cold compress waiting in the freezer. 😉

- Kimberly