Seven Mindful Ways To Manage Perimenopause And Find Relief


I’ve been noticing a theme in my office lately. Many women in their mid-to-late 30s and early 40s are telling me that they are noticing mood swings, difficulty falling and/or staying asleep and an increase in anxiety and depression that seems to come in cycles. The cycles aren’t following the “typical” menstrual cycle of around 28 days, though. For some of these women, their cycle seems shorter. For others, it seems longer. And for many, their cycles are completely unpredictable.

Generally, these women have been suffering privately on their own for months or even years before they come in to talk about it. Often, the conversation is shrouded in a sense of shame or feeling like “something is wrong with me.” They may have been trying to convince themselves “it’s only in their head” which only serves to add to their suffering. Many of these women are surprised to find that a major source of their symptoms is perimenopause.

What is perimenopause? 

Perimenopause is a clinical term to describe the period of time when a woman’s body is preparing to slow down and eventually stop its menstrual cycle, but not many of us know about it. If you are like me, menopause was always an idea in the distant future—something older women experienced, but nothing I could ever identify with. But in reality, menopause really just describes a singular point in time when your body has gone a whole year without a period. Perimenopause, on the other hand, describes the chunk of time that comes before that—when estrogen levels start to drop and your body begins to adjust to a new normal. For some women, this chapter is relatively calm; they don’t experience many symptoms and it’s over relatively quickly. For many women, though, perimenopause can bring on a whole new world of challenges and struggles—and it can last for years. 

Complicating matters, the tests that most doctors order to determine perimenopause can offer conflicting results, especially if they rely on only one test to draw a conclusion. Hormones fluctuate so much over the course of a cycle—and even within the course of a day—that it can be hard to know for certain whether you are, indeed, in perimenopause. And what if you are? There’s an abundance of conflicting and misleading information out there about where to turn for perimenopause symptom relief. 

Attitudes about hormone replacement therapy have swung back and forth over the years, and many women turn to naturopathic doctors for alternative ways to provide relief. It’s easy to see why women get confused about the mixed messages and apparent lack of clear options. Out of desperation for help, they may find themselves falling down the many available Internet rabbit holes of advice.

Here is a list of some of the more common perimenopause symptoms women can experience: 

Do any of them sound familiar to you?

  • lower energy and/or motivation
  • difficulty getting a good night’s sleep
  • changes in menstrual cycle
  • depressed mood 
  • increased irritability
  • PMS that doesn’t seem to take a break
  • Unexplained weight gain
  • hot flashes/night sweats
  • cholesterol levels change, and not in a good way
  • Skin changes (ranging from dry skin to acne)
  • changes in sex drive, resulting not only from the symptoms listed above, but also from increased vaginal dryness, which can make sex painful and downright unpleasant.

What can you do if you suspect you are in perimenopause? 

While the only “cure” for perimenopause is menopause itself, there are steps you can take to reduce your overall discomfort and make it a bit easier on yourself. The following seven tips can help. 

Seven Tips For Managing Perimenopause 

Get informed 

Empower yourself with solid information from trusted sources rather than fall down Google rabbit holes. The North American Menopause Society is a good place to start. 

Consult with your doctor

Talk to a medical provider you trust about your symptoms. MDs and Naturopaths are both good options, as long as the provider is one you trust. Take notes and use your critical thinking skills to sort through the information and ask questions. If your provider doesn’t take the time to answer your questions or if you aren’t satisfied, seek a second or third opinion. 

Find a good therapist

Feeling blue or anxious for a week or two is one thing, but if it lasts longer or gets in the way of your ability to continue doing the things you need to and enjoy, make an appointment with a healthcare professional—ideally one who specializes in women’s health issues. Psychology Today’s therapist finder is like a search engine for local therapists where you can filter your results based on speciality, insurance, location, etc. 


Meditation, especially mindfulness meditation, can help you manage one moment at a time and navigate unhelpful thought patterns as they arise. Mood swings are bad enough, but suffering is compounded when unhelpful thoughts and self-judgment start to spin. Take a meditation class like Mindfulness Based Stress Reduction or give Headspace a try. 

Cultivate self-compassion 

An essential component of mindfulness is self-compassion, which can sometimes be hard to cultivate for yourself during perimenopause. Mindful Self-Compassion is another class worth looking into if this resonates with you. If you can’t attend a class, you could also try this Mindful Self-Compassion workbook.

Share your experience with loved ones 

Communicate with your loved ones about what you are going through. Simply talking about your experience can make a huge difference. Together, you can come up with ideas for how loved ones can best support you when you need it.

Write it down 

Journaling can help you find the common threads that weave through all the varying states of mind you can experience. When you are up, it’s hard to even remember being down and vice-versa. Journaling can help you bridge that gap.

Embrace Impermanence!  

Above all, remember that perimenopause won’t last forever. You will get through it, hopefully with a good dose of self-care and patience. Don’t hesitate to ask for help and support when you need it. And, hopefully sooner than you expect, you will finally transition into the next chapter, postmenopausal zest, where many women report feeling a bit of a renaissance and increased excitement about life.