Perimenopause
You might feel like something is changing, but you cannot quite name it.
Your moods feel unpredictable. Your sleep feels lighter. Your patience feels thinner. You might even wonder if you are becoming a different person.
We want to be clear with you. You are not imagining this.
Perimenopause is a real biological transition, and many people enter it without knowing what to expect.
This article explains what perimenopause is, why it happens, and how therapy supports you through this stage with clarity and compassion.
What Is Perimenopause?
Menopause itself is marked by twelve consecutive months without a menstrual period. Perimenopause happens before that point and can last several years.
Perimenopause is the transitional phase before menopause, when hormone levels begin to fluctuate and the body slowly prepares to end reproductive cycles.
During perimenopause, oestrogen, and progesterone levels rise and fall unpredictably. These fluctuations affect the brain, nervous system, sleep, mood, and energy levels (Santoro et al., 2021).
What are the symptoms of perimenopause?
Emotional and Psychological Symptoms
Many people first notice emotional changes rather than physical ones.
Common emotional symptoms include:
- Anxiety or increased worry
- Mood swings, low mood or tearfulness
- Irritability or anger
- Reduced stress tolerance
- Brain fog or difficulty concentrating
- Insomnia
These changes are linked to how hormones interact with neurotransmitters such as serotonin and dopamine (Gordon et al., 2018).
Physical Symptoms
Perimenopause also affects the body.
Physical symptoms may include:
- Irregular periods
- Sleep disturbances
- Hot flushes or night sweats
- Fatigue
- Weight changes
- Bloating
- Headaches
- Hair and skin changes
- Vaginal dryness
- Bladder issues
Relational and Identity Changes
You may notice changes in how you relate to others.
This can include:
- Reduced patience in relationships
- Shifts in libido
- Feeling disconnected from your previous sense of self
*Symptoms vary widely. There is no single “right” perimenopause experience.
What are the causes of perimenopause?
1. Hormonal Fluctuations
Oestrogen and progesterone levels fluctuate rather than decline steadily, which explains why symptoms feel unpredictable.
2. Nervous System Sensitivity
Hormonal changes affect how your nervous system responds to stress. This can amplify emotional reactions and reduce emotional resilience.
3. Life Stage Stressors
Perimenopause often overlaps with demanding life stages.
These may include:
- Career pressure
- Caregiving responsibilities
- Relationship changes
- Health concerns
These changes can intensify symptoms and emotional strain.
Why is it important to understand perimenopause?
1. Reducing Self-Blame
Many people internalise perimenopausal symptoms as personal failure.
Understanding perimenopause helps you recognise that:
- Mood changes are biological, not character flaws
- Fatigue is not laziness
- Emotional sensitivity has physiological basis
2. Improving Early Support
Early understanding allows you to seek support sooner rather than normalising distress for years.
3. Supporting Long-Term Wellbeing
When left unsupported, perimenopause can increase vulnerability to anxiety and depression (Soares & Zitek, 2008)
Understanding perimenopause restores self-compassion and choice.
When To Seek Help?
You may benefit from professional support if:
- Mood changes affect daily functioning
- Anxiety or low mood feels persistent
- Sleep disruption affects your wellbeing
- Relationships feel strained or overwhelming
You do not need to wait until symptoms become severe.
How Can Us Help You?
Therapy Approaches
1. Cognitive Behavioural Therapy (CBT)
CBT helps you understand how hormonal changes interact with thoughts and behaviours.
How it works:
You learn to identify unhelpful thinking patterns, manage anxiety, and build coping strategies for sleep, mood and stress.
Benefits:
- Reduces anxiety and low mood
- Improves emotional regulation
- Builds confidence during change
CBT is evidence-based for perimenopausal mood symptoms (Hunter & Smith, 2015).
2. Psychotherapy
Psychotherapy focuses on emotional processing and identity shifts
How it works:
You explore emotional responses, life transitions, and relational patterns in a supportive space.
Benefits:
- Supports identity adjustment
- Processes grief and life changes
- Strengthens emotional resilience
3. Acceptance and Commitment Therapy (ACT)
ACT helps you respond differently to difficult internal experiences.
How it works:
You learn to accept emotional discomfort while reconnecting with values and meaning
Benefits:
- Reduces emotional struggle
- Builds psychological flexibility
- Supports purposeful living
Our Therapists
What To Expect
Initial Consultation – A Space to Be Heard
The first session is all about getting to know you. It is a conversation—one where you can share what is been on your mind, what has been feeling difficult, and what you would like support with. Your therapist will ask questions about your background, experiences, and goals, but there is no pressure to answer any questions—just a safe space to begin.
Questionnaires & Onboarding Surveys – Understanding the Full Picture
To help tailor therapy to your needs, you may be asked to fill out some brief questionnaires before or after your first session. These can give insight into things like mood, stress levels, relationship patterns, or coping strategies. They are not tests—just tools to help your therapist understand how best to support you.
Individual Therapy Sessions – Your Journey at Your Own Pace
Each session is a step forward in your journey. Therapy is not just about talking—it is about discovering new ways to navigate life’s challenges, make sense of emotions, and feel like you are getting the most out of your life. Depending on your needs, sessions may focus on:
- Exploring patterns of thought and behavior
- Understanding past experiences and their impact on the present
- Developing practical coping tools
- Strengthening emotional resilience
Feedback Sessions – Reflecting and Adjusting
After the first few sessions (or after assessments), a feedback session provides space to reflect on how therapy is going. This is a chance to talk about what has been helpful, what you would like more of, and how therapy can continue to best serve you.
Intervention – The Heart of Therapy
Intervention is where meaningful change happens. Every therapy journey is unique, and the approach will be shaped around what works best for you. Some common approaches include:
🌱 Cognitive Behavioral Therapy (CBT) – Helping to identify and shift unhelpful thought patterns, reduce anxiety, and develop healthier ways to cope and new patterns of behaviour.
🧠 Schema Therapy – Deep, transformational work to uncover long-standing patterns that might be keeping you stuck, often rooted in early life experiences.
💙 Acceptance and Commitment Therapy (ACT) – Learning to handle difficult emotions with self-compassion and move towards what truly matters in life.
🌊 Eye Movement Desensitization and Reprocessing (EMDR) – A powerful approach for healing trauma and distressing memories, helping the brain reprocess them in a way that feels less overwhelming.
🧘 Mindfulness-Based Approaches – Building self-awareness, grounding techniques, and ways to manage stress and emotions with greater ease.
Fees
Individual Counselling Rates
Clinician type
Fees and Duration
Clinic Founder
$325
Principal Psychologist
$305
Senior Clinical Psychologist
$277
Clinical Psychologist
$251
Senior Counsellor
$251
Counsellor
$185
Associate Counsellor
$120
Phone calls / Emails
Clinicians rate pro-rata (10 Mins)