When was the last time you struggled with something new? By the time many people reach midlife, it can feel like novel experiences don’t come along as often as they did in the past. If things are going well, you might feel like you’re pleasantly coasting through life, and even if you get thrown a few curveballs, you can figure it out. Best case scenario, you’re in the middle of your favorite decade yet—one of confidence, competence, purpose, and stability. New things just don’t faze you like they used to.
Then the mother of all plot twists comes along: perimenopause!
If you have a lot of conversations about menopause, like we do, you might start to notice a trend when it comes to how some people describe their experiences. Everyone phrases it differently, but the fundamental ideas are similar: I didn’t know what to expect. Nobody warned me about this. I had no idea what was going on in my body. I was totally caught off guard. Perimenopause rocked my world, and not in a good way. I didn’t feel like myself anymore.
If you had older female friends or relatives who were forthcoming about menopause, they might have given you some idea of what to expect, but when it comes to fully understanding the highs and lows, there’s nothing like living through it yourself.
So is it any wonder that perimenopause can bleed (no pun intended) into every aspect of your life and make you feel like you’ve stepped into a whole new world you’re not sure how to navigate? Of course it’s disorienting and overwhelming—you’ve never done this before!
There’s no way to lifehack your way through the menopause transition—if there were, we’d have told you by now—but fortunately, access to menopause-savvy healthcare providers is expanding every day. As for other tools and remedies, you could spend a small fortune on menopause products that might ease your symptoms to some extent, some through legitimate means and others, not so much.
But there’s one tool that costs exactly zero dollars: your mind.
No, you can’t control menopause symptoms with your mind (again, we definitely would have told you that) but mindset can be a powerful tool for navigating times of change and disruption, which perimenopause certainly is. It may sound a little woo-woo, and we’re certainly not suggesting that you just need to “think positive!” or “relax!” and you’ll sail through this transition, but we want to put forth an idea:
What if you embraced being a beginner—a perimenopause novice?
What if you could support your mental health by letting go of unreasonable standards for yourself and acknowledging that you’re in unfamiliar territory; by learning and using new knowledge about your body and mind during the menopause transition; by treating this not-exactly-optional experience as a growth opportunity, even a messy one?
That’s our pitch: learn about how to make parts of this major transition easier on yourself by practicing the principles of “beginner’s mind.”
What it is:
The concept of beginner’s mind originates in Zen Buddhism, but you certainly don’t need to practice Buddhism or even have experience with meditation or mindfulness to try the techniques.
The premise is simple on paper: to practice having a beginner’s mindset, drop any preconceived notions you’ve cultivated through experience or expectation, and regard whatever you’re facing with curiosity and an open mind.
When you approach a situation like a complete beginner, you can give yourself permission to not excel at it right away. You may notice new ways of doing things that you wouldn’t have seen if you’d defaulted to your go-to process. You may find renewed energy or appreciation for parts of your life that have grown stale. The idea is that someone with an “expert’s mind,” who knows what works, already has their own way of doing things—they’ve cultivated shortcuts, routines, and assumptions that are effective and efficient, but may also close them off to new ideas and possibilities.
This technique is useful for learning skills or solving problems in new ways, but it can also help with a mindset shift if you’re being hard on yourself for not living up to internalized expectations—like, for instance, how you “should” tackle life through the menopause transition.
What it’s not:
Beginner’s mind is not the idea that it’s better to be naive, or that you shouldn’t prepare for a new situation, or that you must throw out everything you’ve already learned and ignore prior knowledge.
It’s not realistic or helpful to suggest that you shouldn’t draw on your skills and life experience. Those things can serve you well, and probably already have many times. What beginner’s mind advocates for is to find new ways to apply what you know, and to be receptive to the idea that what worked before might not work again for every single situation in which you find yourself. We’ll talk more about how to put this idea into practice during perimenopause later on.
