Tending Our Fire: A newsletter on the psychological impact of perimenopause and menopause
Psychological Impact of Perimenopause and Menopause
As a licensed psychotherapist, I write about the psychological impact of perimenopause and menopause, including anxiety, mood swings, brain fog, rage, and the disorienting sense of not feeling like yourself. If you want to learn more, I invite you to subscribe to my newsletter, Tending Our Fire.
As Octavia Butler once wrote, “God is Change.”
And there are few things that change those of us with a uterus more than the multi-layered process of perimenopause and menopause.
Why I Write Tending Our Fire
I am writing Tending Our Fire to address the shocking lack of helpful and accessible psychological information and resources regarding perimenopause and menopause.
Tending Our Fire fills this critical knowledge gap by connecting the impact of physiological changes on our emotional, cognitive, and visceral wellbeing for living into perimenopause and menopause and coming out the other side with more self-understanding, neuropsychological-resilience, compassion and life purpose.
The Gap in Perimenopause and Menopause Education
A 2023 peer-reviewed survey of 829 postmenopausal women, published in Post Reproductive Health, found that 94% had never been taught about menopause at school and 49% did not feel informed at all. More than 60% began looking for information only once their symptoms had started. This underscores the need for effective psychological education and resources for the turbulence that comes with this natural life experience.
Perimenopause and menopause have long been taboo subjects. Women have suffered the physiological and psychological pains of this transition in silence. Over the past several years mainstream media and the publishing world have begun to bring more attention to perimenopause and menopause, and the emphasis has importantly been on treating and managing physical symptoms, necessary diet and lifestyle changes, the role of estrogen in midlife health, and improving sexual health–but the breadth and depth of the psychological fallout remains largely a footnote.
Tending Our Fire seeks to break the silence around the profound impact this multi-year journey has on women’s mental health and brings the discussion into the open for the benefit of everyone going through it, their loved ones who are impacted, and to inform culture-at-large.
Why Subscribe to Tending Our Fire?
If you are struggling to understand what in the world is happening to your sense of self, your relationships, and your life purpose as you grapple with perimenopause and menopause, please consider subscribing to Tending Our Fire, my newsletter on perimenopause mental health. Often we need to face old ways of relating to ourselves and others that no longer work for us including codependent patterns, how comfortable we are with intimacy, and childhood trauma.
Tending Our Fire is an exploratory space to learn ways to be with the potent psychological state of change that comes with perimenopause and menopause. To be in relationship with this many-moons process we will look at how we meet change and how we tend to our life force—our inner fire. This experiential newsletter focuses not only on the psychological impact of peri-menopause, but also offers resources that build a robust inner anchorage for our odyssey into sacred maturity.
Perimenopause and Menopause Mental Health Topics I Cover
Tending Our Fire opens us to the intimacy and vulnerability of this time and how to live into new questions about who we are.
I focus on a number of themes including:
The neuropsychology of change
Shifts in self-trust and self-esteem
Perimenopause rage, anger, and grief
Body-image and sensuality
Relationship conflict and how to talk about change with loved ones
Cultural messages around aging
The intention of Tending Our Fire is to bring you into dialogue with your becoming and to offer practices that buttress and enliven you as you transform.
Frequently Asked Questions About the Psychological Impact of Perimenopause and Menopause
If you are wondering whether what you are feeling is connected to perimenopause or menopause, here is some research that might help. The research on the psychological side of this transition is still growing.
What is the psychological impact of perimenopause and menopause?
Perimenopause and menopause can touch our mood, anxiety, irritability, memory, and concentration. Not every woman experiences distress, but research suggests the transition can increase vulnerability for some of us. Sleep, hot flashes, earlier mental health history, and life stress all play a part, which is why this transition looks different from one person to the next. What this time means for our sense of self and who we are as our bodies and energy change, is the heart of my newsletter, Tending Our Fire.
Can perimenopause cause anxiety?
For some of us, yes. In the Study of Women’s Health Across the Nation (SWAN), women who began with low anxiety were more likely to report high anxiety during perimenopause and after menopause than before the transition, with odds roughly 1.6 times higher. Women who already lived with high anxiety tended to stay high across every stage.
Can perimenopause cause depression and mood swings?
It can raise the risk of depression for some women. Researchers have studied depressive symptoms and irritability more often than “mood swings” as such, so that is where the evidence is strongest. In the Harvard Study of Moods and Cycles, 460 women with no history of major depression were followed over time. New-onset major depression occurred in 16.6% of those who entered the menopausal transition, compared with 9.5% of those who had not.
Is perimenopause rage real?
“Menopause rage” is a popular phrase rather than a clinical diagnosis. In the Seattle Midlife Women’s Health Study, irritability, impatience, and feeling out of control were more severe in the early menopause transition. Anger and irritability were also higher in the days before menstruation. The findings have limits. Most participants were white, partnered, and employed, and the study mostly included women who were still having menstrual cycles, so it cannot tell us about later stages.
What causes brain fog in perimenopause, and does it go away?
If you have been losing words, walking into a room and forgetting why, or struggling to concentrate, you are not imagining it. In SWAN’s cognitive study (Greendale et al., Neurology, 2009), 2,362 women aged 42 to 52 were tested over four years. Verbal memory scores improved with repeated testing before and after menopause but not during early or late perimenopause, and learning returned to premenopausal levels after menopause. The authors concluded that these difficulties may be time-limited.
Working Together
If you are curious to explore how perimenopause and menopause are affecting you psychologically, you can learn how I work with clients going through this multi-year journey. I can be reached at 415.721.3355 or by email to discuss how we can work together. You can also read more about my approach to therapy.
Fiona Brandon, MPS, MA, LMFT is a licensed psychotherapist in private practice in Noe Valley, San Francisco, specializing in contemplative and somatic psychotherapy, attachment, and the nervous system patterns that shape how we relate to others. She serves as core faculty at the Nalanda Institute for Contemplative Science.