11 ways to survive the perimenopause

How to cope with anxiety, depression and your relationship!

Chances are, you’re here because you wonder if you’re experiencing the early symptoms of the menopause.

Very briefly, the menopause is a normal, natural phase in a woman’s life or the consequence of a medical intervention (e.g. chemotherapy or removal of the ovaries). Your ovaries are slowly producing less oestrogen. The gradual shift in hormone levels potentially causes a cascade of symptoms.

If not caused by medical intervention, it starts with the perimenopause which can begin one, two or more years before the actual menopause. This heralds the end of a woman’s childbearing years and, hooray, the end of the monthly bleeds.

It’s usually a midlife process, although for some women it starts early.

In this article, I’m aiming to help you understand what it means for you personally, your partner and your relationship. And, of course, I’ll give you tons of tips and advice on how to make it a positive experience.

Let’s start with the most common signs and symptoms. Know, though, that the experience of the (peri)menopause is a very personal one. It can be different for each individual woman.

Photo: Woman looking at a sunset. Text: Signs you've reached the (peri)menopause & 11 ways to survive it

The potential signs and symptoms of the menopause

Any or all of the following can be the first signs and symptoms of early menopause (before age 40) and the perimenopause.


See if you recognise any of the following…

1. Symptom: you’re becoming very forgetful

  • You appear to be terribly forgetful; you’re likely to have doubled-booked appointments, or not made promised arrangements for this or that. You don’t appear where you were expected or you’ll turn up where you weren’t.
  • You appear to forget what you were talking about mid-sentence
  • You seem to lose your and everybody else’s stuff.
  • You can’t remember what you were on your way to do when you’re halfway up the stairs.

2. Anxiety!

  • You may have been the most confident person before, but now you may even suffer from panic attacks.

2. Symptom: you’re having trouble concentrating

  • Your driving may not be as sharp as it used to be (maybe similar to when you were pregnant).
  • You seem to be unable to figure out how to get from A to B.

3. You’re losing your confidence

  • You’re finding it harder to make decisions and you change your mind frequently. Other people may think that you don’t appear to know what you want.
  • You have all sorts of great ideas, but you already suspect they’re probably not going to come to fruition.

4. Your feel down a lot of  the time

  • You seem to have lost your sense of humour.
  • You’re down in the dumps a lot of the time.

And if that isn’t enough…


  1. Your monthly periods become less than monthly (any other changes – visit your health clinic), or at times more often.
  2. Your body odour might have changed.
  3. Your belly looks more rounded.
  4. Your breasts are getting smaller (oh, and they can feel sore too!).
  5. You’re growing some facial hair, whilst that on your head is thinning.
  6. Your body’s expanding – even if you’re trying every diet under the sun, the menopause and weight-gain often go hand-in-hand.
  7. Your genital area may not look quite the same as you’re used to and another symptom is that it may feel less responsive (see my article about what to do when your physical relationship is non-existent).
  8. You suffer from hot flushes (flashes in US English) – breaking out in hot sweats or waking up soaking wet. You frequently throw the bedding and bedclothes off in the middle of the night. You suddenly have the urge to open doors and windows even in mid-winter.
  9. You can suffer from extreme fatigue.
  10. Sleep can be hard to come by (this could also be a mental symptom) – see my article Natural sleep remedies for help.

And we haven’t even talked about your physical relationship yet.

Pfffttt! I wouldn’t be surprised if you’ve thought a few times that you’d better see a doctor and sort yourself out.

So let me reassure you right off: most of these are temporary problems. They’re likely to be caused by normal hormonal changes.

“A lot more men should get to know more about women’s problems. It really helps to talk about it.”


What you’ll need to take into account


  • A sudden sense of insecurity
  • Often on the edge of tears
  • Really disoriented
  • Tired and listless
  • Angry with yourself
  • Generally down and at a loss (see Treating depression without medication)
  • Wound up all too often
  • Fearful of things you wouldn’t have batted an eyelid about before;
  • Frustrated with yourself if you take your unhappiness out on your partner or anyone (everyone) else.

Know that all of these symptoms are connected. Stress alone, for example, may lead to tiredness, lack of sleep and difficulty concentrating.

I strongly advise you to just have a medical checkup. If those signs and symptoms are due to the menopause, you can most likely manage them yourself. But, it’s important to first rule out any other health problems.

Why your friends’ symptoms may be more or less severe

We are all as individual as any star in the night sky.

Your DNA, medical history, diet and other lifestyle factors all play a role. Therefore, just like any other aspect in your life, comparing yourself to someone else is a waste of energy.

