Menopause Rise and Thrive | Helping Women Navigate Midlife and Menopause

139. Emotions hit hard in midlife

• Dr. Sara Poldmae | Healer, Doctor of Acupuncture and Chinese medicine, and Functional Medicine Practitioner

Share episode

Use Left/Right to seek, Home/End to jump to start or end. Hold shift to jump forward or backward.

0:00 | 17:34

Are your emotions feeling a little… unpredictable lately? One moment you’re fine, and the next you’re overwhelmed, irritable, or wondering why everything suddenly feels so heavy. If you’re in perimenopause or menopause, you’re not imagining it—and you’re certainly not alone.

In this episode, Dr. Sara Poldmae opens up about the emotional toll that midlife hormonal shifts can take. She breaks down what’s happening in the body—from fluctuating estrogen to declining progesterone—and why these changes can create mood swings, anxiety, loneliness, or even guilt around intimacy. More importantly, she shares compassionate, practical ways to support your emotional well-being during this transition so you can move through midlife with more awareness, support, and self-compassion. 

In this episode:

  • Why perimenopause and menopause can feel like an emotional roller coaster—and why that experience is completely normal
  • How fluctuating estrogen, declining progesterone, and shifting testosterone levels influence mood, anxiety, sleep, and libido
  • The role of cortisol (the stress hormone) and why stress can feel more intense during midlife
  • How Chinese medicine concepts like liver Qi stagnation and declining kidney Qi may help explain emotional imbalance during menopause
  • The emotional impact of low libido, including guilt, shame, and relationship tension—and why open communication matters
  • Why loneliness can become more common in midlife as friendships shift and we enter a more reflective phase of life
  • Simple practices that can support emotional balance, including meditation, movement, therapy, and connecting with other women

Links and Resources: 

Connect with me, Sara Poldmae:

Ready to feel more empowered in midlife? Explore Sara’s resources and programs designed to help you navigate perimenopause and menopause with clarity, support, and confidence.

And if this episode resonated with you, consider sharing it with a friend who may also be navigating the emotional side of this transition.

Have a question I can answer? Send me a message! I love to hear from my listeners!

Sara Poldmae:

