perimenopause · menopause
Therapy for Perimenopause in Lakewood Ranch, FL
Perimenopause · Menopause Support
feel like yourself again
It changes everything.
the women of seaside
None of the symptoms seemed big enough to talk about.
But now, all of them are adding up.
The women who come to Seaside are in their 30s through midlife — most live on the Gulf Coast of Florida, including Lakewood Ranch, Bradenton, and Sarasota.
You remember the birthdays, the refills, and the forms that are due on Friday. People have described you as organized and put together. Until recently, that was true.
Then you lost a word in the middle of a sentence. You reread the same email three times and still couldn't tell anyone what it said. You snapped at someone who didn't deserve it and thought about it all afternoon. You woke up at three in the morning with your heart beating rapidly.
Most of the women I see have spent time wondering if these changes were caused by heightened stress, their job, or their age. Very few walked in certain that this is perimenopause.
For many women, perimenopause arrives tangled up with anxiety, or in the middle of a life transition, and it's hard to tell which one you're actually in.
THE HATS YOU WEAR
The Invisible Load Women Carry in Perimenopause
You wear a lot of hats: someone's wife, someone's mom, someone's daughter. The one who runs the house. The one people count on at work.
You coordinate all of the appointments, get the kids to school, complete the work project ahead of schedule, and still come home and make dinner for the entire family.
What catches women off guard is that job runs on memory. On patience. On sleep. On anticipating what's needed before anyone thinks to ask for it, and keeping six tabs open in the spreadsheet you run in your head.
Those are the tasks that get more difficult during perimenopause. The load doesn't get any lighter, but you have less emotional and physical bandwidth to carry it.
i don’t feel like myself
What Is Perimenopause?
Your emotional bandwidth narrows. Your patience, with others and with yourself, changes. Your nervous system has less of a buffer than it used to.
You may find yourself missing the woman who had more energy, more patience, and a sharper memory. So many symptoms of perimenopause go unspoken, but they don’t have to. There can be relief in learning how all of this is connected.
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This can look like heightened anxiety, irritability, or significant changes in your mood that impact your daily routine and your relationships.
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It often presents as brain fog — ordinary tasks take longer than normal.
In your nervous system, it can feel like being "wired but tired," with less tolerance for noise.
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It is often interrupted sleep, increase in fatigue, and changes in desire.
The physical side of this will be addressed by your physician — the emotional side of this is what we work through together.
your 30s
It Rarely Starts With Hot Flashes
This transition begins earlier than most women expect.
Perimenopause in Your 30s
In a recent study conducted by UVA Health and the women's health app Flo, more than half of women between the ages of 30 and 35 were already experiencing moderate to severe symptoms associated with perimenopause on the Menopause Rating Scale.
At this age, perimenopause looks like elevated anxiety, trouble sleeping through the night, and feeling more irritable than you used to. Many women do not connect it to perimenopause this early. Most assume it is stress or a temporary change in their hormones.
This is the decade where reaching out for help changes things the most.
your 40s
Perimenopause in Your 40s
This is when the emotional symptoms peak. In the same study, women ages 41 to 45 reported the highest levels of anxiety, low mood, and irritability — well before the physical symptoms of perimenopause.
Cycles often begin changing during this time, becoming shorter before they get longer. Brain fog, along with word-finding difficulty and struggles with memory, tend to be more apparent now as well.
It is also the decade when everything else in your life is changing. Children become teenagers. Parents are aging and may need your help more often. Your career is more demanding. Your marriage may need attention it has not had in a while.
Most of the women I work with are in this decade. They are managing everything. Therapy at this stage is about having one hour where you are not the person holding everything together for everyone else.
your 50s
Perimenopause and Menopause in Your 50s
The symptoms that most women associate with this stage in midlife finally arrive. That same research study found hot flashes and night sweats peaked between the ages of 51 and 55.
Menopause itself is a single point in time — the day you have completed twelve consecutive months without a period. On average, this happens around age 51. Everything leading up to it is perimenopause, and everything after it is postmenopause.
