Perimenopause, Self-Esteem, and Your Relationships: How Therapy Can Help

Cheryl MacDonald

Perimenopause is something that’s rarely talked about and even less understood. This is the time in a woman's life BEFORE Menopause (defined as the cessation of menstruation for at least 12 months), and this is actually when most of the big changes are happening. Even more surprising? That most women over 35 are already in perimenopause, even if they don’t show significant symptoms, this coincides with a woman's drop in fertility. 


Perimenopause isn’t just about hot flashes and irregular periods. It’s a deeply personal transformation that can shake your confidence, impact your relationships, and make you question your sense of self. I know this not just as a psychotherapist but also as a yoga master, health coach, and the creator of YogaPause (and author of best-selling book by the same name)—a method I developed after years of working with women navigating this life stage.



I’ve spent over two decades guiding women through transitions, and I’m currently writing my research thesis on self-esteem and relationships in women aged 40-55. I see more clearly than ever how perimenopause can challenge our identity. The good news is that you don’t have to go through it alone. Therapy can help you navigate the changes, build your confidence and reframe what you want from life going forward.

How Getting Older Affects Your Self-Esteem


Perimenopause has a sneaky way of making us question ourselves. It stirs up emotions, shifts our bodies in ways we don’t always recognize, and brings up thoughts like: Who am I now? Do I still matter? What the hell am I going to do with my life now?

Here are some of the things that could be chipping away at your self-esteem:

1. Your Body Doesn’t Look The Same

Suddenly, the body you’ve known for decades starts to feel foreign. Weight gain, bloating, thinning hair, dry skin—these changes can make you feel very self-conscious. Many of us look in the mirror and don’t recognize ourselves, we’re self-critical and insecure.

2. Brain Fog 

Ever walked into a room and forgotten why? Or struggled to remember someone’s name mid-conversation? Perimenopause can bring cognitive shifts that leave us feeling less than sharpand doubting our abilities. When you start second-guessing yourself, your confidence takes a big hit.

3. Emotional Sensitivity and Self-Doubt

Mood swings, irritability, and feeling emotionally raw are all common. One moment, you feel fine; the next, you're in tears over an advert with an injured hedgehog. When your emotions become unpredictable, it’s easy to start doubting yourself and feeling like you’re “too much” or “not enough.”

4. Women Are Supposed To Be Young FOREVER

Society isn’t always kind to women over 40. From media to workplace biases, we get messages that our worth diminishes with age. Many women struggle with feeling invisible, less desirable, or irrelevant—especially in their careers and relationships.

This Is How Perimenopause Can Impact Your Relationships:

When our self-esteem starts to waver, our relationships feel the strain. I see this time and again in the women I work with. They tell me: I don’t feel connected to my partner anymore. I feel lonely, even when I’m surrounded by people.

Here’s some of the ways perimenopause could be affecting your relationships:

1. You’re Pulling Away From Your Partner

If you’re feeling low about yourself, it’s easy to pull away—emotionally and physically. Changes in your libido, body image worries, and mood fluctuations can lead to less intimacy and more misunderstandings.

2. Your Grumpy and Irrational

Hormonal changes can make emotions feel bigger than normal: Think PMS on Steroids. Small things that never bothered you before suddenly feel overwhelming. If you find yourself snapping at loved ones or feeling unheard, you’re not alone and it’s normal.

3. You Feel Alone In This

Many women say, No one understands what I’m going through. This feeling can lead to withdrawing from social circles, avoiding deep conversations, or even drifting away from close friends. Perimenopause is REAL and big and challenging and you need to be supported by other women who understand and can relate.

4. Changing Family Roles

At this stage of life, many of us are also dealing with our kids growing up and leaving home, ageing parents, or career transitions. All of these stressors can add to feelings of overwhelm, and lack of purpose or sense of self, making it even harder to prioritize relationships.

 

How Therapy Can Help You Figure Out Who You Are AndWhat You Want From Life 40+


Here’s something I want every woman to hear: You are not losing yourself. You are evolving.Therapy can help you navigate this transition with self-compassion, clarity, and confidence. 40+ can be the best stage of your life - you just need to approach it in the right way.

1. It Can Help You Rebuild Your Self-Esteem

Therapy helps you challenge the negative self-talk that can come with ageing. It’s about shifting the focus from what’s changing to what’s still strong within you - or better yet, what’s STRONGER. Learning to redefine beauty, value, and self-worth is an essential part of this process.

