Perimenopause and Menopause

When your mood, sleep and relationships change in midlife, and you don’t feel like yourself

Part of The ShieldMee Guide: Depression →

“I don’t recognize myself anymore.”

“I used to handle everything. Now I cry over nothing, or I snap.”

“I’m exhausted, but I can’t sleep.”

“My husband thinks I’m angry at him. I don’t know what I am.”

If you’re in your 40s or early 50s and you feel like someone changed the settings on you, you may be right.

Perimenopause can affect much more than your periods.

What perimenopause is

Perimenopause is the time leading up to menopause. Hormone levels rise and fall in uneven ways.

It often starts in your 40s, sometimes earlier. It can last several years.

Menopause is when you’ve gone a full year without a period.

Common changes include hot flashes, night sweats, poor sleep, irregular periods, brain fog, lower sex drive, and changes in mood.

The mood part nobody warned you about

Many women notice more anxiety, irritability, sadness or tearfulness during perimenopause.

Research shows the risk of depression goes up during this time, even for women who never had depression before.

Poor sleep makes all of it worse.

This isn’t you being dramatic. It isn’t a character flaw. Your body is going through a real change, and so is your mind.

If you’ve had thoughts of not wanting to be here, please call or text 988 today. You don’t have to wait for an appointment.

Working with your doctor

Some of what you’re feeling may be helped by medical care, like hormone therapy or other medicines. That’s a decision for you and your doctor.

I don’t prescribe. With your permission, I’m glad to coordinate with your OB-GYN, primary care doctor or menopause specialist.

See your doctor soon for very heavy bleeding, bleeding after menopause, or new chest pain or a racing heart. Those need a medical check.

If sleep is your main problem, a doctor or sleep specialist may be the best first step.

What therapy can help with

• Anxiety, low mood and irritability
• Feeling like you’ve lost who you were
• Big life changes that often land at the same time: kids leaving, aging parents, career shifts
• Body changes and how you feel about them
• Changes in desire and intimacy
• Strain in your marriage or family

Perimenopause and your relationship

Many couples feel this time without having words for it.

You may want less sex, or feel different about touch. You may have less patience. You may need more help and not know how to ask.

Your partner may take it personally. They may pull back, or push harder.

In couples sessions, I listen for the sentences you keep trading. “You’re always angry.” “You never notice how tired I am.” They show where the two of you lost each other.

Then we work on talking about what’s really changing, so it stops feeling like a fight.

If arguments ever turn into threats, pushing or one partner controlling the other, call the National Domestic Violence Hotline at 1-800-799-7233. It’s free and open 24/7.

How I work

I look at the whole picture: your body, your sleep, your work, your marriage, your family.

I also pay attention to how you talk about yourself right now. Words like “useless,” “crazy” or “old” tell me a lot about how heavy this feels.

Who this work is for

• Women in Florida going through perimenopause or menopause
• People whose mood, anxiety or sense of self has changed in midlife
• Couples feeling the strain of these changes
• People who want therapy alongside medical care
• Spanish-speaking or bilingual adults

You don’t need lab results or a diagnosis to start.

Who this isn’t for

I work with adults. If you are under 18, this page is not describing services for you.

If you are in immediate danger or thinking about suicide, call or text 988 for the Suicide & Crisis Lifeline.

I don’t treat pregnancy or postpartum concerns. If that’s what you’re facing, I’ll help you find a specialist.

Sessions must take place while you are physically located in Florida.

Frequently asked questions

How do I know if it’s perimenopause or something else?

Your doctor is the best person to check the medical side. In therapy, we focus on how you’re feeling and coping, whatever the cause.

Do you prescribe hormones or medication?

No. I’ll coordinate with your doctor if you’d like, so your care fits together.

Can my partner come too?

Yes. I see individuals, couples and families. Whether couples sessions are covered depends on your insurance plan. You’ll see your estimated cost on my Headway page before you book.

Do you offer therapy in Spanish?

Yes. Sessions can be in Spanish, English, or both.

How much does therapy cost?

It depends on your insurance plan. Most clients pay a copay or coinsurance. You’ll see your estimated cost on my Headway page before you book.

Do you take insurance?

Yes. I’m in-network with Aetna, Cigna, Florida Blue, UnitedHealthcare, Oscar, and other plans through Headway. Check your coverage and book on my Headway page.

When can I start?

Appointments are generally available the next day or within the same week, every day except Saturday.

Related reading: Sexless Marriage · High-Functioning Depression · Anxiety vs. Worry