Sometimes referred to as “PMT on steroids”, perimenopause is affecting women all over the world. Besides physical challenges like hot flashes, heavy periods or muscle pain, it brings with it a whole host of psychological issues.

Mood swings, fatigue, irritability, anxiety, depression – all of these often made worse by sleep problems as well. Since peri-menopause can start 5 or even 10 years before actual menopause occurs, the sudden onset of all of these symptoms can be frightening and confusing. One client said that it felt like “I have gone mad overnight”. Perimenopause can seriously affect your daily functioning, undermine your performance at work and challenge relationships. Often the situation for women is aggravated by having teenage children at home, who are going through their own hormonal changes.

Yet not much attention is paid to this issue by medical professionals. You might be told it is “just hormones” or suggested to try HRT or antidepressants. As much as both can be really helpful to some people, they will be of little or no use if we have not addressed the underlying problems that are present in our lives.

Perimenopause is a time of high emotional sensitivity and any unresolved conflicts and issues are magnified and require our attention. If your relationship does not quite work, but you kept it going for the sake of the children, it might suddenly seem unbearable. Or if you have been a helper all your life, you might now find it impossible to keep up with all the demands that people place on you.

Perimenopause is the time to be honest with ourselves and find out what it is that we really want.

Perimenopause is the time to be honest with ourselves and find out what it is that we really want. If some issue requires your attention, there is no point dismissing it as “just hormones”. It is time to set your priorities, learn to ask for help and look after yourself.

Counselling can be tremendously helpful at this time of life. Talking things through with an independent professional, who is not involved in your family or social life, could help you process old unresolved conflicts, get rid of emotional baggage and figure out who your truly are.

One of my clients was struggling to do things for herself. She was so involved in looking after children, being a perfect wife for her husband and also taking care of her ageing parents, that she never even thought she had needs. Entering perimenopause made her feel like she couldn’t keep up anymore, that she was suffocating. Changing small things like booking time for gym or saying no to some of the demands of the family helped my client learn to acknowledge her needs and look after herself.

Another client suddenly felt an overwhelming anger towards her husband. The client’s husband has been unfaithful several times over the years and every time my client forgave him and suppressed her anger “for the sake of the children”. Counselling sessions gave my client space to process her anger and sadness at the break of trust, and also make decisions on how to proceed in this relationship.

So don’t dismiss your feelings as “just hormones”. Stop for a moment and pay attention, it could be an issue you have been avoiding for years. Writing a diary can often help you make sense of things and see logic in your emotions. If you feel you can’t think clearly because of the broken sleep or fatigue, research herbal remedies and vitamin supplements that can help you sleep well and regain your energy levels. 

Most importantly – listen to your body, maybe it is trying to tell you something.

Details of case studies have been changed to preserve confidentiality

Anna Storey is a therapist on the welldoing directory.