2. Understanding and Managing Your Emotions

Cognitive Behavioral Therapy (CBT), mindfulness, and breathwork can be powerful tools for managing hormonal mood swings, anxiety, and self-doubt. In my practice, I often integrate yoga and breathwork and nutrition alongside psychotherapy to help women create a mind-body connection that fosters emotional balance. A full life approach is the most effective way to move forward into this next life stage.

3. Strengthening Your Relationships

Does your marriage have a whole new range of issues? Feeling disconnected from friends? Therapy can help you identify how your self-esteem impacts your relationships and help you communicate what you need and how you’re feeling with confidence.

4. Accepting Your Changing Body

Instead of seeing physical changes as losses, therapy can help shift the narrative to self-acceptance. My YogaPause method combines gentle movement, breathwork, and mindfulness to reconnect women with their bodies in a way that feels empowering rather than defeating. Building physical strength and mental resilience are an essential part of the journey.

5. Finding a New Sense of Purpose

Perimenopause isn’t an ending—it’s also a beginning. Many women feel lost in this transition, but therapy can help them rediscover passions, set new goals, and redefine what fulfillment looks like in this next chapter. This can absolutely be the best time of your life.

You Deserve Support

Perimenopause is more than a biological transition—it’s an emotional, psychological, and deeply personal one. It can feel overwhelming, but help is available.

Therapy provides a space to rediscover yourself, strengthen your relationships, and step into this new life phase with confidence. If you’re feeling lost, struggling with self-esteem, or noticing strain in your relationships, reach out. You are not alone.

Hope and Healing Trauma : I’ve learned that hope isn’t about perfection and healing isn’t about erasing the past.

By Fitz Anugerah • September 1, 2025
When I volunteered to write this month’s note on Hope & Healing Trauma, my mind was overflowing with ideas. There’s so much to say, so many perspectives, so many lived experiences. But as I began writing, I realised I had to bring it back to basics…the simplest truth. My wish is that if you take away just one thing from this note, it’s this: At the end of hope, lies your potential. Hope is a tricky thing. It can lift you up or it can feel completely out of reach depending on where you are in your healing journey. For someone carrying the weight of trauma, hope can feel foreign, almost unrealistic. And yet, even the tiniest glimmer of it can create the spark that helps us climb out of the darkest places. I’ve been there. I’ve had to pick myself up after the heartbreak of a toxic relationship that broke down my self worth in my twenties. I’ve had to rebuild form burnout at work, restart my finances after leaving a five figure corporate job to pursue entrepreneurship and even fight through a cancer diagnosis that changed everything I thought I knew about life. Reading these words here may make them sound neat and manageable, but what’s missing are the tears, the anxiety, the worry behind the scenes. What carried me through those moments wasn’t grit or resilience alone, it was hope. Hope that the only way was up. Hope that if I kept showing up for myself, I would eventually find light on the other side. But here’s the truth: healing is not linear. It’s messy. It’s haphazard. Some days you feel like you’re making progress and other days you feel like you’re back at square one. That doesn’t mean you’re failing, it means you’re human. The true goal isn’t to avoid setbacks, but to get better at picking yourself up when they happen. For years, I lived angry; angry at relationships that hurt me, angry at an environment I didn’t feel I fit into, angry at life’s unfairness. But when I turned inward, I realised the anger wasn’t really about others. It was about me. I wasn’t showing up authentically for myself. I wasn’t giving myself permission to heal. That realisation became my tipping point. It wasn’t easy. It took years of counselling, meditation, journaling and one practice that profoundly shifted everything for me: BodyTalk . BodyTalk is a holistic healthcare system that looks at the whole person; your mind, your body and your experiences, not just your symptoms. Our bodies carry stories: traumas, emotions and unresolved memories that show up as stress, illness or pain. In BodyTalk these stories are gently uncovered and released. For me, it meant letting go of emotionally charged experiences I’d been unconsciously holding onto as my identity; stories that were taking up unnecessary space in my mind and body. When I allowed myself to release them through BodyTalk sessions, something incredible happened. I felt freer. My body felt lighter. And more importantly, my mind felt spacious again. Ready to hold, not pain, but potential. That’s where hope led me: to potential. The potential to be myself. The potential to heal. The potential to live differently, to go against the grain and be okay with it. So if you take away just one thing from this note, let it be this: hope is not about perfection and healing is not about erasing your past. Trauma doesn’t have to define you. When you stop letting it own you, you begin to uncover the space for who you are meant to be. And at the end of hope, always, lies your potential.

