Why your perimenopause symptoms are getting worse - and what actually helps

How living in survival mode amplifies hot flushes, heavy bleeding, anxiety, and insomnia - plus the herbal solution that changes everything.

By Simone Jeffries, Naturopath & Herbalist

When everything you used to handle becomes overwhelming

It's 3am and you're wide awake again. Your mind is racing through tomorrow's endless to-do list while hot flushes wash over you in waves. The anxiety that started as a low hum during the day has now become a full orchestra of worry keeping you from sleep.

You used to be the woman who could handle anything - work deadlines, school pick-ups, elderly parents, household management - but now even simple decisions feel impossibly hard.

Many of my clients describe this experience as "high functioning anxiety" - they're still getting everything done on the outside, but inside they feel like they're barely holding it together. The brain fog that often accompanies this makes everything feel even more difficult.

If this sounds familiar, you're not imagining things. You're experiencing what happens when perimenopause collides with the survival mode so many Australian women live in during their 40s and 50s. The symptoms you're struggling with aren't just about declining hormones - they're being amplified by the very stress that's become "normal" in our society.

The connection between chronic overwhelm and perimenopause symptoms

I see this pattern daily in my Sydney northern beaches naturopathic practice. Women arrive feeling completely overwhelmed, describing anxiety that came from "nowhere," crazy heavy periods, hot flushes that are worse when they're feeling pressured, brain fog that makes simple tasks feel impossible, and that terrible 3am wake-up where their minds won't switch off. Many have tried over-the-counter herbal remedies that didn't work, leaving them frustrated and wondering if anything can help.

What these women don't realise is that their symptoms aren't just about estrogen and progesterone declining - they're about how chronic stress makes everything worse during perimenopause.

Living in survival mode: the Australian woman's reality

"It is extremely common for women to live with increased stress levels during perimenopause. This is a life stage that can be accompanied by huge responsibilities at work and at home. And yet when I question women about their stress levels, they often deny that they are under stress. I believe this is because what women juggle day to day is considered 'normal' in our society." Simone Jeffries, naturopath

I'm thinking of one client who was driving between home-visit client appointments. She was barely sleeping because of stress, and worried sick about being safe on the roads. There countless women juggling school-aged children's activities while taking on increasing responsibility at work, feeling they can't reduce hours because their boss wouldn't be happy, and they can't manage the mortgage if they earn less money.

This isn't just being "busy" - this is survival mode. And when you're living this way during perimenopause, your symptoms become dramatically worse.

Why your adrenal glands hold the key to perimenopause symptoms

Here's what's happening in your body when chronic overwhelm meets perimenopause:

The progesterone connection As perimenopause begins, your body produces less progesterone - your natural calming hormone. This progesterone decline means everyday pressures feel more overwhelming than they used to. Without progesterone's soothing influence, the same responsibilities that you managed in your 30s now feel impossible to cope with.

The 3am wake-up call Many of my clients describe waking at 3am with busy minds, finally falling back to sleep at 5am just before they need to start the day again. This happens because overwhelmed adrenal glands disrupt your natural cortisol rhythm. Instead of cortisol being lowest at night (allowing deep sleep), it spikes in the early hours, flooding your system with stress hormones when you should be resting.

The adrenal takeover As your ovaries wind down hormone production, your adrenal glands step in and produce hormones that can be converted to estradiol - a form of estrogen important for bone health, heart health, and brain function after menopause. But when your adrenals are already exhausted from chronic overwhelm, they can't perform this crucial backup role effectively.

The mental load factor Women carry an enormous mental load - keeping track of everything needed to run a family, household, and career. During perimenopause, when progesterone isn't there to buffer daily pressures and help with clear thinking, this mental load becomes overwhelming. Brain fog, anxiety, and feeling "scattered" aren't character flaws - they're the natural result of hormonal changes combined with an unsustainable load of responsibilities.

The brain fog reality One of the most distressing symptoms my clients describe is the brain fog that seems to come from nowhere. You walk into a room and forget why you're there. You lose words mid-sentence during important meetings. You can't remember if you've already told someone something, or you repeat yourself without realising. When you're already juggling an impossible mental load and your brain stops cooperating, the overwhelm becomes even more intense. This creates a vicious cycle - the more overwhelmed you feel, the worse the brain fog becomes.

Why generic herbal remedies often fail

Many women have tried black cohosh tablets from the chemist or standard menopause supplements, only to find they don't help much. There's a reason for this - and it's not that herbal medicine doesn't work.

The issue is that effective herbal medicine for perimenopause needs to be personalised to your unique symptom pattern and current life demands. That black cohosh needs to be supported by other herbal remedies. A woman with anxiety-driven insomnia needs different herbs to someone with heavy periods and mood swings. Someone living in survival mode needs nervous system support alongside traditional menopause herbs.

Generic, one-size-fits-all formulas simply can't address the complex interplay between your daily overwhelm, adrenal function, and changing reproductive hormones.

The herbal solution that actually works

In my clinic, I've seen remarkable improvements when women receive individualised herbal medicine that addresses both their perimenopause symptoms and their overwhelmed nervous system. Here's my approach:

Gentle adrenal support

I combine traditional adaptogenic and adrenal herbs to help your body cope with daily demands more effectively. These herbs work gradually to restore your natural resilience without overstimulating an already exhausted system. You may find that you can reduce your reliance on coffee - with the added benefit that you may sleep more soundly.

Nervous system calming

Specific nervine type herbs help quiet that racing mind and support deeper, more restorative sleep. These work particularly well for the 3am wake-ups that plague so many perimenopausal women.

Traditional menopause symptom support

I include well-researched herbs like black cohosh and sage for hot flushes and night sweats, but the key is combining them with nervous system support herbs rather than using them alone.

