By Leigh Anne Hulva, BSN, RN— Women’s Health Educator
Perimenopausal loneliness can feel confusing because you may be surrounded by people and feel unseen, disconnected, or unlike yourself. For women in Nashville, this article explains why hormone shifts, identity changes, and midlife transitions can feel so isolating-and what kinds of support can help.
Catching up With Nina: Feeling Lonely in Perimenopause
Lately, Nina has been thinking about Sundays.
Not one particular Sunday, just Sundays as they used to be. The quality of the weekend, back when it felt restorative and fun. Since she’s entered the world of perimenopause, and the anxiety it has brought with it, she just doesn’t feel like she gets anything out of weekends.
These days, Nina just feels… depleted. And, if she’s honest, she feels lonely. She’s not alone— in fact, sometimes it feels like her husband is around almost too much. And work is going fine; she likes her colleagues and (most of the time) her students. But something has shifted. She doesn’t particularly want to spend time with any of these people.
She tries to explain this to her husband when he asks what’s wrong. But all she can say is, “I just wish I could talk to someone who already understands this feeling, without me having to explain it.”
Perimenopausal Loneliness: The Experience Nobody Talks About
The loneliness of perimenopause is the specific loneliness of living an experience that our society has inadequate language for. Middle-aged women are famously underrepresented in movies and media. Women in midlife who live in the spotlight are expected not to age, not to change, not to lose the energy and sensuality of youth. The truth of the midlife female experience is so different from the lie that we’re fed as a society that it’s no wonder we feel lost when we’re faced with reality.
Our society hasn’t yet developed adequate language for the complexity of perimenopause. As a woman’s hormones shift during this transition, every system in her body is affected. This isn’t just about periods slowing and stopping; it’s about sleep, mood, identity, sexuality, discomfort, cognition, metabolism. Weight shifts around, thermoregulation seemingly goes haywire, sensitivity to noise and smells and light can be heightened. It’s no small thing.
And medicine hasn’t done us any favors. Up until very recently (and even still, in some cases), medical schools spent more time teaching about rare tropical illnesses than the menopause transition. Women seeking help for their perimenopausal symptoms were often sent away with advice to “lower their stress” or were given prescriptions for antidepressants without diving into the reason behind the depression.
A woman navigating this transition without a roadmap, without proper medical support, without the language to discuss it even with her friends, might understandably feel profoundly alone. Women deserve to be able to give this experience a name, and to have it recognized. Because this experience is real, it is common to all women who live long enough, and understanding it is the first step to feeling better.
Why Perimenopause Feels So Isolating
The Language Gap around Perimenopause
One huge contributor to perimenopausal loneliness is the lack of adequate language for the experience. Hot flashes have a name. Insomnia has a name. But the other, more nuanced experiences of perimenopause? That’s trickier. The experience of waking at 3 in the morning, filled with a dread you cannot name? Feeling your body change in myriad ways without knowing what’s coming next? Grieving the energy of youth in a body that feels unfamiliar to you? These things are harder to name.
The Invisibility of Midlife Women
There is also a very important social context when it comes to middle-aged women that deserves to be named. Midlife women are among the most invisible members of society. The cultural attention paid to youth, to fertility, to the earlier stages of womanhood does not extend into the perimenopausal years. Women in their late 40s and beyond often describe a sense of becoming less visible, not just to men, but to society in general. They are underrepresented in film and other media, and their style options are more limited in clothing stores. They begin to feel invisible in work settings, even as their male peers of the same age seem to receive more attention rather than less.
All of this is happening just as a woman is often beginning to feel more, rather than less, internally complex.
Research on ageism and gender consistently shows the particular disadvantage of midlife women in a variety of areas, from healthcare to employment to media representation. A woman needs to be aware that this is a societal shortcoming and not a personal failing. She hasn’t aged out of an interesting life; there’s just something wrong with society’s apparent perception of the middle-aged woman.
Relationship Changes in Midlife
The years of perimenopause often coincide with a period of significant relationship transitions. If the woman is a mother, her children are likely growing up, even leaving home for the first time. Her parents may be aging, may be requiring care. Friendships that have drifted on the fringes fall away as emotional energy becomes more limited. Even partnerships and marriages are taking a hit. Separation and divorce rates climb to a new high at this age. The hormonal shifts of midlife arrive on this already complex scene without first asking permission, and it can feel like a hand grenade is being lobbed into the midst of an already chaotic scene. These different kinds of losses can add to the sense of loneliness a woman feels at this stage.
The Sunday Quality: Why Weekends Can Feel Especially Lonely
Nina’s feelings about Sundays capture her sense of not having certain things to fill what used to be a day for family and fun and relaxation. Her children are grown, she has allowed her circle of friends to shrink to a more manageable number, and they’re often busy too. The busyness of a weekday keeps the loneliness at bay, but these hours stretching before her without the anchoring of family or social tethers just make her feel… alone.
Perimenopause and Identity: Who Am I Now?
Women who have formed their sense of selves around their roles of mother, professional, partner, caregiver… they may find these roles shifting in a way that makes it hard to answer that old “Who am I?” question. It’s easier when you have young children at home, a career taking off, a romantic relationship with a clear definition. It’s also easier when your hormones aren’t seemingly conspiring to make everything more complicated.
This “identity renegotiation” is part of the psychological work of perimenopause. This is complex, difficult, taxing work that our current culture doesn’t adequately support, validate, value, or even fully acknowledge.
