Perimenopause can be a confusing time. You may notice changes in your sleep, energy, mood or concentration, yet find it difficult to understand what's happening or how best to respond.
Perhaps the routines that once worked for you no longer feel quite right. You might be juggling a demanding career, family responsibilities and your own health, with little time to work out what needs to change.
You may have read about menopause, tried different approaches and gathered plenty of advice, but still feel unsure where to start.
Perimenopause coaching offers a space to make sense of your priorities, explore practical lifestyle changes and work out what feels realistic for your life at this stage.
It isn't about trying to control every aspect of your health or following a perfect routine. It's about understanding your options and making considered decisions about the support and changes that may help you move forward.
Why Perimenopause Can Feel Difficult to Navigate
Perimenopause is the transition leading up to menopause. Hormonal fluctuations can contribute to a range of symptoms, and experiences vary considerably from one person to another.
You might experience changes in your sleep, menstrual cycle, mood, concentration or energy. You may notice several changes at once, or find that what you experience varies over time.
At the same time, life doesn't necessarily become less demanding.
You could be managing work pressures, supporting children or ageing parents, maintaining relationships and trying to look after yourself. Finding the time and energy to make changes can be difficult when you're already stretched.
This can leave you feeling caught between knowing that something needs attention and not knowing what to do first.
You may find yourself asking:
Is this related to perimenopause, or could something else be going on?
Which lifestyle changes are worth prioritising?
How can I look after myself when my energy and routines feel unpredictable?
How do I make changes that fit around my responsibilities?
Where should I turn for reliable support?
These are reasonable questions. You don't have to answer all of them alone, and you don't need to change everything at once.
If you're still trying to understand the transition itself, you may find it helpful to read What Is Perimenopause?.
What Is Perimenopause Coaching?
Perimenopause coaching is a collaborative process that helps you explore your health and lifestyle priorities during this stage of life. The emphasis is on making informed choices, setting realistic goals and reviewing how your approach is working.
Coaching does not diagnose the cause of symptoms or replace medical advice. If you are experiencing symptoms that concern you, your doctor or an appropriate healthcare professional can help assess them and discuss treatment options.
Coaching can sit alongside that care, helping you work on relevant lifestyle goals within your own circumstances.
How Coaching Can Help During Perimenopause
1. Finding a Starting Point When Everything Feels Connected
When several aspects of your wellbeing feel different, it can be tempting to tackle them all at once.
You might try changing your diet, starting a new exercise programme, taking supplements and completely overhauling your sleep routine at the same time.
That can quickly become overwhelming, especially when you're already managing a busy life.
Coaching can help you step back and identify the priorities that matter most to you.
Perhaps getting a more consistent evening routine feels like the most useful place to begin. Perhaps you want to build strength or make your meals easier to plan around work.
There is no universal starting point. The aim is to identify a manageable next step rather than adding another long list of things you feel you should be doing.
2. Making Lifestyle Changes Fit Your Life
Advice can sound straightforward until you try to apply it to a normal week.
You may want to prepare balanced meals but spend long days travelling for work. You might want to exercise regularly but struggle to find time between caring responsibilities. Or you may be so tired after a demanding day that a complicated new routine feels unrealistic.
Coaching gives you an opportunity to consider these practical barriers and explore alternatives.
That might mean finding simpler meal options, identifying realistic opportunities for movement or making small adjustments to your daily routine.
The point isn't to fit your life around a plan. It's to explore changes that can fit into your life.
3. Responding When Your Needs Change
Perimenopause is not always a predictable or linear experience. Your priorities may change as your circumstances, symptoms and routines change.
A strategy that works for you now may need adjusting later.
Coaching can provide a regular opportunity to review your goals, reflect on what's working and consider what needs to change.
If something isn't practical, you can explore the barriers rather than treating it as a personal failure. If a new routine is helping, you can decide whether to maintain it or build on it.
This flexible approach can be particularly useful when you are trying to develop habits without adding unnecessary pressure.
4. Making Space for Your Own Health
Midlife can be a demanding stage of life. You may be accustomed to looking after other people, meeting professional expectations and keeping everything running.
Your own needs can end up at the bottom of the list.
Coaching creates dedicated time to consider your health, reflect on what matters to you and decide where you want to direct your attention.
That doesn't mean ignoring your responsibilities or making unrealistic changes. It means recognising that your wellbeing deserves consideration too.