Sarah, welcome to menopause. Rise and thrive. I am Dr Sarah pulled May, and this podcast is your go to guide for navigating perimenopause and menopause. If you are feeling a little overwhelmed, trust me, you are in great company each week, I'll bring you expert advice, raw, honest conversations and simple tips to help you stay grounded and maybe even find some humor in the process. Let's rise thrive and tackle this wild ride together. Welcome to another episode of menopause. Rise and thrive. I'm Dr. Sarah pulled May and today we are diving into a topic that really resonates with so many women in midlife, including myself, and that is the emotional toll that perimenopause and menopause can really take on us, because menopause and perimenopause can really hit hard in ways that we're not expecting. For those of you that have been tuning in for a while, you know, we talk about all the things, from sex to fatigue to brain fog to everything, right? We talk about all the things. And one of the things we talk about a little bit, but I think we need to talk about more is the emotions that come along that can really feel like a storm in this chaotic time of our lives, and it's perfectly normal to feel feel overwhelmed. In fact, I'm a quote, unquote expert in this medicine, and I'm going through it myself, and I want to share some insights on why this happens, and, more importantly, what we can do to navigate this journey with grace and a sense of empowerment, because this can be a really special time of life, and I can share a little bit about what helped me. So let's start by understanding the hormonal changes that can lead to these emotional shifts, because each sex hormone kind of has its job to do, and estrogen is a hormone that plays a really vital role in mood regulation. As estrogen levels drop, a lot of things can happen, and unfortunately, estrogen doesn't take a smooth, easy decline. It can go all over the place. So sometimes you'll feel great for a couple of months, and then you'll be like, Oh my god, what is wrong with me? So many women can experience mood swings, irritability, anxiety, all the things, and it can feel like your emotions are a real seesaw because of estrogen not playing nice. Really. I think we think of estrogen as like, oh, it definitely declines, and that is true, but the road to the decline is not always super smooth. Progesterone is often called the calming hormone, and this hormone does indeed decline at a steady pace from about 35 on, and as it declines, many women will start to feel reported kind of increases in anxiety. I see that a lot in clinic, as well as insomnia, and I'm going through that, and I work on sleep as if it's my job, because I can never tell whether the anxiety is because of life circumstances or if I didn't get a good night's sleep. You know, waking up with doom and gloom at 3am like it takes me a lot of work to sleep well. And the next sex hormone that we want to talk about is testosterone. I've talked about that on the past two episodes, and testosterone is definitely vital for our libido and energy levels. And when testosterone dips, it can lead to a decreased sex drive and also really a sense of disconnection from our partners. And lastly, there's cortisol, which is not a sex hormone, it's a stress hormone. And during this time, many of us feel that we are more stressed, and our cortisol levels can be spiking and falling, and that can definitely make us feel like we're on an emotional roller coaster. So I want to layer in, because I don't think that that's the full picture. I want to layer in a little bit of Chinese medicine, because in this particular tradition, we talk about Qi, or energy, and its connection to our emotional health. And one concept that we look at in Chinese medicine is what we call liver Qi stagnation, when our liver energy is stuck, it can manifest as frustration or anger or just being on edge. And this is something to really be aware of, and it is super, super common here in our culture, especially during those perimenopausal years. And we also. Consider kidney essence, our kidney chi is crucial for our vitality and emotional balance, and kidney chi declines as we age, and there's a big decline in kidney chi during this perimenopausal transition. And supporting kidney health, kidney chi can really help us to navigate through our emotions and have us stay more grounded. So if you're curious about Chinese medicine, its practices, I encourage you to find an acupuncturist in your area that is is trained in women's health. So let's get to some real common experiences that either I face or the women in my clinic or my friends face, because many of you have shared these feelings. One of the big ones I encountered a lot over the past couple weeks in clinic is the feeling of guilt surrounding a diminished sex drive, right? So it's not uncommon for women at this stage of life to have low libido, but it's also not uncommon. So I want you to feel like you're not alone. If you feel like you even cringe when your partner touches you. I had a few women in clinic last week say, not only do I not have a sex drive, but like, I don't know, like, I jump when my husband touches me, and that can really lead to some deep feelings of guilt and maybe even shame for not, like, pulling your weight in your relationship. And I'm not here to be your couple's counselor, but I am here to tell you that having a healthy sex life can mean a lot of different things to a lot of different people, and your husband may have different sexual needs than you do. So again, not a sex therapist here. I can't really untangle that, but what I can do is tell you that those emotions are normal and you're not alone, and that there is help out there to get you to feel better in order to maybe have that sex drive kick back in from a physical standpoint, and maybe some of that cringing while you're being touched, that may be more of a nervous system thing. So there is help on both fronts. Monique and I practice exclusively in the midlife space, and we help women to navigate through whether some of those feelings are physical or emotional, and hormones definitely play a part, but they may not be the whole story. So finding practitioners that can really help you to to navigate through, like, what's what's physical, what's emotional, it's all tied together. But in which avenue do I need to pay more attention in order to get the results that I want? And midlife is supposed to be the time where we pause and figure out what we want. So sometimes it's just about, you know, giving yourself that time and that grace and finding the support you need in order to find out like what a healthy sex life would look like for you in your 40s, your 50s, your 60s. Because, again, that's going to be different for each woman, and it's going to be different for each man, and as a part of a whole relationship, you certainly want to have open conversations about what that looks like to you, but again, talking about emotions in this episode, that guilt that you feel, that shame that you feel, maybe the depression that comes along with not feeling like you're living up to your husband's needs. All of that really needs to be looked at, and it doesn't need to be looked at with a sense of urgency or pressure, just knowing that you're not alone and that you deserve to feel more satisfied, whatever that means to you is is something that you can work on. Additionally, another thing that I saw a lot the past couple weeks in clinic. It was an