The good news is, though, that your psychology – your mental attitude – can make a whole lot of difference. Generally speaking, you’re likely to suffer more if you allow those (peri)menopausal symptoms to become your everyday focus.

I accept though that, of course, there are some signs and symptoms you just cannot ignore.

In any case, my advice is that you first inform yourself about the menopause (that’s why I’m chuffed you’re reading this article) before you avail yourself of medical advice.

My focus is mostly on the psychology of the transition of your childbearing years into the next stage in life, and the effect it has on your relationship.

The physical and emotional side-effects of the menopause (and perimenopause) are all too real. But they can be even harder to cope with if the two of you have already been struggling to keep your relationship or marriage afloat.

If you focus on what's behind you, how can you see what lies ahead.' -Chef Auguste Gusteau in Ratatouille

What does all this mean for your relationship or marriage?

Perhaps the two of you were already having some problems before you even became perimenopausal (see my article on common relationship problems).

The menopausal signs and symptoms then only add another complication to what middle age may already present.

You may already be dealing with elderly parents, children leaving – or coming back – home, financial worries, job dissatisfaction, a feeling of being stuck etc.

I’m pretty sure neither of you bargained for any of these kinds of mid-life issues when you first got together (unless you met later in life)!

However, here’s how your partner could potentially interpret the signs of what’s likely to be ‘the change’…

The menopause is an opportunity to (re)build your relationship or marriage and to deepen your love, admiration and respect for each other.


Your partner may have thought any of the following…

Any of these may or may not be true! In any case, the menopause is likely to play a significant role.

So, here is some advice on how to you can best approach your husband or partner…

3 Step plan with advice on how to engage your husband or partner

Your partner won’t be able to read your mind.

My advice is that you take the time to explain the above first. You could also print this page for easy reading.

Move the conversation on

Say something like:

  • “I know I’m …., but I hope you now understand a little better what’s happening.”
  • ”I wonder what’s it been like for you. Do tell me, please.” (Then listen of course, without interruption.)
  • “It would really help me if you would just…”
  • “What can I do that would help/remind you?”

Make a plan to revisit this kind of conversation.

Plan a board meeting and to discuss all that’s happening: the menopause, the kids, the grandkids, the house, the garden, the rent, the bills, the hols, whatever. Don’t wait for issues to arise – anticipate them and together work on solving them.

Your partner needs:

  • good information (share this article with him/her)
  • explanation about what it all means to you personally;
  • preparation –  when you know you’re particularly moody, just let them know and reassure them that’s it’s not about them;
  • apologies when you know you’ve lashed out for no good reason at all.


  1. Offer the start of your change as an opportunity
    You’re starting the next phase of your lives together. Okay, I accept that this may feel a little too optimistic for you. But, I’d really like you to at least consider the concept though. 
  2. Nourish your sense of humour
    – laugh at yourself whenever you can. Joke with them.
  3. Focus on the good times
    Be on the lookout for the good times between the upsets, and make the most of them together. Remind yourselves of the positives in the day before you go to sleep.
  4. Remind your partner that this will pass too
    The menopause is a process: you’ll slowly transition from the perimenopause to the menopause, postmenopause and into a new stage of life.
  5. Offer reminders without criticism
    Yep, I know that may be hard! It’s best though to just accept it: it is what it is. Be sure, though, to have their full attention when you do.
  6. Apologise
    Say you’re sorry when you know you’ve been in the wrong.
  7. React kindly to their offers of help
    When he or she suggests a fix, instead of being angry, say – kindly – something like: “Thank you for your thoughts, I really appreciate it that you care.”  You need not say anything more. “But…” may well to raise their hackles! Do also read my article on relationship communication.
  8. Ask for practical help
    whenever you need it. Your husband/partner probably cannot see what you see (however obvious it might seem to you). And again, they cannot read your mind and believe me when I say – hinting doesn’t work!
  9. Remember to be there for them too
    Be there to listen to their personal problems. Remember that your husband or partner too may go through a challenging time. Be there, to hear how they experience the change in you.
  10. Don’t be goaded to react to criticism
    And, as long as you’re sure you’re not in an abusive relationship, don’t take it personally. See it as feedback.


I suspect you wouldn’t be here if you were sailing through the menopause without any problems. I hope, though, that this article has given you not only food for thought but practical ways to help you both deal with the upheaval.

I hope too that you can see the menopause as an opportunity to say a fond farewell to a beautiful phase in your lives (I hope it was so for you, even if there were troubling times), and to look forward to the next chapter of your story together :-)

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