For some women, that begins with a small practical adjustment. For others, it means reviewing established routines or reconsidering how they allocate their time and energy.
The right approach depends on your circumstances.
5. Building Confidence in Your Next Steps
Perimenopause advice can feel overwhelming, particularly when different sources recommend different approaches.
You may find yourself moving from one suggestion to another without feeling confident about what is appropriate for you.
Coaching can help you clarify your goals, explore your options and make considered decisions about lifestyle changes.
The aim is not to tell you what to do or make you dependent on ongoing support. It is to help you develop a more considered approach to your health and build confidence in making choices that fit your circumstances.
When questions involve symptoms, diagnosis or treatment, those decisions should be discussed with an appropriately qualified healthcare professional.
Taking Ownership Doesn't Mean Doing Everything Yourself
Taking an active role in your health can be valuable, but it shouldn't become another demand you place on yourself.
You do not need to research every symptom, try every recommendation or become an expert in menopause before you can take a useful next step.
Nor does asking for support mean that you have failed to manage things independently.
Sometimes taking ownership means gathering reliable information. Sometimes it means seeking medical advice. Sometimes it means choosing one manageable lifestyle change rather than attempting a complete overhaul.
And sometimes it means recognising that having support could make the process feel clearer and more manageable.
The aim is to make informed decisions about what you need, rather than feeling that you must navigate every aspect of perimenopause alone.
Is Perimenopause Coaching Right for You?
Coaching may be worth exploring if you:
Feel unsure where to start with the lifestyle changes you want to make.
Have read plenty of advice but struggle to put it into practice.
Want to establish more realistic routines around food, movement, sleep or stress.
Find that work, family or caring responsibilities make it difficult to prioritise your wellbeing.
Would value having time to reflect on your goals and review your progress.
Want support that takes your individual circumstances into account.
You do not need to have everything worked out before considering coaching. You can start with the questions or priorities that matter most to you.
However, coaching isn't the right answer to every concern. If you have symptoms that need medical assessment, start with your doctor or another appropriate healthcare professional. If you already feel confident managing your lifestyle goals independently, you may not need one-to-one support.
If you're uncertain whether coaching is appropriate for you, read Do I Need a Menopause Coach? 5 Signs You're Ready for Support.
What Happens When You Work With a Menopause Coach?
If you're considering one-to-one support, you may want to understand what working with a menopause coach actually involves, including the structure of the programme and the boundaries of the coaching relationship. Read What Does a Menopause Coach Do? for a fuller explanation
What If You're Not Ready for One-to-One Coaching?
You may want guidance through perimenopause without committing to individual coaching sessions. Or perhaps you'd prefer to start learning at your own pace before deciding whether you need more personalised support.
My Menopause Essentials programme offers a self-paced option to explore practical approaches to your health and wellbeing.
It allows you to start with the guidance and structure of a programme while working through the material in your own time.
If you're looking for a free starting point, you can also explore the Menopause Blueprint.
You don't have to choose the most intensive level of support straight away. The important thing is to find an approach that suits your needs, circumstances and preferences.
Your Next Step Doesn't Need to Be a Big One
You don't have to transform your entire routine or have a complete plan for the years ahead.
You can start by identifying what's bothering you most, considering what support you need and deciding on one practical next step.
For some women, that may mean learning more about perimenopause. For others, it may mean speaking to a healthcare professional, making a small lifestyle adjustment or exploring coaching.
If you would like to understand your options, you can book a free 30-minute Menopause Clarity Call.
We can talk through your circumstances, discuss what you hope to work on and explore whether my approach could be a good fit. There is no obligation to proceed.
You can also start with the free Menopause Blueprint if you would prefer to explore practical guidance independently.
Perimenopause may bring questions and changes you didn't expect, but you don't have to solve everything at once. The next step is finding the information and support that make sense for you.
References
National Institute for Health and Care Excellence (2015, updated 2024) Menopause: identification and management. NICE guideline NG23. Available at: https://www.nice.org.uk/guidance/ng23 .
National Institute for Health and Care Excellence (2017) Menopause: quality standard. NICE quality standard QS143. Available at: https://www.nice.org.uk/guidance/qs143 .
Harlow, S.D., Gass, M., Hall, J.E. et al. (2012) ‘Executive summary of the Stages of Reproductive Aging Workshop +10: addressing the unfinished agenda of staging reproductive aging’, Climacteric, 15(2), pp. 105–114. doi:10.3109/13697137.2011.650656. PMID: 22338612.
