Perimenopause & Menopause Support
Something has shifted and you’re not sure when it happened or who you are on the other side of it.
Your body feels unfamiliar. Your desire has quietly disappeared and you don’t know if it’s gone for good or just hiding. Maybe you’re more irritable than you used to be, or more anxious, or more done with things you used to tolerate without a second thought. Maybe you look at your relationship and wonder how you got here, or look in the mirror and don’t quite recognize the woman looking back.
You’re not falling apart. You’re in the middle of one of the most significant transitions of your life, and nobody prepared you for how much it would touch everything.
This Is More Than Hormones
Perimenopause and menopause are real biological events. The hormonal shifts are real. The physical symptoms are real: the irregular periods, the sleep disruption, the changes in your body that nobody warned you about clearly enough.
But what often goes unaddressed is everything else this transition stirs up.
Who am I now that my body is changing? What do I actually want – in my relationship, in my life, in how I spend my time and energy – when so much of what felt certain no longer does? What do I do with the parts of myself I set aside for years, the needs I minimized, the ways I quietly accommodated everyone else while losing track of what I actually wanted?
This is the work I do. Not just the symptom management (that’s important, and your gynecologist and other providers are part of that picture) but the deeper layer underneath. The identity piece. The relational piece. The erotic piece. The question of who you are becoming and what you want that to look like.
What You Might Be Experiencing
When Desire Changes or Disappears
You used to feel sexual. You used to want your partner or at least be open to it. Now it’s just… not there. Or it’s there occasionally and then gone. Or it feels different: slower, more conditional, harder to access. And you don’t know if that’s permanent.
Feeling Like a Stranger to Yourself
The woman you were in your thirties felt more knowable. This version of you is harder to read, harder to predict, sometimes harder to like. Some women describe it as losing themselves. Others describe it as being forced to finally find themselves, but that doesn’t make it comfortable.
When Your Relationship Is Showing the Strain
Your partner doesn’t understand what’s happening. Or you can’t explain it. Or you’ve been managing so much internally that there’s nothing left for the relationship by the end of the day. The distance has been growing and you’re not sure how to close it.
A Body That Feels Less Familiar
Sex may have become uncomfortable or painful. Arousal takes longer or doesn’t come the way it used to. Your body feels less predictable, less familiar, less yours in some ways. And alongside the physical changes can come something harder to admit — a quiet grief for the version of your body and your sexuality you used to know, and uncertainty about what’s possible now.
Anger, Irritability, and a Lower Tolerance
Something in you has stopped being willing to accommodate everything. The patience you used to have feels thinner. Resentments that were quiet are getting louder. This can feel alarming, or it can feel like the beginning of something honest.
Anxiety, Brain Fog, and a Loss of Groundedness
Brain fog, mood shifts, a sense of unsteadiness that feels new. Many women in perimenopause describe a kind of disorientation: not depression exactly, but not quite themselves either.
What Therapy Addresses
This isn’t about fixing you. You’re not broken. But you may be at a crossroads that deserves more than a prescription and a pamphlet.
In our work together we explore:
Desire and Why It’s Rarely Just Hormonal
Desire is relational, psychological, historical, and contextual. It responds to how safe you feel, how seen you feel, how much resentment you’re carrying, what you’ve been taught to want or not want, and what your body is doing at any given moment. We look at all of it.
Identity and Who You’re Becoming
Many women arrive at midlife having spent decades organizing their lives around others: their children, their partners, their careers, their roles. Perimenopause has a way of making that arrangement suddenly feel unsustainable. We work on what it means to want things for yourself again, to take up space, to stop performing a version of yourself that no longer fits.
Your Body and Your Sexuality
If sex has become painful, loaded, avoided, or anxiety-producing, we address that directly. As a certified sex therapist, I bring clinical training to this that goes beyond general talk therapy. We work with what your body needs now, not what it needed ten years ago.
Your Relationship
The relational impact of this transition is real and often underestimated. We work on communication, on desire differences, on how to navigate a partnership when one person is going through something the other can’t fully understand.
The Grief and the Possibility
Midlife is both. There are real losses in this transition: of fertility, of a particular version of your body, of certainty about who you are. There’s also something that becomes available when you stop performing and start being honest. We make room for both.
A Note for Partners
If your wife or partner is going through perimenopause or menopause and you’re trying to understand what’s happening and what you can do, this section is for you.
What she’s experiencing is real. The irritability, the withdrawal, the changes in desire, the sense that she’s not quite herself: these aren’t personal, and they’re not permanent. But they’re also not nothing, and they deserve more than being waited out.
The most common things partners describe: feeling shut out, not knowing what to say, walking on eggshells, missing the intimacy you used to have, not understanding why things that never bothered her before suddenly do.
The most common things women describe: feeling unseen in what they’re going through, feeling pressure around sex when their body isn’t cooperating, feeling like they have to manage everyone else’s feelings about their transition on top of managing their own.
Couples therapy during this time can help you both understand what’s actually happening, communicate about it honestly, and find a way through that doesn’t cost you the relationship. If you’re looking to support her and also get some support yourself, that’s exactly the kind of work I do.
Working Together
I work with women individually and with couples navigating this transition together. Sessions are via Zoom, 50 minutes, typically weekly to start. I work with clients throughout California and am also licensed in Florida, Idaho, and Vermont. I see clients internationally as well, including through a virtual office in Hong Kong.
I’m a licensed clinical psychologist and AASECT certified sex therapist. That means I hold the clinical, relational, and sexual dimensions of this work together, not as separate conversations, but as the interconnected thing they actually are.
Ready to Talk?
I offer a free 15-minute consultation. That’s enough time to get a sense of how I work and whether this feels like the right fit.
Dr. Kristin Zeising, PsyD, CST | Licensed Clinical Psychologist | AASECT Certified Sex Therapist | San Diego, CA | Telehealth via Zoom
