Why does perimenopause make me anxious?

How to manage Perimenopause by Caring for Your Mind and Body.

There comes a point in many women’s lives when things start to feel… different. Your body doesn’t quite respond the way it used to. Your moods shift unexpectedly. Sleep becomes lighter, anxiety louder, memory a little foggier. You might find yourself asking, “Is this just stress, or is something changing?”

For many of us, this is perimenopause.

Perimenopause isn’t a single moment - it’s a transition. And transitions, especially ones we weren’t taught how to navigate, can feel unsettling. What I want to share here isn’t about “fixing” yourself. It’s about understanding what’s happening and learning how to support your body and mind with kindness, consistency, and sustainable choices. Our body and mind are in constant conversation with one another. This means that improving mental health isn’t only about working with our thoughts; it’s also about how we care for our bodies and what we nourish them with.

Alcohol: The Quiet Disruptor

The body and mind are deeply connected. So while I will talk about improving mental health through a cognitive lens and how to develop a healthier mind, I also want to look at what we fuel our bodies with—because this plays a vital role in how we think, feel, and cope. And I’m going to start with one topic that often raises an eyebrow… yes, alcohol.

For a long time, I didn’t question it. Alcohol was normal, social, and even comforting at times. What I didn’t realise, however, was how significantly it was affecting both my body and my mental wellbeing—especially during perimenopause. One of the most eye-opening things I learned was that alcohol actually slows down your metabolism. This means that not only are you consuming a calorie-dense drink, but your body also prioritises processing the alcohol over burning fat or supporting energy balance.

Understanding this helped me reframe my relationship with alcohol. It wasn’t about willpower or self-control—it was about biology. Learning how alcohol impacts the body allowed me to make more compassionate and informed choices rather than blaming myself.

A podcast that really helped me understand this more clearly was Nutrition Science Bites with Professor Clare Collins AO, which explains these processes in a grounded and accessible way.

Healing the Gut, Supporting the Mind

What we eat doesn’t just fuel our bodies - it feeds our hormones, our gut, and our brain.

During perimenopause, gut health becomes especially important. A diet that includes probiotic-rich foods can help reduce inflammation, improve digestion, and support mood regulation. Foods like natural yoghurt, kefir, sauerkraut, kimchi, miso, and fermented vegetables gently nourish the gut microbiome, which plays a direct role in anxiety, depression, and cognitive function.

This doesn’t mean following a rigid or trendy diet. Sustainability matters. Think:

·       Whole foods over ultra-processed ones

·       Fibre-rich vegetables, legumes, and grains

·       Healthy fats like olive oil, nuts, seeds, and oily fish

·       Enough protein to support muscle and hormone balance

Eating this way isn’t about perfection. It’s about creating a steady, supportive foundation that your body can rely on - especially during times of hormonal fluctuation.

Exercise That Supports, Not Punishes

Exercise during perimenopause isn’t about shrinking yourself. It’s about strengthening and stabilising.

As oestrogen levels change, we naturally lose muscle more easily and store fat differently—often around the stomach. This can be frustrating and emotionally challenging. The good news is that the right kind of exercise can make a real difference.

Strength and resistance training help:

·       Tone and maintain muscle

·       Support metabolism

·       Reduce abdominal fat over time

·       Improve posture and body confidence

Gentle core work, Pilates, yoga, and functional strength exercises can be particularly effective for supporting the stomach area without stressing the nervous system.

Adding regular walking, stretching, or low-impact cardio also helps regulate mood and reduce anxiety. Movement becomes a form of self-care—not something to “burn off” food or emotions, but something that brings you back into your body. Think of your exercise as medicine for the mind.

If you’d like to explore the science behind this, this research shows that mind-body exercises such as yoga, Pilates, tai chi, qigong, and mindfulness can support bone health, improve sleep, and reduce anxiety, depression, and fatigue during perimenopause and menopause. Effects of mind-body exercise on perimenopausal and postmenopausal women: a systematic review and meta-analysis.

The Mind Follows the Body

One of the most overlooked aspects of perimenopause is how deeply physical changes affect mental health.

Low mood, anxiety, and memory issues are not personal failings. They are often the result of hormonal shifts, disrupted sleep, inflammation, and nervous system overload. When you reduce alcohol, nourish your gut, and move your body with intention, you create the conditions for mental clarity to return.

Many women notice:

·       Less intrusive anxiety

·       Improved mood stability

·       Sharper memory and focus

·       A stronger sense of emotional resilience

This isn’t about becoming “your old self” again. It’s about becoming a more supported, more attuned version of who you are now.

A Gentler Way Forward

Perimenopause asks us to slow down, listen more closely, and care more deeply for ourselves. It invites us to let go of habits that no longer serve us and replace them with routines that restore balance.

You don’t have to do everything at once. Small changes—less alcohol, more nourishing food, gentler movement—add up. And most importantly, you don’t have to navigate this alone or in silence.

This phase of life can be a turning point. Not just a challenge to endure, but an opportunity to build a healthier relationship with your body and mind—one rooted in compassion, understanding, and long-term wellbeing.

You deserve to feel well. And it’s never too late to begin supporting yourself in ways that truly matter.