Hope & Healing Trauma: A Gentle Path Back to Wholeness

By Jeanette Qhek • September 1, 2025
Trauma can feel like a fracture - a sudden break in the rhythm of life. It lingers not only in our memories, but also in our bodies, our nervous systems, and the quiet ways we hold ourselves back. At first, healing can feel impossible. Hope can feel far away. And yet, again and again, I’ve witnessed that hope has a way of returning, sometimes softly, sometimes like the first crack of light after a long night. Healing from trauma is not about erasing the past, but about learning to carry it differently. It’s about reclaiming safety, connection, and trust in ourselves, one step at a time. When Trauma Stirs Old Wounds Often, what makes trauma feel so heavy is not only the event itself, but the way it awakens older wounds beneath the surface — fears of rejection, abandonment, or not being enough. These layers of pain can leave us feeling raw, isolated, and unsure of who we are without the identities or roles we once clung to. I remember this in my own journey. When life shifted suddenly and a physical skin illness pulled me away from the familiar roles and anchors of career and identity, it felt like everything I had built myself upon crumbled. On the surface, it may have looked like “just” a physical setback, but beneath it stirred deeper fears I had carried for years — the fear that without my achievements or image, I would not be enough. Like many people, I had learned to protect myself through identities: the achiever, the perfectionist, the one who blends in. These strategies helped me survive, but they also muted the most authentic parts of me. And yet, in the collapse of those identities, something unexpected happened: what felt like an ending became the beginning of something deeper. It wasn’t only a trauma healing journey — it became a path of rediscovery of myself. The Role of Hope Hope rarely arrives in dramatic ways. More often, it appears in small, almost ordinary moments. For me, it came in glimmers: Sitting quietly and realizing I could breathe again. Starting a small creative project during one of the darkest seasons of my life, just to make sense of what I was going through. Discovering the simple joy of being in nature, or feeling my body soften in therapy when I felt truly seen. The gentle presence of my therapist, who reminded me that I wasn’t broken. These moments didn’t erase the pain, but they reminded me that maybe things didn’t have to stay that way forever. Hope didn’t come as a single breakthrough; it came as tiny openings, each one widening my capacity to see possibility. And this is often how hope works. It doesn’t always arrive as a grand transformation, but as soft reminders that healing is possible. Step by step, we begin to reclaim the parts of ourselves that have been muted — the playful child who wanted to create, the intuitive self who sensed more than what could be “proven”, the tender parts of me that longs for connection without performance or perfection. What looks like collapse may, in truth, be initiation — a cracking open that makes space for authenticity. What Helps Us Heal Through my lived experience and my work as a psychotherapist, I’ve learned that healing is both universal and deeply personal. Safety comes first. Healing happens when there is enough safety — with ourselves, with others, or in a therapeutic space. The body remembers. Trauma imprints itself into the nervous system, which may keep responding as if the danger is still present. Healing means teaching the body it is safe again, so we can reconnect with who we truly are. Connection heals. True healing often comes when we allow ourselves to be seen, not hidden. Self-trust grows slowly. Over time, we can learn to trust our inner wisdom — discovering that love, acceptance, and authenticity flow naturally from it. Hope as a Practice Healing trauma doesn’t mean forgetting the past. It means weaving it into the tapestry of who we are — not as the whole story, but as one chapter. For me, hope has become a practice of unmuting — expressing myself more fully, even when it feels scary. It’s about remembering that being seen isn’t dangerous. It’s deeply healing. Hope whispers that our story isn’t finished. That we are more than what happened to us. That the same energy once used to survive can also be used to create, to love, and to thrive. Even on hard days, hope reminds us: you are not broken — you are becoming.

