Perimenopause and Grief: Navigating Loss While Your Body Is Changing
Grief and perimenopause share many symptoms: exhaustion, brain fog, disrupted sleep, and emotional volatility. Here is how to navigate both with self-compassion.
When Grief and Hormones Look the Same
Grief and perimenopause share a striking number of symptoms. Both can cause profound exhaustion, disrupted sleep, difficulty concentrating, emotional unpredictability, and withdrawal from everyday life. When you are experiencing both at the same time, it can become genuinely difficult to know what is driving what. You might grieve more intensely because your hormones are making emotional regulation harder. Or your perimenopause symptoms might be mistaken for prolonged bereavement by the people around you, and by yourself. This overlap is not something to worry about in itself. Recognising it is the first step to responding appropriately to both.
The HPA Axis Under Grief Stress
Grief is a major stressor, and the body responds to it through the HPA axis, the hypothalamic-pituitary-adrenal system that regulates cortisol and other stress hormones. Elevated cortisol during grief compounds hormonal disruption. In perimenopause, the hypothalamus is already receiving inconsistent hormonal signals from the ovaries. Adding the cortisol load of grief can worsen hot flashes, increase anxiety, and further disrupt sleep and mood. This does not mean you should try to suppress grief. It means your body needs extra support during this period, and managing cortisol through sleep, movement, and social connection is genuinely physiologically useful.
Giving Yourself Permission Not to Distinguish
One pressure women in this situation often describe is the pressure to categorise what they are feeling. Is this grief or is it hormones? This question can become exhausting and counterproductive. You are allowed to simply be having a hard time without needing to attribute every difficult moment to a specific cause. The experience of loss is real. The experience of hormonal change is also real. Both deserve acknowledgment. Self-compassion, the practice of treating yourself with the same kindness you would offer a friend in the same situation, is one of the few responses that works for both at once.
Practical Support for Both
Some approaches support wellbeing during both grief and perimenopause simultaneously. Consistent sleep routines help both hormonal regulation and grief processing. Gentle physical movement, even short walks, supports mood and sleep. Avoiding alcohol reduces sleep disruption and emotional fragility. Maintaining social connection, even when it feels like effort, protects against isolation. Eating regularly stabilises blood sugar, which matters when both hormones and grief can destabilise mood. These are not cures for either grief or perimenopause. They are the foundations that make both more survivable.
When to Seek Professional Support
There is no universal timeline for grief, and there is no point at which experiencing loss stops being appropriate. However, if you find that you cannot function at work or at home, that your sleep has been severely disrupted for several weeks, that you feel you are not safe, or that you have no capacity to experience any positive emotion, these are signs that professional support is warranted. A GP can help assess whether hormonal treatment might relieve the perimenopause layer of what you are experiencing. A therapist or grief counsellor can help with the emotional work. You do not have to choose between addressing the two.
Tracking as a Tool for Clarity
When you are in the middle of grief and hormonal change simultaneously, the picture can feel entirely chaotic. Tracking symptoms consistently over weeks and months can introduce some order. PeriPlan lets you log symptoms and track patterns over time, which can help you see whether symptoms have a cyclical hormonal quality or whether they are more constant, which is more typical of grief alone. It can also help you notice improvements that are easy to miss when each day feels difficult. Bringing this record to a doctor or therapist gives them more to work with and gives you more agency in your care.
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