Perimenopause: Why Don’t I Recognise Myself?

Before perimenopause, you felt like you had it all under control. You juggled work, family and friends, and you almost always remembered where you put your keys. But now? You’ve never felt less on top of things or less like yourself. Sound familiar? You’re not alone.

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During perimenopause, we go through a major hormonal shift, and unfortunately that comes with some very real side effects. From tossing and turning all night, to losing your patience at the slightest inconvenience and suddenly feeling really low, it can be confusing, exhausting, and just a lot to deal with.

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So, if you’re wondering why you don’t recognise yourself anymore, it’s not just you. There’s a lot happening under the surface, and it’s no wonder you’re feeling off. 

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What is perimenopause?

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Most of us will have heard of menopause, but perimenopause tends to get less air time. To clear things up, perimenopause is the transitional phase that you go through in the lead up to menopause; think of it a bit like a warm-up act, but with none of the entertainment. 

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During perimenopause, your hormones, oestrogen and progesterone, start to fluctuate and decline, and your ovaries release less eggs. Because you’re not ovulating as often, you’ll likely notice changes to your menstrual cycle, like your cycle becoming longer, or your periods getting lighter and heavier. 

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It’s also when menopausal symptoms tend to kick in, although not everyone will experience them. The average age to start perimenopause is 47 years old, and it can last anywhere from a few months to ten years (we know!) but the average duration is four years. When you’ve not had a period for 12 months, this means that you’ve officially reached menopause.  

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Symptoms of perimenopause:

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We’ve listed some of the most common symptoms below, but there are actually over 30 recognised signs of menopause, so if you’re experiencing anything else new or unusual, it’s a good idea to make a note and get it checked out. 

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• Changes to your menstrual cycle, including irregular periods
• Hot flushes and night sweats
• Sleep problems
• Vaginal dryness
• Headaches
• Struggling to concentrate or remember things (AKA brain fog)
• Joint and muscle pain
• Incontinence and bladder issues
• Low libido or loss of interest in sex
• Mood swings
• Depression
• Anxiety

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Why don’t I feel like myself?

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Just because menopause is something that all women go through, that doesn’t mean that it’s easy. So many people struggle to feel like themselves during this phase of life and that’s more than understandable.

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Changing hormones can have a huge impact on your brain. They can make you feel angry, irritable, anxious or extremely low. Things that might have rolled off your back before might now send you into a spiral of rage or a panic. Throw symptoms like brain fog, forgetfulness and a lack of sleep in there and you can even start to wonder if you’re losing the plot.

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Your self-esteem might be affected too. Hormones can play a part in this, but so can physical symptoms. Things like weight gain, hot flushes and bladder leaks can make you feel self-conscious and less confident, so you might stop going out, exercising or sociailising, which all adds up to you feeling less like yourself.

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All in all, perimenopause can trigger a lot of difficult feelings. It’s not unusual to think things like “what’s happening to me?” and  “I don’t feel like me anymore”. Just remember to be kind to yourself, what you’re going through is hard enough without applying internal pressure. This phase isn’t forever and it doesn’t mean that you won’t get back to yourself. 

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How to get back to yourself

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There isn’t a one-size-fits-all answer to how to cope with perimenopause, but there are different things you can try to feel more like you again, from treatments to lifestyle changes. Making these changes can help you to feel more in control of the situation and (hopefully) more like yourself again. Whichever route you choose, it’s a good idea to make an appointment with your GP to talk through your options. 

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Lifestyle changes:

• Exercise can boost your mood, make you feel more relaxed and improve your overall wellbeing (who doesn’t want that?). Any form of movement is great, but strength training is particularly beneficial during perimenopause as it can improve your bone density and reduce the risk of osteoporosis.
• Because alcohol is a depressant, it can affect your mood and how well you sleep. You might want to try drinking less often to see if it makes a difference to how you feel.
• Bad news for coffee lovers, but lots of people find that cutting down on caffeine or switching to decaf can help with menopause symptoms. Caffeine can cause heart palpitations and bring on hot flushes, plus it can irritate your bladder and exacerbate incontinence. 
• Making time for self-care can be a game-changer for your mood and your sense of self. Self-care doesn’t have to be anything too fancy and it looks different for everyone - it could be reading a book to watching your favourite show uninterrupted or catching up with friends. As long as you’re unwinding and genuinely enjoying yourself, you’ll feel the benefits.

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Treatments:

• Your doctor might recommend hormone replacement therapy (HRT) which replaces your oestrogen levels to help you feel more balanced. 
• HRT isn’t for everyone, so there are non hormonal medications that your GP can suggest too. 
• Talking therapy, including cognitive behavioural therapy (CBT) can be really helpful during perimenopause. CBT teaches you to recognise and change unhelpful thought and behaviour patterns. It can help you to manage your mood and your mental health, reducing anxiety and stress, so that you feel more in control of your emotions. At ieso, we offer typed CBT via our secure online platform. Our service is confidential and flexible with appointment times that fit around you. Refer yourself here. 

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Resources: 

Learning about perimenopause and its symptoms can help you to feel more in control of your experience, and talking to people who are going through the same thing can help you to feel supported, so we’d recommend doing both! Here are some resources and organisations to check out:

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• The British Menopause Society
• The Menopause Charity
• The Daisy Network for women who experience premature menopause
• Menopause Cafe for meet-ups to discuss menopause
• Queermenopause for people who identify LGBTQ+