Postpartum and Perimenopause: When Hormones Turn the Volume Up

There’s something slightly humbling about spending years telling new parents to eat properly, drink enough water, rest when they can, get outside, move their bodies gently, accept help and give themselves some grace… only to reach a stage of life where you realize:

Oh. Apparently, I need to take my own advice.

This past week has been one of those weeks for me.

I’ve felt tired. Emotional. Overwhelmed by things I would normally handle without giving them much thought. My motivation disappeared somewhere between the laundry pile and my morning coffee. At times, my brain has felt like it has approximately 47 tabs open — and I can't find which one is playing the music.

And as someone currently navigating perimenopause, it struck me how strangely familiar some of these feelings are.

Because I've been here before.

I've experienced the enormous hormonal transition of postpartum twice myself. And professionally, I've spent years supporting families through those early weeks and months after birth.

Now I'm experiencing another major hormonal transition — from the other side of motherhood.

And there are more similarities between postpartum and perimenopause than many women realize.

Two Very Different Life Stages — With Some Familiar Hormonal Chaos

Postpartum and perimenopause aren't the same thing, of course. But both involve significant changes in reproductive hormones, particularly estrogen and progesterone.

Immediately after birth, estrogen and progesterone levels fall dramatically as the placenta is delivered. In the days and weeks that follow, the body begins another complicated adjustment — one that can also be influenced by breastfeeding, sleep deprivation, physical recovery and the enormous psychological transition into caring for a baby.

Perimenopause happens much more gradually, typically over several years as the ovaries begin transitioning toward menopause. But “gradually” doesn't necessarily mean smoothly.

Hormone levels can fluctuate considerably.

Estrogen may rise and fall unpredictably. Progesterone often becomes less consistent as ovulation becomes less regular. Sleep can change. Periods can change. Temperature regulation can change.

And for some women, so can mood.

Anxiety, irritability, low mood, brain fog, difficulty concentrating, fatigue and disrupted sleep can all occur during the menopausal transition.

Reading that list as a postpartum professional feels remarkably familiar.

The Hormones Aren't the Whole Story

Something I regularly remind my postpartum clients is that we can't look at hormones in isolation.

Imagine you've recently had a baby.

Your hormones are changing. You're recovering physically. You're waking repeatedly during the night. You may be breastfeeding or pumping. You're forgetting meals because somebody always needs something. You're probably drinking cold coffee. Exercise and fresh air may have disappeared from your routine.

Then we wonder why you don't feel like yourself.

Perimenopause can create a surprisingly similar perfect storm.

For many of us, it also arrives during an incredibly demanding stage of life.

We're raising children or teenagers. Managing households. Working. Supporting partners. Caring for aging parents. Running businesses. Coordinating calendars. Driving everyone everywhere.

And somewhere in the middle of all of that, our own bodies start asking for more attention.

Mine certainly has.

This Past Week, I Had to Practice What I Preach

This is where I'm going to be vulnerable.

I've had periods recently where I haven't felt quite like myself emotionally.

There have been days when I've felt more anxious, flat, tired or overwhelmed than usual. Things that normally roll off my back have occasionally felt enormous. My motivation hasn't always been there.

And my instinct was to figure out what was “wrong.”

Was it hormones? Was it my HRT? Was I exhausted? Was I stressed? Did something need changing?

Probably the most useful realization, though, was much simpler.

Before trying to fix everything, I needed to start supporting my body properly again.

And that's when I realized I had become spectacularly bad at following some of the advice I've given families for years.

Eat regularly.

Prioritize protein and nourishing foods.

Drink water.

Get outside.

Move your body.

Protect your sleep.

Rest without feeling that you have to earn it.

Stop expecting your body to operate beautifully while continually running it on empty.

Apparently, postpartum doulas are not exempt from this advice.

Who knew?

Never Underestimate the Power of a Walk

One of the easiest things I've started reminding myself to do is walk.

Not a 10,000-step challenge.

Not a punishing workout.

Not an hour at the gym.

Sometimes it's simply getting outside and walking for ten or fifteen minutes.

Physical activity has well-established benefits for mental health, sleep and overall health, and it doesn't have to be intense to count. Walking gives me a change of scenery, gets me away from the never-ending visual to-do list inside my house and gives my brain somewhere else to go for a little while.

