Survival, Healing & Perimenopause

rfbreilly
3 days ago
5 min read

Introduction

I’m sharing this not only as a practitioner, but as a woman who has lived this.

As someone with a history of trauma—and someone who has committed deeply to her own inner work—I recognize these patterns not just professionally, but personally. I see them often in the women I work with. And I know how confusing, disorienting, and at times defeating this phase of life can feel.

My hope in sharing this is simple:That if this is you, you feel less alone…Less defeated…And more informed than ever before.

So much of what’s happening during this time flies beneath our healing radar. It can feel like something has suddenly gone wrong—when in reality, something deeper is being revealed.

I’m deeply grateful to the doctors and researchers who are beginning to take both a closer and broader look at women’s health, trauma, and healing. Their work is helping to bring language and understanding to experiences many women have silently carried for years.

Survival and Perimenopause

There’s a sentence that deserves to be read slowly—maybe even more than once:

“Perimenopause doesn’t create dysregulation, It reveals what was already there—because the body can no longer buffer it the way it once did.” — Dr. Aimie Apigian

As a 50-year-old woman who has been through a lot—and has done a significant amount of healing work—The stress I had been through launched me into peri-menopause, I managed to manage most os the symptoms but about seven years into my perimenopause phase, other larger shifts started to emerge ie. ferocious auto-immune flares, which I had never been diagnosed with or experienced before. I knew my body very well and deep down inside, my intuition told me, this is hormone related.

So my research began.

And I now feel it’s essential for all women to have a deeper understanding of this topic. Because for many, this realization doesn’t arrive as clarity.

It arrives as overwhelm.

Yes, the more recognizable shifts begin to occur:

Sleep becomes unreliable
Moods feel unpredictable
Anxiety rises without warning
A body that once felt manageable begins to feel unfamiliar—sometimes even unsafe

[Link to free 40 minute neuro-somatic anxiety workshop: https://youtu.be/-7GnYau1Oos]

And somewhere beneath all of that, a quieter question surfaces:

“Why does this feel like more than hormones?”

As Dr. Aimie Apigian shares:

“Think of how you have adapted to survive your life…All those adaptations were intended to help you survive at that time…But then the heat gets turned up.”

Perimenopause is that turning point.

Not because something is going wrong—but because something long-held is no longer being buffered. If you’d like to explore this lens more deeply, her Biology of Trauma Podcast, Episode 168: The Biology Behind Hormones, Trauma, and Menopause offers an important foundation for this conversation.

When Biology Stops Buffering

As estrogen declines, it takes with it key neurochemicals that have quietly supported your ability to cope:

Serotonin — mood stability, emotional resilience
Dopamine — motivation, reward, drive
GABA — calm; the braking system for stress
Acetylcholine — supports memory, learning, and nervous system communication

For years—often decades—these helped hold things together. They softened stress, muted emotional intensity, and allowed survival patterns to run in the background without overwhelming you.

But as these levels shift, the system loses its buffering capacity.

The shock absorbers thin out.

And suddenly, what once felt manageable becomes overwhelming.

Not because you are weaker—but because your biology is no longer compensating for what your nervous system has been carrying.

When Survival Strategies Get Stress-Tested

By now, you may recognize your dominant survival pattern—even though it can shift depending on the person, place, stress level, or sensory load:

Fight → irritation, control, intensity
Flight → anxiety, busyness, overthinking
Freeze → shutdown, fatigue, numbness
Fawn → over-giving, loss of boundaries

In perimenopause, these patterns don’t disappear.

They intensify—until they can no longer run unchecked.

Perimenopause is not a test of who you are (not that you need any more tests).But it does become a reflection of how you’ve adapted.

Every survival strategy you’ve relied on is quietly being asked:

“Can you still hold this… without the same biological support?”

And often, the answer is no.

Survival strategies are not the problem. They were intelligent, necessary responses to earlier, often intolerable experiences. But if they haven’t been integrated—or updated—science now shows they can be pushed beyond their limits during this phase.

You may notice:

Hyper-independence becoming exhausting rather than empowering
People-pleasing shifting into irritation or quiet resentment
Perfectionism becoming unsustainable, with rising anxiety
Emotional suppression no longer working
Freeze states deepening into brain fog, fatigue, or disconnection

These patterns carried you—until your system could no longer sustain them.

As Dr. Apigian states:

“All survival strategies get stress-tested.”

Why Hot (and Cold) Flushes Feel So Different

Image Created by AI

Hot and cold flushes are often described as purely hormonal—but in the body, they are also nervous system events.

They are part of the thermoregulatory system, governed by the autonomic nervous system—the same system involved in your stress response.

A hot flush involves dilation of blood vessels → heat, flushing, sweating
A cold flush involves constriction → chills, shakiness, depletion

These are not random, they are deeply connected to your nervous system state.

For some women, a flush is brief and tolerable.

For others, it becomes an agonic experience—a moment of intense internal distress where the body interprets the surge as threat:

“Something is wrong. I’m not safe.”

This difference matters.

Because the same physiological event lands very differently depending on your baseline regulation:

Regulated system → rises, peaks, resolves
Survival-patterned system → amplifies, loops, escalates

The Missing Piece in the Conversation

We’re hearing more about menopause than ever before:

Hormones. Supplements. Sleep. HRT [With research now saying when administered correctly is perfectly safe- refer to podcast mentioned above] .

But what’s often missing is the deeper layer:

The nervous system
The impact of trauma and chronic stress
The role of emotional regulation
The body’s learned relationship to safety and sensation

Without this lens, many women are left believing:

“This is just what happens.”

But clinically, they are seeing something more nuanced:

How it happens depends largely on the state of your nervous system.

Working With the Body: Sequencing Matters

Trauma changes how you experience your body—especially your ability to interpret internal signals (interoception).

It is not just psychological or physiological.

It is also sensory.

For some, signals become too quiet:

numbness
disconnection
flatness

For others, too loud:

anxiety
heat surges
hyper-reactivity

Both are adaptations.

And both can be worked with—but how you work with them matters.

A Sequenced Approach

Healing follows a natural order:

Brainstem → Safety and regulation

Sensation → learning the language of the body

Deeper processing → when readiness is present

Healing is less about time—and more about readiness.

And within that:

Sensation — what you feel
Perception — what you make it mean
Response — how you respond with capacity and choice

In survival mode, this sequence is disrupted.

Healing gently restores it—not by forcing release, but by building capacity at the level of sensation first.

Providing Biological Support: Where to Begin

This is not about doing more.

It’s about supporting your system differently.

Stabilize before analyzing
Support your body first—through grounding, hydration, rest, and gentle movement
Start with small, safe sensations
Neutral or pleasant cues: breath, feet, support, connection
Track your patterns
Notice hyperarousal (overwhelm) and hypoarousal (shutdown)
Support daily regulation
Movement, nature, sleep, relational safety
Go at the pace of your body
Not urgency. Not expectation.

A Rite of Passage, Not a Breakdown

Many traditional cultures understood this phase as a transition—not a decline.

A time when what was unfinished rises.

Not to overwhelm you—but to be completed.

If this feels like too much at times…

It may be because your system is finally saying:

“We can’t keep doing it the old way anymore.”

And that moment—is also a threshold.

If this speaks to where you are:

You are not alone.

And more importantly—

There is a way to work with what’s surfacing, rather than feeling overtaken by it.

Connect with me: https://www.handsoftimehealing.com/about

RISE to WISE | 1:1 Healing Work | Neuro-Somatic Stress And Emotional Integration