Understanding Burnout and Perimenopause: A Holistic Approach

Midlife can be a time of profound change - physically, emotionally, and professionally. For many women, this period brings about perimenopausal symptoms that often overlap with burnout, creating a confusing and challenging experience. To shed light on this complex intersection, I recently spoke with Dr. Rachael Chrystal, a GP and accredited menopause specialist, whose research and clinical experience offer valuable insights into how hormonal shifts, stress, and life pressures intertwine during this pivotal phase.

The Overlap of Burnout and Perimenopause
Rachael explains that women often present with symptoms like exhaustion, brain fog, and emotional detachment—signs that can be mistaken for depression or simply stress. However, these symptoms frequently occur alongside hormonal fluctuations characteristic of perimenopause. The challenge lies in disentangling what’s caused by hormonal change from the effects of stress and burnout.

Hormonal changes (particularly fluctuations in estrogen, progesterone, and testosterone) impact brain function, resilience, and our ability to manage stress. As estrogen levels decrease and become more erratic during perimenopause, women may find themselves less able to cope with everyday demands, leading to increased fatigue and emotional exhaustion.

Researching Women’s Lived Experiences
Rachael’s qualitative research involved interviewing 15 women experiencing burnout during perimenopause. Her analysis revealed four key themes, one of which she describes as feeling “lost in transition.” Women shared feelings of identity loss, grief, and confusion, especially when their symptoms were atypical or unexpected—like experiencing menopause symptoms in their early 40s or even late 30s.

Many women felt overwhelmed by invisible pressures (both visible and societal) such as workplace expectations and gender stereotypes. They often described managing a multitude of responsibilities: careers, caregiving, and personal commitments—all while feeling increasingly exhausted and detached.

The Diagnostic Dilemma
One of the recurring issues women face is difficulty in getting clear diagnoses. Many are told their symptoms are due to stress, depression, or other conditions, especially when blood tests don’t provide definitive answers. Rachael emphasizes that blood tests in perimenopause are not always reliable, and understanding the pattern of symptoms—such as cyclical changes—can be more helpful.

She suggests tracking symptoms, noting how they fluctuate during menstrual cycles or time away from stressors like holidays or time off work. This can provide valuable clues about whether symptoms are hormonally driven or related to stress.

Pathways to Support and Empowerment
Support is crucial. Some women find relief through hormone replacement therapy (HRT), which can quickly alleviate many physical and psychological symptoms. However, Rachael stresses that a holistic approach (including lifestyle changes, coaching, counseling, and community support) is essential.

Building strong boundaries, re-evaluating life priorities, and fostering open conversations about menopause help women regain confidence and a sense of control. Many participants in her research reported feeling empowered after navigating these challenges, often emerging with a renewed sense of purpose and resilience.

Creating Safe Spaces and Normalizing Conversation
Normalizing discussions about menopause and burnout reduces stigma and encourages women to seek help without shame. Community activities—like walking groups, spending time in nature, or sharing stories—foster a sense of belonging and understanding.

Rachael highlights that support from peers, workplace policies, and accessible healthcare are vital. When women feel heard and supported, they can better manage their symptoms and thrive in midlife.

Looking Ahead: Hope and Possibility
While the journey through perimenopause and burnout can be difficult, many women report emerging on the other side with greater self-awareness, stronger boundaries, and a sense of freedom. As Rachael notes, this can be a “reckoning” that leads to positive change—re-evaluating life choices, relationships, and careers.

Midlife is not just a time of loss but also of potential growth. By understanding the interplay between hormonal shifts and stress, seeking holistic support, and fostering open conversations, women can navigate this transition with confidence and empowerment.

If you’d like to join our Holding Up The Sky community for women in midlife, click here to find out more. 

Click here to listen to the full interview with Dr Chrystal on the Middling Along Podcast.