emotional couple weeks, and I think that's partly because it was the end of February. This episode will air in March sometime, but in the end of February, I think people are just feeling all the feels right, especially here in Maryland, it has been extremely cold. We had a lot of snow and ice recently, and I think that just affects our emotions. So being in midlife with these emotions already storming around. Add in a little bit of a long, cold winter that we're not as used to, can really feed into it. But I've seen a lot of loneliness in clinic, and that crept up a lot the past couple weeks, but has been thematic in my practice. Loneliness can creep up for quite a few reasons. The number one reason, I would say, is because midlife does definitely take us more internal, like it has us, and it's supposed to have us in a time of reflection, trying to figure out what we need, and just reflecting on like what, what did life look like, and what can it look like in the future? And sometimes. Going deep like that, can feel a little bit isolating. Is normal, as long as we don't get stuck in it. So a little bit of loneliness here and there is okay, but if you're staying stuck in that, I urge you to to get some help, because loneliness can really be uncomfortable. We don't want to stay there long, but it also isn't isn't healthy. Long term loneliness can cause severe health problems, so I encourage you to get health if you help, if you feel like you've been stuck there for a while. Another reason that I see loneliness creep in during midlife, besides that turning inwards, is our friendships shift, and we talked about that a lot on the podcast, from a sense of like, Why do friendships shift? We want different things from our relationship. So that's, you know, part of it, but it's important to remember that you again, are not alone in these feelings. Many women are navigating similar challenges. So what can we do to turn these things around? Right? This challenging journey can also be a beautiful one when you really look at and take some action items, action steps towards empowering yourself. So a few things that I talk about in clinic and that I practice myself are mindfulness and meditation. Practicing mindfulness can really help you to stay in touch with your emotions and manage them better, and even a few minutes of mindfulness and meditation daily can really make a difference. I have had an extremely challenging past six months, starting with the fire, and I can tell you that I don't live an extremely easy life as an entrepreneur. I have a million different things going on, and normally I enjoy that, but sometimes, if my health isn't great, or if I've just got too many things that are unexpected piling on, I can really get into a state of overwhelm, and the one thing that helps me to pull through these things is my meditation practice. And this doesn't mean that I meditate every day for a prolonged period of time. Sometimes it's only five or 10 minutes at a time. Sometimes it's just laying down on the couch relaxing with my puppies, putting on a meditation from Insight Timer, and just taking a few minutes to connect with myself. That is really, really a saving grace for me, especially in these past six months, but through midlife in general. So I encourage you, if you don't have a meditation practice and you can always reach out to me to find out more, but start using one of those meditation apps, even if it's for five minutes a day. You do not have to invest a ton of time, but that can be really super useful physical activity. So physical activity exercise reduces stress levels, increases endorphins, which are your feel good hormones, whether it's walking, yoga or dancing, find a movement that you love. Sure, in midlife medicine, we start talking about strength training. We start talking about bone building exercises. All of that is important, but for emotion, specifically for feeling good in general, you really just need to get that blood moving. I don't need to pick the right type of exercise for you. It's more important to pick the exercise that you will actually do and incorporate daily into your life. Because if you are moving your body, your brain feels better open communication. I think that that's huge. And in midlife, we start to feel like, Oh, what have I not been saying? So talking to the people in your lives, whether it's your partner or your friend, and sharing thoughts and helping them to understand where you're coming from and what you want more of and maybe what's bothering you can be really super helpful. So our relationships can be challenging because we start to turn inward and find things that may not be serving us anymore. So figuring out communication tools, finding books or talking to your therapist about how you can communicate better your needs, wants, desires, can be super helpful at this time in life, connecting with other women, whether through women's circles, friends, however, you can connect with women and start to build new relationships if your old relationships are falling apart, can be really, really, extremely rewarding, and sharing commonalities And stories during this time can be really validating. If you find that you are really struggling emotionally and you are not seeing a therapist, I encourage you to find a therapist that you can work with, that you enjoy. It is not a sign of weakness to reach out for help. I. Definitely have used therapy on and off throughout my adult life, and have found that when I was having really big hormonal shifts a couple years ago, I needed to lean on my therapist more than ever. So the things that I do are really I focus on sleep, because if my sleep isn't good, my emotions are not good, I focus on rest and meditation. I focus on moving my body and, you know, just practicing some of those communication tools. Because I'm not always great in the moment at saying what I need or what I want. That's something I'm working on. So I hope that some of these things help you. As we wrap up today's episode, remember that this journey through perimenopause and menopause can be beautiful with the right tools and support. If you are in Maryland, we would be honored to work with you through this and help you to optimize your hormones, help you to navigate through your lifestyle, to make sure that it's fitting with what you need in the moment and for the long term, and know that you have the power to navigate through this time with a lot of grace. I think it's important to really acknowledge that we do have the power, even if we don't feel it today. It doesn't mean that that power is not with us somewhere deep inside. So I'd love to hear your thoughts or experiences related to today's episode. Please feel free to reach out hello at rising woman project.com and don't forget to share this episode with a friend who you feel might benefit from it. Couple of exciting things that I have going on are my retreats. We have a retreat at the end of April in West Virginia. We'd love to see you there. And if you're looking for a larger experience, we're going to Italy in October. My first week in Italy sold out in 10 days, so we added a second week, and we have, I think, six or seven spots left, not sure that they'll be there by the time this episode airs, but I'll put the links in the show notes for those retreats. Thank you so much for joining me today, and I hope that you have a beautiful March, a beautiful spring, and that you feel good emotionally foreign.

Head Shot

Dr. Sara Poldmae

Host