We’re also not suggesting that beginner’s mind is meant to be a menopause cure-all. This is not a challenge to just “grin and bear it” or to try to think your way out of very real symptoms instead of seeking medical care for relief. Without probing the idea more closely, beginner’s mind is at risk of sounding like a type of misguided magical thinking: “Approach everything with wonder like a child, and it will all get better!” Nope, no way. That’s not what any perimenopausal woman wants to hear.
Instead, think of this concept as one of many tools for meeting this time of transition; something you can use to keep from getting backed into a corner if you’re frustrated, or a way to renew your sense of purpose if you’re feeling discombobulated or stagnant during midlife.
Even if you have a reasonably smooth experience with perimenopause, it’s still a transition that you didn’t exactly sign up for, and you can’t always predict how your body’s going to change, whether you’ll struggle with hot flashes, insomnia, or unexpected itching, or what kind of hoops you might have to jump through in order to feel heard about your symptoms.
(Hot tip: with Gennev clinicians, there are no hoops. Our physicians and Registered Dietitian Nutritionists are menopause-trained and ready to help.)
Your energy and capacity for things you used to do might change—you may have to shift how you eat, exercise, and sleep in order to keep feeling like yourself. It’s a lot to deal with, particularly during a time of life when other things, like work, relationships, and family needs, are changing too.
Alongside treatments or medications you need to support your physical and mental health, practicing having a beginner’s mindset during perimenopause can help you:
In some meditation practices, you’re asked to notice the sensations that arise in your body, thoughts that drift through your mind, or sounds you hear in the background. You’re not supposed to do anything about them, just acknowledge them as a means of staying present.
When it comes to perimenopause, it’s hard not to notice your symptoms, and the idea of meditating through irritability and discomfort might sound laughably unhelpful. But if you make a habit of checking in with yourself intentionally throughout the day, it could help you identify perimenopause-related patterns or notice if something significant is changing.
You might notice things like, “Okay, my hot flashes don’t really last as long as I thought they did,” or “I seem extra short-tempered with my kids on days I don’t work out,” or “That’s interesting, I actually do sleep better if I skip that second glass of wine with dinner.”
This curiosity is a way to have more lightbulb moments instead of getting through the day on autopilot at the mercy of your hormones. You may not be able to make quick changes based on all your realizations, but the simple act of noticing patterns in your symptoms and emotions can go a long way toward helping you feel less out of control. If nothing else, this practice of noticing can be a great way to gather detailed talking points for discussing your symptoms with a healthcare provider.
Asking questions is a powerful technique for cultivating a beginner’s mindset for two reasons:
Asking questions of yourself as a thought exercise can help you get to the heart of what you really want or need and give you a way to move through situations where you feel stuck. Even if you don’t have the answers or decide not to act on them, practicing curiosity can be a creative way to tackle challenges, avoid jumping to conclusions, and tune in to your gut instincts for more clarity.
Need some inspiration? Start with these cues and tailor the questions to your own perimenopause pet peeves
Asking questions of others can help you find people going through similar struggles, learn from their experiences, or get connected to others who can help you. It’s a fantastic way to build camaraderie and trade support during a time when that’s especially important. When it comes to menopause information and visibility, sharing really is caring.
This one can be hard. If you’re someone who’s used to having it all together, who usually has everything dialed in and can juggle lots of life’s spinning plates at once, you probably have high expectations of yourself and your ability to get stuff done. For most of your life that’s probably worked just fine, but perimenopause can complicate things.
Whether it’s weight gain, brain fog, or anxiety, changes during the menopause transition can thwart your usual habits and make things that used to come naturally to you feel a lot more difficult.
It’d be completely understandable to think that you just need to work harder: wake up earlier, cut calories, exercise more intensely, work longer hours, just grind more. If all that worked when you were younger, why not now?
A beginner’s mindset would remind you that approaching the new, often frustrating, shifts of perimenopause with the assumption that you should be able to just do it is a recipe for disappointment, self-criticism, even injury, illness, or burnout.