Personalised blending

Each herbal tonic I prepare is specific to the woman I'm working with. Your current life demands, sleep issues, anxiety levels, and physical symptoms all influence which herbs I choose and in what combinations.

Beyond herbs: supporting your whole system

Effective perimenopause support goes beyond herbal medicine, though it's often the missing piece that makes everything else work better:

Identifying pressure points Where possible, we look at reducing or managing the sources of overwhelm in your life. Sometimes this means setting boundaries or saying "no" more often - challenging for women conditioned by society to be helpful and accommodating.

Sleep hygiene Simple changes to your evening routine can dramatically improve that precious sleep that's so disrupted during perimenopause.

Gentle movement Regular exercise helps balance stress hormones, but during perimenopause, intense workouts can sometimes increase cortisol. Finding the right type and intensity of movement for your current energy levels is crucial.

Mindfulness practices Even five minutes of daily breathing exercises or meditation can help reset your nervous system's response to daily pressures.

Taking the first steps

If you recognise yourself in this description - living in survival mode while struggling with perimenopause symptoms that seem to be getting worse rather than better - please know that you don't have to continue suffering.

Most women find that herbal medicine is an excellent starting point because it can help them feel like they're coping better within as little as 3 days. Once that shift happens - when you're sleeping a bit better and feeling less overwhelmed - the other lifestyle changes suddenly seem much more manageable. It's hard to implement new habits when you're barely keeping your head above water, but herbal support can give you the breathing space you need.

The combination of personalised herbal medicine with supportive lifestyle changes can transform how you experience this transition. I've watched countless women move from feeling overwhelmed and exhausted to feeling capable and energetic again.

Your symptoms aren't a sign that you're failing to cope - they're your body's way of telling you that it needs support during this major hormonal transition.

Questions & answers

Q: Will the brain fog ever get better? I feel like I'm losing my mind. A: Brain fog is one of the most common and distressing perimenopause symptoms, but it absolutely can improve. The combination of declining hormones and feeling overwhelmed creates a perfect storm for fuzzy thinking. Herbal medicine that supports both your nervous system and cognitive function often helps women notice clearer thinking within the first few weeks.

Q: How long does it take for herbal medicine to work for perimenopause symptoms? A: Most women notice some improvement within 3 days, particularly with mood and a feeling of wellbeing/coping. Anxiety and brain fog may take 2 to 4 weeks. Hot flushes and heavy periods may take 6 -12 weeks to show significant improvement as herbs work gradually to rebalance your system.

Q: Why didn't the menopause supplements from the chemist work for me? A: Generic supplements can't address your individual symptom pattern or stress levels. Effective herbal medicine for perimenopause needs to be tailored to your specific needs, stress response, and symptom combination.

Q: Can herbal medicine help if I'm already on antidepressants or hormone replacement therapy? A: Yes, herbal medicines can often be safely used alongside conventional medications, but this always requires professional guidance. I work carefully with your existing treatments to ensure safety and effectiveness.

Q: Is it normal to feel like I can't cope with things I used to handle easily? A: Absolutely. The combination of declining progesterone (your natural calming hormone) and the chronic overwhelm many women live with creates this exact experience. It's not a personal failing - it's biology meeting an unsustainable lifestyle.

Q: How do I know if my adrenals need support? A: Common signs include difficulty falling asleep despite exhaustion, waking between 2-4am with a racing mind, feeling "tired but wired," needing caffeine to function, feeling overwhelmed, and procrastinating about normal daily responsibilities.

Ready to transform your perimenopause experience?

Living in survival mode doesn't have to be your normal, and struggling through perimenopause isn't inevitable. Personalised herbal medicine, combined with gentle lifestyle support, can help you reclaim your energy, sleep, and sense of calm during this transition.

Individual consultations: Book a consultation to discover your personalised herbal medicine protocol and start feeling like yourself again within days rather than months.

BOOK NOW

THRIVE Perimenopause Coaching Program: For women ready to take a comprehensive approach to their perimenopause journey, my THRIVE program combines personalised herbal medicine with practical coaching to help you navigate this transition with confidence and vitality.

PERIMENOPAUSE COACHING

I'd love to help you experience perimenopause as a natural transition rather than a daily struggle.

Simone :)

References

1. Briden, L. (2023). Hormone Repair Manual. CreateSpace Independent Publishing.

2. Harvard Health Publishing. (2021). "Perimenopause: Rocky road to menopause." Harvard Medical School.

3. Santoro, N., Roeca, C., Peters, B.A., & Neal-Perry, G. (2021). "The Menopause Transition: Signs, Symptoms, and Management Options." Journal of Clinical Endocrinology & Metabolism, 106(1), 1-15.

4. Baker, F.C., & de Zambotti, M. (2019). "Sleep and Sleep Disorders in the Menopausal Transition." Sleep Medicine Clinics, 13(3), 443-456. PMC6092036.

5. Mehrpooya, M., Rabiee, S., Larki-Harchegani, A., et al. (2018). "A comparative study on the effect of black cohosh and evening primrose oil on menopausal hot flashes." Journal of Education and Health Promotion, 7, 36.

Hi! I'm Simone Jeffries. I am a naturopath, nutritionist, herbalist and certified wellness coach. I am also a foodie and an advocate for a whole food diet.

I love to support you with hormonal conditions, histamine intolerance and vaginal imbalances.

I welcome clients to consult with me at my clinic in Manly on Sydney's Northern Beaches, and online from anywhere in Australia.

The information in this blog is from my Bachelor of Health Science degree, experience from working with women in my clinic, and continuing research.

This article is for educational purposes only and is not intended to replace professional medical advice. Always consult with your healthcare provider before making changes to your treatment plan.