I Pushed Through Everything. Then Perimenopause Rewrote the Rules for my Nervous System.
- Sarah Gilbertson
- Nov 10
- 4 min read
It didn’t happen overnight. But one day, the old strategies stopped working - and my body made me listen.
How the Perimenopause Nervous System Rewrites Your Capacity
For years, I was the woman who just kept going.
Cold? Layer up.
Tired? Push through.
Anxious? Sort it later.
Busy? Don't stop.
And for years, it worked. Until it didn’t.
At first, I thought it was burnout. I’d been here before - stressed trying to meet sales targets, driving around constantly, under-rested, running on caffeine and willpower. But this time was different.
The fatigue didn’t lift with rest. My heart raced for no reason. I couldn’t regulate my temperature. And the tools that used to help - breathing, exercise, early nights - didn't work like they used to.
It wasn’t burnout. It was perimenopause. And my nervous system had just changed the rulebook.
The Slow Shift No One Talks About
It’s not all or nothing. There isn’t one dramatic moment when everything falls apart. It’s a slow erosion of how you used to bounce back.
The hike that used to clear your head now leaves you feeling more tired than energised. Cold-water swims that once felt glorious, suddenly tip you into exhaustion. The “I’ll just push through” muscle? Gone - or at least unreliable.
And still, you keep trying to make old strategies work. Because that’s what got you here: persistence, competence, resilience.
But perimenopause isn’t asking for more effort. It’s asking for a different kind of leadership - one that starts inside your own body.
The Science Bit (In Plain English)
During perimenopause, your nervous system shifts in ways most women aren’t warned about - what I call the perimenopause nervous system effect.
When oestrogen levels drop, your vagus nerve - the line of communication between brain and body, loses some of its flexibility. That nerve helps you recover from stress, regulate temperature, digest food, and return to calm after challenge.
Less oestrogen = less vagal tone.
Less vagal tone = smaller window of tolerance.
So you feel:
Wired and wiped out at the same time
Hot, then freezing
Restless but unable to concentrate
Like you’re failing at things you used to handle easily
It’s not weakness. It’s your nervous system recalibrating around hormonal change.
This connection between hormones and the vagus nerve has even made mainstream news recently - the BBC’s feature on the vagus nerve and stress, highlighted how regulation, not resilience, is often the real key to recovery.
Cold exposure, for example, can activate the vagus nerve - but for many women in perimenopause, it actually increases stress hormones. When temperature control is already unstable, plunging into ice water can feel like threat, not therapy. Warmth, rhythm, and rest regulate this stage better than shock and strain.
The Grief, and the Gain
When my body started changing, so did my sense of self. I hadn’t planned for perimenopause at 42.
I didn’t expect grief - especially not about choices I’d already made. It wasn’t regret. It was the loss of an option I hadn’t realised mattered until it was gone.
But here’s what surprised me; once I stopped fighting the change, the fog began to lift.
My body wasn’t failing. It was asking for partnership instead of management.
What Actually Helped
Not hacks. Not “resets”. Not more discipline.
What worked was capacity building - slowly, deliberately, and without shame.
Warmth before grit. Cold showers and “tough love” no longer regulate; they drain.
Movement as rhythm, not punishment. Walks, stretching, dancing in the kitchen - all send safety cues.
Micro-pauses. Five minutes between tasks, eyes off screens, shoulders down. Give your nervous system a chance to replenish.
Rest without guilt. Not as a reward. As maintenance.
Medical support. Finding the support that's right for you. For me, HRT stabilised my hormones so my nervous system could follow.
I still push through sometimes. The difference is, I now replenish afterwards. I build rest in like oxygen, not luxury.
[If you’re curious about options, the NHS guide to Hormone Replacement Therapy (HRT) explains how different forms work and who they can support].
What This Really Means
Perimenopause isn’t the end of resilience. It’s the end of unquestioned resilience - the kind that runs on depletion and calls it drive.
You can still climb mountains, run businesses, teach, parent, lead.
You just can’t do it on empty. Capacity becomes your new currency.
And once you learn to work with your nervous system instead of fighting it, you start getting returns again - energy, focus, even joy.
You’re not broken. You’re just running a different operating system. Learn its language, and everything starts to make sense.
Even broadcaster Emma Barnett has started speaking publicly about hitting perimenopause in her late thirties - a reminder that this shift can arrive much earlier than most women expect. Her BBC Radio 4 interview has opened a conversation many of us have needed for years.
If This Sounds Familiar
I work with women navigating perimenopause, midlife transitions, and the quiet space between “signed off” from illness and injury to actually feeling ready.
You might also like:
Free resources: Explore simple nervous system resets, guided audios, and practical tools to help your body remember calm is safe again.
📬 Flourish Notes from Sarah - my monthly letter of grounded tools, stories, and nervous system insights for midlife women.→ Join here: flourishwell.coach
About Sarah
Sarah Gilbertson is a certified Therapeutic Coach specialising in nervous system literacy for women in midlife. At 51, she brings lived experience to her work with women navigating perimenopause, post-injury recovery, and the gap between being “signed off” and actually feeling ready.
She’s also a BASI Level 2 qualified ski instructor and creator of Nervous System Literacy™ for Ski Professionals.
You’re not broken. You’re just ready.
Sarah x
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