How Mealtime and Young Mental Health is Connected

By Claudia Correia • July 30, 2025
Do you prioritise family mealtime? In today’s fast-paced environment, where everyone often feels pulled in different directions, family meals can be easily dismissed and missed. Family meals can be truly magical; besides nourishing, they pull families into unity and support mental, physical and emotional health. The benefits span across all age groups. In teenagers specifically, a large body of research shows that families who have meals together show: • Better school performance, with a higher likelihood of achieving A’s, is in school. • Lower the risk of teenage behaviours such as smoking, substance abuse, eating disorders, teenage pregnancy and violence. • Lower risk for depression and anxiety, and higher self-esteem • Lower obesity risk and better cardiovascular health Family meals can play a vital role in strengthening family bonds, promoting stability, and fostering a sense of unity and connectedness. They also have the potential to enhance the developmental assets of adolescents, including problem-solving skills and social-emotional growth. Additionally, family traditions and routines, such as shared meals, provide a sense of consistency and an opportunity to connect while promoting healthy attitudes and behaviours related to food. Family meals are also powerful for adults, as well, with parents having better nutrition, less dieting patterns, more self-esteem and lower risk of depression – I see this happening every day in my practice. Eating meals together as a family also has a profoundly positive impact on the child’s and adolescent’s eating habits and diet quality; the more meals eaten together, the greater the impact. Number of meals together In today’s world, where schedules are packed and families barely meet, meals together can sound like quite an unrealistic task. Frequent regular family meals are usually defined as 3-7 times a week, keeping the consistency, reflect a sense of connection and priority. So, if you have only one meal a week together, consider how you can adjust your schedule to increase the number of family meals you have routinely. We have at least 16 possible times for families to eat together—seven breakfasts, seven dinners, and two weekend lunches. And let’s not forget snack time or bedtime snacks, which can also be used as a meaningful connection time over a fruit, nuts, and a glass of milk or a cup of yoghurt. Making family meals engaging and welcoming The ideal meal combines nutritious, balanced, and delicious food with fun and conversationbut not always easy to cultivate a welcoming and open environment and dining table. If keeping the conversation with your teen is hard, thefamilydinnerproject.org has some creative tips. Here are some: • Set an example and keep devices out of the dining table, and avoid getting distractedby them. • Encourage Sharing. Invite each family member to share highlights from their day or something they’re looking forward to. This sets a tone of openness and encourages everyone to participate. Start the conversation by sharing something about your day and asking for feedback from the children, e.g., how would you suggest Dad deals with his co-worker in that challenging situation? • Celebrate Small Wins . Use mealtime to acknowledge achievements, no matter how small. Celebrating these moments can boost a teenager’s self-esteem. • Cook Together. Involve your teenagers in meal preparation. This not only teaches them valuable life skills but also creates a shared experience that can make the meal more enjoyable. Play games if talking and sharing at the dining table is not something you are comfortable with yet ; games are a great way to break the ice. Here are some examples: • 20 Questions: One person thinks of an object, person, or place, and the others take turns asking yes-or-no questions to guess what it is within 20 questions. • Would You Rather?: Pose fun or silly hypothetical questions, like “Would you rather have the ability to fly or be invisible?” Everyone takes turns answering and discussing their choices. • Story Building: One person starts a story with a sentence, and each person adds a sentence to continue the story. This can lead to some funny or creative narratives! • Two Truths and a Lie: Everyone takes turns sharing two true facts and one false factabout themselves—the rest of the family guesses which is the lie. • Table Trivia: Prepare some trivia questions about family history, fun facts, or themes related to the meal or occasion. • Guess the Song: Hum or tap a rhythm of a song, and others try to guess what it is. You can even create categories like “Disney songs” or “80s hits.” • Charades: Act out a word or phrase without speaking, while the others guess what it is. This can be themed according to the season or a holiday. In Conclusion The link between family meals and mental health outcomes is clear. By prioritising shared mealtimes, families can not only improve their physical nutrition but also enhance emotional well-being through the connections formed around it. Even if it starts with just a few meals a week, the long-term effects on mental health and family bonds are profound. So, consider making family mealtime a cherished routine—you might be surprised by the positive changes it brings to your family dynamic One last note – don’t beat yourself up if family meals are not picture-perfect or don’thappen with the “right” consistency. Knowledge is power, and being aware of the benefits of family meals is important; therefore, this article. However, we also know that “life happens” sometimes, and family mealtime might be put on the backburner during these busy periods. That will not make you and your partner a failure, only human. Just restart building these routines again, step by step – these habits are utterly worth fighting for. Claudia Correia Dietitian and mother of two Accredited Dietitian of Singapore References Harrison, M. E., Norris, M. L., Obeid, N., Fu, M., Weinstangel, H., & Sampson, M. (2015). Systematic review of the effects of family meal frequency on psychosocial outcomes in youth. Canadian family physician Medecin de famille canadien , 61 (2), e96–e106. https://thefamilydinnerproject.org/ https://www.raisingteenagers.com.au/power-familymeals/