So give this a try: next time you’re irritated by some menopause-related hurdle, let go of any I should be able to’s and why can’t I’s and this used to be easier’s in your internal monologue, even just for a few moments. That’s your expert’s mind talking, and it’s setting you up for an uphill battle.
Instead, just see what it feels like to say, “Looks like what I used to do isn’t working. I need a new system. I need more information. Maybe I don’t have to do it the way I did before. What can I try instead? Who else can help me with this?”
We’re not saying it’s easy, but if you can let go of expectations about how you should do something during perimenopause instead of turning those judgements on yourself, you might discover new solutions and coping strategies that are more effective and sustainable for this time in your life.
There aren’t many rules of menopause; it’s not like you sign a contract saying you’ll behave a certain way or suffer in polite silence until the chaos subsides. But social pressure is real, and expectations of women are perpetually demanding. What would happen if you adopted a beginner’s mindset to bypass some of the social conventions we rely on to make others more comfortable?
Being a beginner doesn’t mean constantly pushing through discomfort—sometimes it means recognizing when you need to take a break. Beginners aren’t expected to have all the answers, and they’re not expected to perform perfectly at all times. Flawed is okay. Clumsy is okay. Tapping out to reset is okay. So as someone navigating perimenopause for the first time (because really, you are!), give yourself that privilege too.
Next time you’re having a bad day, go rogue. Tell your spouse and the teens they’re on their own for dinner. Take a mental health day. Cry it out. Own the hot flash, don’t pretend it’s not happening. Confess your most unhinged perimenopausal thoughts to a friend, therapist, or your doctor. Do something that seems silly or self-indulgent, just because it feels good. This is, after all, your menopause. While you probably can’t drop everything and run off to a quiet cottage in the woods til it’s all over, you’re allowed to lose your composure sometimes while you figure out your new normal.
Perimenopause can last for a long time, and your symptoms and experiences will probably change along the way. That’ll deliver plenty of opportunities to keep practicing beginner’s mind, if you find it valuable, but may also make it easier to slip into the expert’s mindset—once you get more familiar with whatever shifts perimenopause throws your way, you may get used to them. Symptoms may not feel so disarming all the time. Physical and lifestyle changes might not feel so extreme. You’ll find routines and remedies that work to support you, just like you’ve done before. And that’s fine!
But don’t be afraid to return to a beginner’s mindset if you start to feel stuck again or run into a change that throws you off your game. Ask more questions; get curious about what’s going on with your body; be open-minded about potential solutions. Maybe you need a new med, or a different dose of hormones. Maybe it’s time to switch doctors, or invest in a personal trainer. Maybe you can take a leave of absence from work instead of miserably grinding through day after brain-foggy day.
If you’re still skeptical about how much mindset can help you get through menopause, that’s okay. While mindfulness techniques do show promise for alleviating some menopause complaints, there’s not enough data to suggest that they’ll work for every symptom or every patient, and we’d never suggest that they should replace evidence-based medicine, therapy, and healthcare tailored to your needs.
Instead, think of the beginner’s mind practice as another tool to help you persevere through perimenopause: the more you practice viewing these times as opportunities to learn something new about yourself or try an unexpected mode of problem-solving, the easier it will become to navigate transitions with greater confidence and self-compassion.
Of the many ways that the menopause transition makes itself known, some symptoms are more immediately apparent—and more, well, visceral—than others. Hot flashes, super-soaker periods that show up whenever they please, and puzzling weight gain are pretty dramatic physical signs that things are changing, and they can be hard to ignore. Physical symptoms get a lot of coverage in the current conversations about menopause, which is a good thing, since it means more women have the information they need to seek help and relief.
But alongside the uncomfortable physical symptoms, perimenopause can also stir up new or worsening mental health concerns, like anxiety, depression, brain fog, mood swings, even unexpected rage. In our fast-paced culture packed with distractions, stressors, and endless obligations, it may not occur to some women that these symptoms might be connected to the menopause transition, or that they can get help for them. Add to this the fact that menopause and mental health remain somewhat taboo topics and that many women have their mental health concerns dismissed, and it’s clear we need to be having more conversations about the psychological and emotional symptoms to be aware of during perimenopause.