Support can span perimenopause, menopause, and postmenopause. It is never too early to reach out, and it is never too late. Anxiety, low mood, and brain fog do not always resolve the moment the hot flashes do. The emotional symptoms become something you are working through rather than something you are waiting out.
sessions at seaside
How Therapy for Perimenopause Works
We start with what your everyday actually looks like and how hormonal changes are affecting your mood, sleep, and concentration.
We spend time on your thoughts — the belief that you should be handling this better, or that everyone else manages just fine. Self-care is usually the first thing to go and it's often what helps the most. We’ll focus on getting some of it back — sleep, movement, and time that belongs to you.
There is often grief in this process too. You may be missing the energy, the memory, or the version of yourself you used to be.
Over time, things change. You begin to recognize your own patterns. Saying no gets easier. Rest starts to actually feel like it restores you again.
let’s work together
The Seaside Approach to Perimenopause and Menopause
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What is happening in your body and what is happening in your mood are connected.
The mind-body connection recognizes that the emotional and physical symptoms influence one another. Perimenopause highlights this connection.
A night of broken sleep lowers your threshold for everything the next day. A hot flash during a meeting can bring a wave of self-consciousness that outlasts the flash itself. In session, we work on recognizing those physical signals early, so you can respond to what is happening rather than being caught off guard by a mood you cannot explain.
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CBT looks at how your thoughts shape how you feel and what you do next.
During perimenopause, we use CBT for heightened anxiety, irritability, low mood, and depression.
We identify and process the self-blame. “You should have this figured out by now.” “Everyone else seems to be handling it better.”
Sleep is often the first thing to be negatively impacted. CBT-I is a version of CBT developed specifically for insomnia. It is widely recommended for chronic sleep problems. We look at what is keeping you awake, what you do when you cannot sleep, and the routines that have built up around it.
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A strength-based approach starts with what is already working.
Most women arrive to therapy able to describe what is wrong in detail and unable to name things they are doing well.
We correct that. We identify the coping skills, the judgment, and the resilience you have already built, and we use them as the foundation for the work we do together.
You have made it through every other change in your life.
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Solution-focused therapy concentrates on the next step.
It's short-term and goal-directed. We focus on what you want to change and where to start.
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An integrative approach combines methods from more than one therapeutic model.
Integrative therapy means drawing from several established therapeutic approaches and fitting them together into one plan just for you.
This has been effective with the women I see. They are dealing with sleep, mood, work, and relationships, often in the same week. One method has not been effective for every situation.
In practice: CBT for the anxiety and the sleep, mind-body work for the physical symptoms, solution-focused work for when you need to make a decision.
Frequently asked questions about perimenopause
FAQs
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Yes. Many women are surprised to learn that the earliest signs can begin in the mid-to-late 30s, often years before any physical symptoms appear.
In a study of more than 4,400 women conducted by UVA Health and the health app Flo, more than half of women aged 30 to 35 already reported moderate to severe symptoms associated with this transition.
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Yes. The Study of Women's Health Across the Nation followed nearly 3,000 women for ten years and found that women who had low anxiety to begin with were significantly more likely to report high anxiety during perimenopause.
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It is often both.
The same SWAN research found that significant depressive symptoms were roughly one and a half to two times higher during perimenopause than before it.
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Perimenopause rage is the term many women use for anger that feels out of proportion to what set it off, and is often followed by guilt.
Irritability is one of the four symptoms researchers grouped together when they studied anxiety across the menopause transition.
In therapy we identify the contributing factors, which often include sleep disruption, sustained stress, an overextended schedule, and long-standing resentment that has not been expressed.
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Yes. In 2024 the United Kingdom's National Institute for Health and Care Excellence updated its clinical guideline on menopause to recommend cognitive behavioral therapy for vasomotor symptoms such as hot flashes and night sweats, along with depressive symptoms and sleep disturbance.
The guideline suggests CBT as an option alongside hormone therapy, or as an alternative for women for whom hormone therapy is contraindicated or not preferred.
Therapy is a recommended treatment for these symptoms, not a substitute used when medical treatment is unavailable.
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find joy in the in-between
Let’s Dive In.
So much of life happens in the in-between.
I would be honored to help you find more balance there — and maybe even some joy. Even on the days it's hard to see.
