When Life Happens During Perimenopause

Saturday, 27th June 2026 - tonight is a special night.

Our first fire in about four years.

To some, it's just a fire. But in our whānau, it means so much more. It means gathering wood together. The smell of burning timber. The warmth that slowly fills the house. Games. Conversations. The dogs come for a snuggle (Georgie has prime position!). It means everyone naturally ending up in the same room.

After being out in the rain today, I couldn't wait to get clean, dry, into my pyjamas and sit in front of it. As I sat there tonight, I realised this wasn't just about a fire. It was about being home together. It was about stopping.

It also reminded me of something I noticed in clinic after Cyclone Gabrielle.

Many women who had previously been managing their perimenopause suddenly felt like they weren't coping. Their hormones hadn't necessarily changed overnight, but their ability to cope with life seemed to.

At the time, I found it fascinating. Looking back, I think it makes complete sense.

One of the challenges with perimenopause is that we often try to separate everything into neat little boxes.

Is it hormones?

Is it stress?

Is it anxiety?

Is it burnout?

Is it trauma?

The reality is that our brains and bodies don't work like that.

Life events have long been recognised as increasing the risk of depression. We know that bereavement, relationship difficulties, financial stress, caring responsibilities and natural disasters can all have profound effects on mental health.

What becomes interesting is what happens during perimenopause.

Research suggests that fluctuating ovarian hormones may create a temporary window of increased vulnerability in some women. Not because hormones directly cause depression in everyone, but because they appear to change how the brain responds to stress. Gibbs, Lee and Kulkarni describe this as a possible hormonal vulnerability, where women who are particularly sensitive to hormonal fluctuations may experience stressful life events more intensely than they would have at another stage of life.

The paper also discusses something I think is incredibly important. It may not simply be the number of stressful events someone experiences. Rather, hormonal fluctuations may influence how those events are perceived and processed. Two women may experience the same situation, yet one finds herself completely overwhelmed while the other continues to cope reasonably well.

That doesn't mean one woman is stronger.

It doesn't mean the other is weaker.

It means biology matters.

For me, this validates so much of what I hear in clinic.

Women often say:

"I know nothing has really changed... but suddenly I can't cope."

"I've always managed stress. Why does everything feel so much harder now?"

"I don't recognise myself."

Those comments deserve curiosity, not dismissal.

If hormones are increasing the brain's sensitivity to stress, then supporting hormone health may improve resilience. Equally, if someone has experienced significant trauma, chronic stress or nervous system dysregulation, those factors also deserve attention. One doesn't exclude the other.

This is one of the reasons I often talk about parallel roads.

Hormones are one road.  Life experiences are another.

Mental health, sleep, relationships, physical health and neurodivergence are others.

Sometimes they travel alongside each other. Sometimes they intersect. Sometimes one amplifies another.

The question isn't, "Is it hormones or is it trauma?"

The better question is, "How are they interacting for this person?"

As I sat by our fire tonight, I couldn't help thinking that perhaps this is another example of how our nervous systems heal.

Not all at once.

Not dramatically.

Sometimes healing looks like warmth.

Sometimes it looks like feeling safe.

Sometimes it looks like a fire that hasn't been lit for four years, finally bringing everyone back into the same room.

Reference: Gibbs Z, Lee S, Kulkarni J. What factors determine whether a woman becomes depressed during the perimenopause? Archives of Women's Mental Health. 2012;15:323-332. https://doi.org/10.1007/s00737-012-0304-0