Perimenopause - When it does not feel like “normal PMS” anymore

Understanding Perimenopause

If you’re in your 40s (or even late thirties in some cases) and suddenly thinking:

• “My PMS is on steroids.”

• “I wake at 3am wired, even when I’m exhausted.”

• “I get hot flushes but my blood tests look ‘normal’.”

• “My cycle is changing and I feel like I’ve lost my old self.”

…thats now termed as perimenopause – the transition period before menopause, where your hormones and nervous system start to shift long before your final period.

I see women who arrive saying: “No one explained this. I just thought I was not good at coping.”

You’re not alone. The system is just catching up how disruptive this phase can be.

What mainstream medicine actually says about Perimenopause

A few important things, in plain English:

1. Hormone therapy is still the most effective treatment for hot flushes and night sweats.
   Guidelines and position statements agree that menopausal hormone therapy (MHT/HRT) is the most effective treatment for vasomotor symptoms (hot flushes and night sweats) and for genitourinary syndrome of menopause (GSM – vaginal dryness, pain with sex, bladder symptoms) when it’s safe to use. (Lippincott Journals)

2. There are also evidence-based non-hormonal options.
   A 2023 position statement from a major menopause society recommends cognitive behavioural therapy (CBT), clinical hypnosis and several non-hormonal medicines as evidence-based options for hot flushes and night sweats when hormones aren’t suitable or are declined. (Lippincott Journals)

3. Guidelines now explicitly include lifestyle and mind–body therapies.
   Organisations like NICE in the UK and the Australasian Menopause Society highlight lifestyle changes, mind–body therapies, CBT and relaxation-based approaches as part of the management toolkit – especially when women prefer non-drug options or can’t use hormones. (NICE)

4. Perimenopause is recognised as a transition, not a single disease with one magic pill.
   Management often leans on a mix of symptom relief, lifestyle support and mind–body strategies, tailored over time, rather than a single neat prescription. (Menopause Australia)

That’s the gap Ayusha works in: not “anti-medical”, but natural, mind–body-based support that sits alongside your GP or specialist, especially in perimenopause where many women feel under-served.

Common perimenopause symptoms

Perimenopause can show up as:

• Hot flushes, night sweats, sudden waves of heat

• Anxiety, rage, mood swings, feeling “not myself”

• Insomnia, 3am wake-ups, “tired but wired”

• Brain fog, losing words, feeling less sharp at work

• Heavier, more irregular or more painful periods

• Bloating, IBS-like symptoms, fluid retention, puffiness

• Headaches, palpitations, odd tingling sensations

• Low libido, intimacy stress, feeling disconnected from your body

If you recognise several of these, you’re not imagining it – this is exactly what the menopausal transition can feel like.

Where non-drug, holistic support fits

Research in midlife women shows that mind–body therapies and movement can:

• Improve overall menopausal symptom scores

• Reduce anxiety and depressive symptoms

• Improve sleep quality

• Support fatigue and sense of wellbeing (PubMed)

These include:

• Gentle, perimenopause-aware movement (yoga-style or similar)

• Mind–body practices like mindfulness and relaxation training

• Body-based therapies that work directly with your nervous system and pain

• Guided mind–body work (like CBT-style or hypnosis-informed approaches in the research)

Ayusha’s holistic therapies for Perimenopause Management:

• Ayurvedic-inspired warm oil bodywork for nervous system, gut and pelvic comfort

• Gentle, floor-based movement and breathwork tailored to midlife bodies

• Atma Shakti – a guided mind–body relaxation practice for sleep, anxiety and body image

• A calm, structured way of joining the dots between your symptoms, lifestyle, nervous system and medical care.

You still keep your GP or gynae in the loop; this work is “with”, not “instead of” medical treatment.

How we approach Perimenopause at Ayusha

Every woman’s plan is different, but typically we focus on:

• Mapping your main symptom clusters – heat/sweats, sleep, mood, gut, pelvic, joint, libido

• Prioritising what’s most urgent now (eg, sleep and rage vs gut and bloating)

• Combining deeply relaxing bodywork, movement and other therapies in a way that your body can actually receive

• Giving you a simple home rhythm (a couple of doable practices, not 17 rules)

Women often say after a few sessions:

“I finally feel like someone has joined the dots and my body is not the enemy.”

Interested in managing Perimenopause naturally?

If you’re in Newcastle, Lake Macquarie, Port Stephens, Hunter Valley, Central Coast, Sydney or nearby and suspect perimenopause, you have options.

• If you want a big-picture, held experience, start with a Consultation.

• If you’re curious but unsure, book a short discovery call to see whether Ayusha is the right fit.

You might also like:

• Blog on perimenopause anxiety and rage (for the emotional rollercoaster).

• Blog on perimenopause insomnia and night sweats (for the 3am wake-ups).

• Blog on perimenopause gut changes and fluid retention (if your gut feels off).

You don’t have to wait and suffer silently.