Take this one, for instance: Some women notice a hard-to-put-your-finger-on-it sense of “blahness” or numbness, most profoundly marked by a loss of interest in things they used to enjoy, and a loss of pleasure from things that used to provide it, including food, hobbies, creative pastimes, sex, and social connections.
The term for this is anhedonia, and if it’s not already on your radar, it might be difficult to recognize or articulate at first. Anhedonia doesn’t necessarily rise to the top of the list of conversations about mental health in general, since it’s often considered a hallmark of depression and the neurobiological mechanisms behind it aren’t especially well understood yet.
We think it’s important to spotlight anhedonia in its own right, however, since mental health concerns can vary so widely between individuals during perimenopause, and we’re all about digging into the sometimes uncomfortable and underdiscussed topics you need to know about during this transition.
If you can relate to what we describe here, please consider bringing it up with a healthcare provider or mental health professional, especially one well-versed in menopause. Mental health concerns during menopause can be complex, distressing, and have multiple root causes, but getting help is worth it.
The word anhedonia is derived from the Greek words “an-” meaning “without” and “hedone,” meaning pleasure. It was first used by the French psychologist Théodule Ribot in the late 1800s, and while the definition has expanded over time (especially in the context of clinical depression), you’re still most likely to see it used to describe a lack of interest in formerly enjoyable activities, and/or a lack of pleasure in those activities while doing them.
To understand where anhedonia fits in among other mental health symptoms, it might help to imagine them along a sort of spectrum. Where depression might generally present as a low-energy condition, marked by feelings of sadness, hopelessness, despair, and disinterest in normal activities, and anxiety might present as a higher energy condition, characterized by racing thoughts (and heartbeat!), worry, rumination, and even panic attacks, typical descriptions of anhedonia place it closer to depression. It’s possible to have anhedonia as the sole sign of a mental health disorder (ie, you can experience episodes of anhedonia as a variant of depression without other symptoms), but it is also one of the diagnostic criteria for major depressive disorder (MDD), and several other psychological and neurological disorders, including Parkinson’s disease.
Essentially, anhedonia is responsible for the “disinterest and apathy” symptoms that can accompany depression and other disorders. It’s not associated with having strong negative emotions so much as it is a lack of emotions; it’s waking up feeling “meh,” “blah,” or “take it or leave it,” in the most passive sense, about activities you would ordinarily look forward to and enjoy.
Researchers believe that anhedonia presents when there is dysfunction in the brain’s motivation and reward centers. However, as with so many mental health disorders, it’s hard to narrow down a singular cause or predict what might trigger an episode in any given person, especially since it can be co-present with other conditions.
It’s thought that there may be a genetic component partially contributing to whether an individual is prone to anhedonia. It has also been linked to inflammation in the brain, which interferes with the function of neurotransmitters, such as the “feel-good hormone” dopamine, that play important roles in mood regulation, pleasure, and motivation.
Other contributors to anhedonia can include trauma and PTSD; burnout; substance use disorders; even chronic illness like Long Covid; this raises the question whether it’s driven by something biochemical, circumstantial, or both, in ways science doesn’t fully understand.
As for what spurs episodes of anhedonia during perimenopause, it’s difficult to say with certainty, but plummeting estrogen levels are likely partially responsible. During the menopause transition, we’re at the whims of fluctuating hormones, often for years. These wild hormone swings can bring about not just irritability but other serious mental health concerns, like depression, as we lose the (sometimes) mood-balancing effects of progesterone, and declining estrogen and progesterone interfere with dopamine function.
All these hormonal shifts can result in mood and mental health changes during midlife, and the severity can vary from person to person. Some research suggests that women who experienced depression before beginning menopause may be more prone to depressive symptoms (especially those severe enough to meet the criteria for major depressive disorder) during and after menopause, but mental health struggles can arise for all kinds of reasons, including situational ones, during this time.
