FOR WOMEN | ONLINE THERAPY ACROSS CA
Perimenopause, Anxiety, & Identity Shifts
Because hormones aren't the whole story.
These days, screaming crosses your mind more often than it used to.
AND MORE SERIOUSLY, MAYBE YOU’VE HAD A FEW VISITS TO THE ER BECAUSE YOUR RACING HEART SCARED YOU.
Your healthcare team has helped you understand what's happening physically, but you're finding yourself asking different questions now.
Who am I becoming?
What do I want the next chapter of my life to look like?
After everything I've carried, what do I want to carry forward—and what am I finally ready to let go of?
Ly Franshaua Pipkins, Psy.D., specializes in nervous system-based therapy that helps women navigate the identity shifts that can emerge during perimenopause. Services are available both online and in person. Reach out today.
Perimenopause isn’t just physical—it can also surface deeper questions about identity, aging, ambition, and choice.
YOU’RE READY TO …
Have a space where the emotional realities of hormonal change are taken seriously
Feel validated rather than dismissed or told you’re “just stressed”
Understand the fears, grief, and self-doubt that can emerge during this stage of life
Talk honestly about the changes happening in your body, relationships, identity, and sense of self
Help your nervous system resolve longstanding stress and emotional stuckness
Restore trust in your body as it adjusts to hormonal change
Improve your ability to think clearly, stay present, and feel emotionally grounded
Address older patterns that often resurface during midlife transitions
Feel more connected to yourself instead of constantly pushing through exhaustion
Move through this season with greater steadiness, self-understanding, and support
HOW IT WORKS
Therapy tailored to you can create meaningful, lasting transformation.
This work is designed to address what’s unsettling you at its source—not just how it shows up in your thoughts, but how past experiences continue to shape how your system responds in the present.
Moving with that insight, we focus on what happens in real time when racing thoughts come up—how your attention moves, how your body responds, and what begins to shift when you stay with an experience differently.
Our work is collaborative and paced.
You won’t be pushed into overwhelm.
Instead, we stay within a range where you can remain present while your system begins to process and respond in new ways.
This may include approaches such as Brainspotting and gentle exposure-based therapy. And when you’re ready, we also work through journaling and setting a goal for your next big body of work.
I use each intentionally—to help you engage what’s difficult without reinforcing the same patterns.
Over time, this work supports a different kind of change—less reactivity, more flexibility, and a greater ability to move through moments that once felt consuming.
Move through perimenopause with more support, self-understanding, and nervous system stability.
Frequently Asked Questions
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Yes. Hormonal changes during perimenopause and menopause can affect the systems involved in mood, sleep, and stress regulation. Many women notice increased worry, racing thoughts, physical tension, or a sense of feeling unusually on edge—even if they have never considered themselves anxious before.
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Hormonal shifts can make the nervous system more sensitive to stress. At the same time, many women are managing significant life demands such as career transitions, aging parents, changing relationships, and evolving identities. Together, these factors can make longstanding patterns of anxiety feel more intense.
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Yes. Some women experience sudden episodes of racing heart, shortness of breath, dizziness, or a sense of impending doom during perimenopause. These symptoms can be frightening, especially when they appear unexpectedly. Therapy can help reduce the fear associated with these experiences and support your nervous system in feeling more stable.
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Increased irritability is a common experience during perimenopause and menopause. Sleep disruption, hormonal changes, and cumulative stress can lower your capacity to tolerate frustration. Often, what feels like “menopause rage” reflects both biological changes and the emotional weight of responsibilities that have been carried for years.
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Absolutely. Night sweats, insomnia, and fragmented sleep can significantly impact mood, concentration, and emotional resilience. When sleep is disrupted, anxiety and irritability often become more pronounced. Therapy can help you respond to these changes with greater steadiness and self-compassion.
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For many women, the most unsettling aspect of perimenopause is the unfamiliarity. You may feel less emotionally steady, less patient, or less confident in abilities that once felt effortless. Therapy can provide a space to understand these changes and reconnect with a deeper sense of trust in yourself.
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Yes. Hormone replacement therapy and other medical treatments can be extremely helpful and, for many women, provide significant relief. Therapy addresses the psychological and relational aspects of this transition, including anxiety, identity changes, and the broader emotional impact of midlife.
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Yes. Although perimenopause and menopause are normal developmental transitions, they can be emotionally and psychologically significant. Therapy offers support during a time when many women find themselves confronting changes in mood, relationships, identity, and their relationship with their own bodies.
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Nervous system–based therapy addresses how stress and emotional patterns are held in the body and brain, not just in conscious thoughts. This can be especially helpful during perimenopause, when women often understand what is happening intellectually but still feel unusually reactive, anxious, or unsettled.
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The best way to find out is through a brief consultation. We can discuss what you have been experiencing, answer your questions, and explore whether this approach feels like a good fit for your goals during this stage of life.