In this blog, I'll be discussing a recent study that explores the unsettling experience many women describe as "not feeling like myself" (NFLM) during the menopausal transition (a.k.a perimenopause). This phrase, heard frequently in clinics and conversations, reflects a complex mix of physical and emotional changes. Personally, I can relate to this feeling. In my late 30s, I experienced similar struggles with fatigue, mood swings, and brain fog that made me feel completely unlike myself. It wasn't until I began treatment with hormone replacement therapy (HRT) and made lifestyle modifications that I started to regain my sense of balance. This study dives deep into understanding NFLM and highlights ways we can support women in reclaiming themselves during this life stage.
Understanding the Symptoms Behind NFLM
The study identified several specific symptoms associated with NFLM, including:
• Fatigue
• Feeling overwhelmed and less able to cope
• Low mood and depressive feelings
• Anxiety and nervousness
• Irritability and mood volatility
• Difficulty making decisions
• Brain fog (trouble with focus and memory)
• Sexual symptoms
In my own experience, I remember feeling unusually anxious and overwhelmed, as though I couldn't handle things that would typically be manageable. This study found that such symptoms fall into three main categories: emotional responses, cognitive changes, and mind-body shifts. These shifts help explain why women in menopause often feel disconnected from their usual selves; hormonal fluctuations bring about changes that can affect mood, energy, and even identity (Braden et al., 2023).
Anxiety and Mood Volatility: Often Overlooked in Menopause
The study's findings on anxiety were especially striking for me. Although depressive symptoms in menopause are well-documented, anxiety often receives less attention. The research found that fluctuating estrogen levels can trigger anxiety-like behaviors, which felt unsettling and unfamiliar to me at the time. I also experienced mood volatility—frequent irritability and sudden emotional shifts—that often felt beyond my control. The study noted that this volatility contributes to the feeling of losing control over emotions, a central aspect of NFLM (Vansintejan et al., 2023; Braden et al., 2023).
Cognitive Challenges: The "Brain Fog" of Menopause
Cognitive symptoms, often called "brain fog," are another major contributor to NFLM. Like many women, I struggled with forgetfulness, difficulty concentrating, and making decisions. These symptoms were especially challenging, as I was managing both a busy work schedule and family life. The study highlights that these cognitive changes can feel distressing, particularly for women in demanding roles, and contribute to feeling out of sync with one's usual self (Raisanen et al., 2023).
Impact on Identity and Roles
The experience of NFLM extends beyond the physical and mental symptoms; it can affect a woman's identity and her interactions with others. During this period, I found that changes in my emotional responses and stress tolerance affected how I viewed myself and managed relationships. The dissonance between who I felt I was and who I wanted to be was challenging. The study acknowledges this clash, noting that women experiencing NFLM may feel disconnected in caregiving, professional, and social roles, all of which add to the complexity of the menopausal transition (Braden et al., 2023).
The Importance of Recognizing NFLM in Perimenopause Care
The study emphasizes the importance of recognizing NFLM as a valid and complex experience. By understanding the range of symptoms associated with NFLM, healthcare providers can set more realistic expectations and provide comprehensive support to women during perimenopause. In my case, beginning HRT and making lifestyle changes around stress management, exercise, and nutrition were essential in regaining my sense of self. For many women, a multifaceted approach may be necessary to address cognitive, emotional, and physical symptoms directly, helping them reclaim a sense of control (Raisanen et al., 2023; Vansintejan et al., 2023).
Conclusion: Supporting Women Through the "Not Feeling Like Myself" Phase
As women navigate the perimenopausal transition, understanding the experience of NFLM can offer validation and encourage targeted support. Addressing emotional, cognitive, and physical symptoms can help women reconnect with themselves during this phase. By taking a comprehensive view of NFLM, both women and healthcare providers can find solutions that honor this transformative stage and empower women to feel like themselves again.
If you're experiencing any of these symptoms, consider reaching out to a trusted healthcare provider who can offer guidance and support. You're also welcome to book a free discovery call with me to explore if working together might be the right fit for you.