Perimenopause, Mental Health and Self-Sovereignty: In Solidarity with Em Rusciano’s Rage Against the Vagine
If you’ve ever ugly cried in the Woolies car park, sworn at the printer for jamming again, stared at the fridge like it holds the answers to life… and wondered who the fck you are now that you can’t spin the plates you used to spin, you’re in good company. You’re in perimenopause. And perimenopause isn’t just about hot flushes and night sweats, it’s a mental health, identity, and self-sovereignty revolution. Perimenopause is the transitional stage leading up to menopause where hormonal, neurological and psychological changes collide, often triggering brain fog, mood swings, anxiety, relationship shifts and a deep reassessment of what you can keep doing and what you’re finally done with.
And because this is written in full meno-solidarity with Em Rusciano and her Rage Against the Vagine community, I want to speak to you directly.
Dear Em and every glorious human in the Rage Against the Vagine posse,
Consider this a rally cry, a hug, and a knowing smirk all rolled into one. Because if you’re here, you already know perimenopause is not just a “stage of life”. It’s a psychological, emotional and identity-shaking rock show that does not give a flying fck about your to-do list.
I’m a psychologist who works with women riding this exact rollercoaster. And let me tell you… you’re not imagining the emotional whiplash. Perimenopause mental health is a 'thing' and support, in whatever shape or form, vital. Because the brain fog, the mood swings, the late-night overthinking, the sudden nope, I’m done moments… they’re as real as your vagina is dry.
And it’s not just my clients. In my own perimenopause years, I was caught completely off guard. Despite decades in women’s mental health, I didn’t connect the dots between the shifting moods, the bone-deep fatigue, the sleep disruption, and that jarring feeling that I didn’t quite recognise the woman looking back at me in the mirror.
And woman after woman was sitting in front of me, describing the same thing. We were all trying to keep functioning, all wondering what we were doing wrong, all unaware that this storm was perimenopause and not a personal failing (oh and for me and many, a little ol' late diagnosis of ADHD too).
We should at least be given a bloody pamphlet by the time we’re 35. Clearly that’s been too much to ask… even in 2025.
It’s Not Just Hormones… It’s a Whole Life Shake-Up
The old story says menopause is about hot flushes, vaginal dryness and a few grumpy moods. But here’s the truth… perimenopause isn’t just a biological event. It’s a developmental stage as big and identity-shifting as puberty and motherhood. And it’s designed to disrupt you.
Why? Because it’s not only your hormones changing, it’s your brain health, your priorities, your tolerance for crap, and your willingness to keep performing roles that no longer fit.
Think of it like this…
In puberty, you become someone new.
In perimenopause, you are invited (sometimes pushed) to return to your truest, unfiltered self. The self you were before a lifetime of patriarchal conditioning taught you the most soul-destroying definitions of what it means to be a “good girl” or “good woman”. This is the woman who knows her worth, who owns her voice, who wears her invisible crown without apology.
“There’s got to be a voice deep within you that is untouched by definitions. And it is there that you become divinely who You are.” Viola Davis
Oestrogen, sometimes called the hormone of accommodation and servitude (eww), starts to fluctuate and decline. That’s the hormone that’s been helping you tolerate, smooth over and juggle everyone else’s needs. When it goes AWOL, the rose-coloured glasses come off… and you see all the ways you’ve been settling or self-silencing.
And then? SNIP.
No more saying yes just to keep the peace.
No more putting yourself dead last.
No more martyr cape membership.
This is where the Queen in you starts to rise. She’s not here to please. She’s here to reign.
Your Brain is Rewiring for the Next Chapter
The hormonal rollercoaster of perimenopause doesn’t just make you feel tired and wired at the same time… it also triggers neuroplasticity. That’s your brain’s ability to rewire and reshape itself.
This “brain pruning” is like a ruthless spring clean.
Old neural connections you no longer need get cut away.
The ones that matter for this next phase of life get strengthened.
Yes, that pruning can feel like chaos. Hello brain fog, mood swings, overwhelm. But it’s also an opportunity to rewire in ways that align with your values now, not the ones you inherited 20, 30, 40… even 50 years ago.
Your brain is making space for the woman who leads herself, who knows what she stands for, and who is no longer afraid to claim her throne.
Reverse Puberty Is Real
Just like adolescence, this is a threshold moment. In puberty, the question is… “Who am I apart from my family?”
In perimenopause, it’s… “Who am I apart from my roles?”
Roles like wife, partner, mother, daughter, carer.
The dependable one. The over-giver. The peacekeeper. The one who holds it all together. The one who always gets shit done.
When those roles no longer fit, you might feel lost for a while. That’s not failure… that’s the work.
What Helps While You’re in the Thick of It
You don’t need to burn your life down overnight. In fact, that’s the fastest way to fry your nervous system. Start small. But start deliberately.
Claim breathing space in your day… moments with no output, no caretaking, no explaining. Even five minutes can shift your whole system.
Notice your “full body no”… the sigh, the tension, the dread. They’re early warning signs something’s no longer sustainable.
Speak out loud what you’ve been swallowing… even if it’s just to yourself or a trusted friend. Silence feeds the stuckness.
Let relationships evolve. Some will deepen. Others will loosen. Both can be healthy.
Find your anchors… practices, places, people that remind you who you are outside your roles.
None of these are quick fixes. They’re acts of reclamation.
You’re Not Broken… You’re Becoming
The physical symptoms of perimenopause are real and deserve support. But that “WTF is happening to me?” feeling isn’t a sign you’re losing yourself… it’s a sign you’re finding yourself again.
Perimenopause is the invitation (and sometimes the shove) to reassess what’s sustainable, throw out what isn’t, and speak up about what you need… more clearly and unapologetically than ever before.
It’s a recalibration. A remembering. A re-emergence.
If you don’t feel like yourself right now, you’re in good company. You’re stripping away what no longer fits so you can step into the next chapter with a clear mind, strong back, wild heart and wise soul.
That’s not just “not a bad thing”… that’s the point.
You’re not failing. You’re evolving. And in meno-solidarity, we can do it together.
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