Perimenopause is having a moment. Whether it is celebrities speaking about their experiences or doctors taking to Instagram to share information, mainstream media is starting to pay attention to perimenopause. While it’s encouraging to see more open discussion, the critical conversation around how perimenopausal symptoms affect parenting is often absent.
Understanding Perimenopause
Even with the recent surge in media coverage, there is a significant knowledge gap with less than 20% of women having heard of perimenopause or the associated symptoms. So let’s start with the basics. Perimenopause is not a singular event; rather, it describes hormonal shifts and body changes leading up to menopause (defined as one year without a menstrual cycle). Estrogen and progesterone levels decline erratically, and testosterone decreases, producing a variety of symptoms that impact the whole body. The most common physical indicators are vasomotor symptoms, such as hot flashes and night sweats. There are emotional symptoms and psychological concerns too, such as mood swings, anxiety, irritability and brain fog.
The Perimenopausal Parent
While the onset of perimenopause varies, symptoms typically emerge in one’s 40s. Unsurprisingly, perimenopause very much intersects with a decade in which many women are parenting. Parenting is demanding, whether navigating the physical needs of young children, or the emotional or logistical demands of older children, parenting through perimenopause symptoms can be a challenge. For example, symptoms such as fatigue or sleep disturbance can make any parenting task more difficult. Mood swings and irritability can impact parent-child interactions and parental patience, and cognitive changes such as brain fog or poor concentration can impact the organization required to navigate parenting logistics.
This was the case for “Gwen,” a 42-year-old married woman with two children under the age of four, who sought treatment at our practice due to recent changes in her mood. She reported feeling exhausted and irritable and noted that her mood was affecting her interactions with her children. Before working with our team, she hadn’t considered that perimenopause could be a factor in her mood changes. We referred her to a knowledgeable physician and cocreated a treatment plan specifically for her that addressed the physical and psychological symptoms she was experiencing.
Perimenopause at Different Parenting Stages
As the onset of perimenopause symptoms vary, many parents find themselves navigating symptoms at different stages of their child’s development. For example, we’ve worked with many patients who find themselves marching into perimenopause shortly after having children. In addition to the identity shift that comes with entering perimenopause, caring for young children is difficult if your sleep is disrupted and your energy is low. We’ve also worked with parents navigating symptoms when their children are entering adolescence and experiencing their own hormonal shifts. Parenting tweens/teens through mood swings and volatility is challenging enough but can be harder when one’s mood is shaky or reactive. “Holly,” a 45-year-old patient in our practice, struggled with parenting her 11-year-old twins who were starting puberty just as her perimenopause symptoms began. Addressing her symptoms was a crucial part of helping her improve her relationship with her daughters.
Avenues for Support
Thankfully, there are multiple avenues for support to help manage the symptoms of perimenopause. We always recommend our patients consult with a physician trained in menopause management, or better yet, who is a Certified Menopause Practitioner. Treatment options include medication, lifestyle modification, exercise, mental health support and nutritional guidance. Psychoeducation is also crucial and helps our patients better understand their experiences. Making time for self-care is a key part of symptom management and a great way to model healthy boundaries. Lastly, communication with your support network can be very helpful in making sure your needs are met. Ultimately, if you can address your symptoms and get the support you need, navigating your role as a parent is much easier and much more enjoyable.
The landscape of perimenopause/menopause care is changing, with more and more doctors seeking training, women speaking out and awareness increasing. This makes a huge difference in the lived experience of perimenopausal women. We encourage you to get educated and be your own advocate. Organizations such as The Menopause Society and books like The New Menopause: Navigating Your Path Through Hormonal Change with Purpose, Power, and Facts by Mary Claire Haver; MD; The Menopause Brain by Lisa Mosconi, Ph.D.; and The Menopause Manifesto by Dr. Jen Gunter are great places to start.
Dr. Emma Basch is a licensed clinical psychologist based in Washington, D.C. She is the founder and director of Dr. Emma Basch & Associates, a group practice specializing in the mental health needs of women and families. She is a board member of the DC Metro Perinatal Mental Health Collaborative and of Postpartum Support International’s D.C. Chapter, and she teaches and writes frequently about perinatal and reproductive mental health. Caren Ann Appel is a licensed psychotherapist at Dr. Emma Basch & Associates and focuses on late-diagnosed, neurodivergent female-identifying individuals, helping them better navigate their brains and environs. She is a certified complex trauma professional as well as being certified in ADHD assessment and treatment. Appel also has extensive training and experience working with LGBTQ+ people and their families.