This is something I've encouraged postpartum parents to do countless times when they're medically ready: put the baby in the stroller, step outside and walk to the end of the street. Sit on the porch. Feel daylight on your face. You don't have to “work out.”

Movement doesn't have to be punishment.

Sometimes it is simply care.

And I'm learning that lesson again myself.

Nutrition Matters More Than We Sometimes Want It To

The same applies to food.

When we're overwhelmed, exhausted or busy, proper meals are often one of the first things to disappear.

But our brains and bodies still require fuel.

During postpartum recovery, nutrition supports healing and the enormous physical demands placed on the body. During midlife, good nutrition remains important for cardiovascular health, muscle mass, bone health and metabolic health — all areas that become increasingly important as estrogen levels change.

I'm not interested in restrictive diets or telling women that every hormonal symptom can be cured by eating a salad.

It can't.

Sometimes medical treatment is appropriate. Sometimes HRT is appropriate. Sometimes mental-health support is needed. Sometimes bloodwork or further investigation is warranted.

But nutrition, movement, sleep and stress management aren't meaningless just because they aren't a cure-all.

They're part of the foundation.

And I realized recently that my own foundation needed some attention.

Rest Is Not Something We Have to Earn

This may be the hardest one.

I tell postpartum parents all the time that recovery is productive.

Your body doesn't need to earn rest by finishing the laundry first.

Yet somewhere along the way, I stopped extending that same kindness to myself.

There is always something else that could be done.

Another email.

Another load of washing.

Something for the kids.

Something for the house.

Something for work.

Perimenopause has forced me to recognize that pushing harder isn't always the answer.

Sometimes my body isn't asking me to become more efficient.

It's asking me to stop.

Why This Has Changed the Way I Think About Postpartum Support

Going through this hasn't made me less capable of supporting my clients.

If anything, it has deepened my understanding of what I'm asking them to do.

I've personally experienced postpartum twice. I've spent more than two decades working with babies, children and families, and I've supported parents professionally through postpartum recovery, feeding challenges, sleep deprivation and the enormous adjustment that happens after a baby arrives.

But perimenopause has given me another perspective.

I understand even more clearly what it feels like when your emotions don't necessarily match your circumstances.

When logically you know you're okay, but your nervous system hasn't received the memo.

When you're tired but your brain won't switch off.

When something tiny suddenly feels huge.

When you desperately want to feel like yourself again.

And I've been reminded that telling someone to “take care of yourself” isn't particularly helpful unless we help make that care realistic.

Sometimes self-care isn't a spa day.

It's eating breakfast.

It's drinking the water.

It's asking someone else to handle dinner.

It's going to bed instead of folding the laundry.

It's walking around the block.

It's making the doctor's appointment you've been putting off.

It's telling somebody, “I'm not feeling like myself right now.”

We Need to Talk About These Transitions More

Postpartum conversations have improved enormously over the years, although we still have a long way to go.

I think perimenopause deserves the same openness.

Neither stage should require women to quietly white-knuckle their way through symptoms because we're told they're simply “hormones.”

Hormones can absolutely influence how we feel.

But struggling emotionally should never automatically be dismissed as hormonal, either. Persistent anxiety, depression, intrusive thoughts or feeling unable to cope deserves support at any stage of life — postpartum, perimenopause or otherwise.

There is no medal for suffering quietly.

Apparently, I'm One of My Clients Now

So this week, I'm going back to basics.

I'm paying more attention to what I'm eating.

I'm moving my body again without demanding that every workout “count.”

I'm getting outside.

I'm paying attention to sleep.

I'm allowing myself to rest.

I'm continuing to pay attention to my hormones and how I'm feeling, and I'll seek professional support when I need it.

Most importantly, I'm trying to extend myself some of the same compassion I've spent years giving other women.

Because perhaps that's the biggest connection I've found between postpartum and perimenopause.

Both are transitions.

Both can leave you wondering where the version of yourself you recognize has gone.

And both deserve care rather than judgment.

I've spent years reminding new mothers that their needs don't disappear simply because everybody else needs something from them.

It turns out that lesson doesn't stop being true when your babies aren't babies anymore.

Sometimes the caregiver needs caring for too.

And sometimes taking care of yourself starts with something as wonderfully unremarkable as putting on your shoes, stepping outside and taking a walk around the block.

Right now, that's exactly where I'm starting.