What Helps with Perimenopausal Loneliness
Finding Women Who Understand Perimenopause
The most consistently helpful antidote to this loneliness, as reported by women themselves, is to find connection with women who are in or have been through the same transition.
Find women who don’t need everything explained to them. Find women who recognize what it feels like to “feel like you’re disappearing.” This kind of connection can happen in online communities, support groups, and friendships that deepen around this shared experience.
Nina did eventually find an online forum that was a good fit for her. She had been following an Instagram account that talked about the vagus nerve (as described in another article), and she followed that lead until she found a place she felt she fit. She found women who were asking just the questions she was asking, were feeling the same hard-to-describe aloneness and angst that she was feeling. She felt more seen than she had in a while. And then she reached out to a friend that she just had a feeling would understand as well. Over coffee dates over the next few months, their friendship deepened with this shared experience.
Hormone Therapy for Perimenopausal Symptoms
Many women describe the emotional isolation of perimenopause as lifting— at least partially— when they start treating these symptoms and others with hormone therapy. This therapy can help stabilize their neurological environment, which is a solid first step toward calming some of the mood and cognitive issues of perimenopause. This isn’t the whole answer to midlife loneliness, but it might be an important first step for you if you are a candidate for hormone therapy and are interested in pursuing that conversation with your healthcare provider.
Giving the Experience Language
There is something powerful about language, about finding the words to express what you’re going through. The words don’t even have to be the “right” ones. Just try some out, with a journal and pen, or with a counselor, or with a friend. Read articles that catch your attention. You are not the only woman who has felt like a stranger in her own changing body. You are not the only one who has sat at home on a Sunday and thought about how alone you feel. And you don’t have to feel alone alone.
Nina would agree that you are, in fact, in very, very good company.
When to Seek Help for Perimenopausal Loneliness
Seek out a compassionate provider with experience in treating women in midlife. You owe it to yourself to feel better. You are not alone, and you don’t have to navigate this transition alone. People in general, and women in particular, are becoming more and more aware of these issues as they are shared far and wide online and across social media. Find the right (accurate, uplifting) information, connect with a caring healthcare provider or counselor, and go from there. Don’t give up on feeling better until you get the answers and care that you deserve.
Frequently Asked Questions About Perimenopausal Loneliness
H3: Why do I feel so alone during perimenopause even when I’m surrounded by people?
This kind of disconnect is common when your emotional experience feels so unique to you. You might be feeling like you can’t talk to other people about what you’re going through since society hasn’t normalized this (yet… although hopefully, we’re getting there). Cultural support for the experiences of the woman in midlife is inadequate, so putting our experience into words or context is difficult unless we know we’re talking to someone who’s familiar with the experience already. Take your time, find your people. There are online influencers whose entire platforms normalize and celebrate this midlife transition; find them!
Can perimenopause cause depression and social withdrawal?
Yes, both depression and social withdrawal are recognized features of the perimenopause transition. Fluctuating estrogen levels directly affect the neurotransmitters that regulate mood. Add to that poor sleep, physical discomfort, and a sense of identity disruption, and social withdrawal can quickly follow. Persistent low mood can either contribute to or be exacerbated by this social withdrawal— and vice versa, in sort of a chicken-or-the-egg situation. If your quality of life is being affected by either issue, talk to a compassionate provider who is well-versed enough in midlife medicine to help you parse out hormone-driven mood changes, clinical depression, and the grief that sometimes accompanies life transitions.
How do I find support during perimenopause?
There are some spectacular online communities and forums specifically for perimenopausal women. Personally, I have found my Instagram algorithm leans heavily toward perimenopausal health and wellness, often feeding me both solid medicine-backed information as well as humorous takes on what are otherwise difficult issues. I find that this is a real help, that it is relatable and deeply validating in a way that sometimes surprises me. If you have friends your age or a bit older (or an older female friend or relative who you can open up to), test the waters with talking about these issues.
A kind counselor can be a source of meaningful support. A good counselor knows what questions to ask when to help you get to the bottom of an issue. For example, it’s helpful to know where your loneliness or depression has its roots: Are you just too tired to meet up with people you used to see more regularly? Are you feeling less feminine due to the change in hormones? Less sexually vibrant? Are you worried that your health will begin to decline slowly? Do you feel like nobody understands what you’re going through? These are all different issues with different solutions, and a counselor can help you navigate the answers.
Who is Leigh Ann Hulva in Her Own Words
I’m Leigh Anne Hulva, BSN, RN- a registered nurse, women’s health educator, mother of teenaged daughters, and passionate advocate for women navigating perimenopause and menopause. I recently completed the Harvard Medical School course on Women’s Health and in these pages I relish sharing what I learned there alongside what I know from lived experience. I bring to this work not only my training, but also the personal experience of navigating the very transition I write about. It is my privilege to share both, because this work is personal to me. I hope it feels that way to you, too.
I have been on the other side of this conversation, and I understand how much it matters to feel truly heard. At Nashville Concierge Medicines, my work is supervised by Dr. William Conway, MD, and I work directly under his licensure as a nurse educator.
H2: Who is Leigh Anne Hulva by William Conway, MD.
Leigh Anne Hulva is a writer in the tradition of American Humanism. Her voice speaks with a clarity and eloquence rarely found in medical writing.