Transitions during midlife involve so much more than just hormones: it’s a time when our relationships, body image, sense of identity, roles at home and at work can all go through destabilizing shifts too, sometimes with no predictable end in sight. It’s not unreasonable, then, that stress, burnout, overwhelm, anxiety, depression, and anhedonia can set in and prompt a need for more support.
We all have experiences we don’t enjoy sometimes, right? And is it so bad to lose interest in certain things, especially as you grow and change and adjust to new life phases throughout the years? Does moving on from former activities, hobbies, or social groups always mean you’re dealing with anhedonia?
Of course not—that’s just having preferences! Anhedonia isn’t simply disliking an activity or not being interested in a pastime because it’s not your cup of tea or you’ve found something new to try. It’s better described as a sense of apathy or indifference that extends into multiple areas of your life, or a pervasive numbness that leaves you not caring about much of anything, which doesn’t lift even after your favorite pick-me-ups—anything that used to reliably buoy you through a bad mood.
So how does this show up?
Women responding to discussions about anhedonia during perimenopause in various online forums use phrases like:
“faking my way through life”
“I don’t care about anything”
“everything is boring”
“life just feels gray”
“wouldn’t really care if I never saw my friends again”
“going through the motions”
“no sense of urgency”
“can’t find motivation, even for the fun stuff”
“trying to figure out how to want to want something again”
“nothing calls to me”
“I’m just existing”
“I would feel this in my bones…if I could feel feelings”
They describe abandoning hobbies and businesses, withdrawing from social and family obligations, not looking forward to plans, putting off basic tasks, and doing the bare minimum to get through the day, not because their to-do list feels challenging but because they simply can’t work up the motivation to care about following through.
It’s also not uncommon for people experiencing anhedonia to lose interest in, or fail to get satisfaction from, things they used to find enjoyable like food, sex, or engaging with music and art. Particularly with food, this can lead to changes in appetite and eating habits—some people may struggle to eat enough, while others might seek out highly palatable and less nutrient-dense foods, like salty or sweet snacks, in the hopes of finally tasting something satisfying.
If anhedonia saps your motivation, interest, and sense of satisfaction or joy, it’s fair to say that it isn’t compatible with nurturing your well-being, relationships, or self-image—particularly not during menopause, which can bring forth new challenges on these fronts anyway. Wanting relief from anhedonia is as understandable as wanting relief from hot flashes, and just as important for your menopausal quality of life.
Because it’s so often linked to other conditions and we’re still learning about what can cause it, anhedonia on its own can be difficult to treat. There are no treatments designed specifically for anhedonia yet, outside of those meant to address the other disorders it often accompanies, and frustratingly, it’s not always responsive to some of the go-to medications often used to treat depression, like SSRIs.
To offer some hope, though, it seems that anhedonia isn’t always a persistent state for all who experience it. Depending on the factors involved, its severity can ebb and flow over time, and various mental health interventions can help bring about relief for some people. Though there’s no one remedy that’s a proven anhedonia-buster, a combination of approaches may help.
Cognitive behavioral therapy
Atypical antidepressants
Menopause hormone therapy
Without a better understanding of what really causes anhedonia during perimenopause (and in other circumstances), and better data pointing toward effective treatment options, it can be challenging to treat and frustrating when it affects important aspects of your life, especially during a time of such intense change. But this doesn’t mean there’s nothing to be done. If you’re struggling during menopause—with anhedonia, depression, anxiety, or any combination of these—we encourage you to communicate it to a healthcare provider who listens to your concerns and can support you with the right combination of treatments, lifestyle changes, and other mental health interventions for your needs. You and your well-being are worth it.
If you feel you or someone you care about may be suffering from depression, there is help. You can start finding your way back from depression by talking to a doctor or mental health provider, or contacting the 988 Lifeline for immediate, 24/7 support. Gennev’s clinicians can support you through the unique physical and emotional challenges of menopause with personalized treatment plans; book an appointment to get started.