British Menopause Society (2024) Menopause: identification and management—from guideline to practice. Available at: https://thebms.org.uk/ .
Weber, M.T., Maki, P.M. and McDermott, M.P. (2014) ‘Cognition and mood in perimenopause: a systematic review and meta-analysis’, Menopause, 21(9), pp. 990–1005. doi:10.1097/GME.0000000000000163. PMID: 23770320.
Epperson, C.N. et al. (2022) ‘Systematic review and narrative synthesis of cognition in perimenopause: the role of risk factors and menopausal symptoms’, Menopause, 29(10), pp. 1195–1209. PMID: 35878526.
Nowak, M. et al. (2026) ‘Impact of sleep disturbances on health-related quality of life in postmenopausal women: a systematic review’. PMID: 40924877.
Baker, F.C., Willoughby, A.R., Sassoon, S.A. et al. (2024) ‘Sleep disturbance associated with the menopause’, Sleep Medicine Reviews. PMID: 38916279.
Gibson, C.J. et al. (2024) ‘Menopause and sleep disorders’, Sleep Medicine Clinics. PMID: 35707298.
NHS England (2024) Supported self-management: health coaching guide. Available at: https://www.england.nhs.uk/long-read/health-coaching/ (Accessed: 16 October 2026).
Wolever, R.Q., Simmons, L.A., Sforzo, G.A. et al. (2013) ‘A systematic review of the literature on health and wellness coaching: defining a key behavioral intervention in healthcare’, Global Advances in Health and Medicine, 2(4), pp. 38–57. doi:10.7453/gahmj.2013.042. PMID: 24416684.
Kivelä, K., Elo, S., Kyngäs, H. and Kääriäinen, M. (2014) ‘The effects of health coaching on adult patients with chronic diseases: a systematic review’, Patient Education and Counseling, 97(2), pp. 147–157. doi:10.1016/j.pec.2014.07.026. PMID: 25127667.
Oliveira, J.S., Sherrington, C., Zheng, E.R.Y. et al. (2023) ‘The impact of health and wellness coaching on patient-important outcomes in chronic illness care: a systematic review and meta-analysis’, Journal of Clinical Medicine, 13(1), 75. PMID: 37738790.
Kwasnicka, D., Dombrowski, S.U., White, M. and Sniehotta, F. (2016) ‘Theoretical explanations for maintenance of behaviour change: a systematic review of behaviour theories’, Health Psychology Review, 10(3), pp. 277–296. doi:10.1080/17437199.2016.1151372. PMID: 26854092.
Michie, S., van Stralen, M.M. and West, R. (2011) ‘The behaviour change wheel: a new method for characterising and designing behaviour change interventions’, Implementation Science, 6, 42. doi:10.1186/1748-5908-6-42. PMID: 21513547.
Gollwitzer, P.M. and Sheeran, P. (2006) ‘Implementation intentions and goal achievement: a meta-analysis of effects and processes’, Advances in Experimental Social Psychology, 38, pp. 69–119. doi:10.1016/S0065-2601(06)38002-1.
Sirois, F.M., Molnar, D.S. and Hirsch, J.K. (2019) ‘The effect of self-compassion on the self-regulation of health behaviors: a systematic review’, Journal of Health Psychology, 24(14), pp. 2060–2071. doi:10.1177/1359105317713361. PMID: 28810473.
Barry, M.J. and Edgman-Levitan, S. (2012) ‘Shared decision making—the pinnacle of patient-centered care’, New England Journal of Medicine, 366(9), pp. 780–781. doi:10.1056/NEJMp1109283. PMID: 22375967.
Coulter, A. and Collins, A. (2011) Making shared decision-making a reality: no decision about me, without me. London: The King’s Fund. Available at: https://www.kingsfund.org.uk/insights-and-analysis/reports/making-shared-decision-making-reality .
Elraiyah, T. et al. (2022) ‘Effects of health coaching on menopausal symptoms in women: a randomised controlled study’. PMID: 36070877.
Sato, Y. et al. (2024) ‘Validation of the efficacy of a personalised information-provision and coaching app for menopausal women: an interventional trial’. PMID: 39278097.
Phillipa Jacobs-Smith is a UKIHCA-registered menopause health coach supporting women through perimenopause and menopause with personalised, evidence-informed lifestyle coaching.
