It must be my hormones: Ireland’s first perimenopause coach on dealing with the change

Perimenopause coach Catherine O’Keeffe says women who were previously outgoing and confident can experience social anxiety and panic attacks during the transition

Many women find it difficult to talk about the perimenopause, but coach Catherine O’Keeffe is here to help, writes Margaret Jennings

Irish women are still largely adopting the ostrich approach — sticking their heads in the sand — when it comes to thinking or talking about the perimenopause, those years from the mid-40s to mid-50s when the ovaries gradually produce less estrogen before menstruation finally stops.

Yet this is a time of life when anxiety “ramps up” and many are struggling hugely with the condition, says Catherine O’Keeffe, Ireland’s first perimenopause coach, also known as the Wellness Warrior.

As a featured coach on the menopause website My Second Spring, run by Irish woman Aisling Grimley, she has been astonished at how prevalent anxiety is among those who contact the site and how women don’t know enough about the perimenopausal life transition to link cause and effect.

“This can be a time of life when women have lots going on — including family and work commitments — but the hormonal changes that are taking place also contribute to anxiety levels. A lot of women I’ve spoken to as a coach or through the website, say ‘I think I’m mentally unwell, I’m losing it,’ and it’s very sad. Once a woman realises the link, it’s like ‘phew! I can relax a bit, knowing I’m not going mad’.”

Catherine has written an e-book,

The Best Friend’s Guide to Anxiety, now available on the website, which aims to empower women to build their own strategies to deal with the condition on a daily and a long-term basis.

“The reason Aisling asked me to do the book is that we just saw the hits coming — the comments on anxiety were just phenomenal,” says Catherine.

“It is one of the two biggest sections, the other being the physical symptoms, that are constantly viewed on a daily basis on the website which receives 6,500 hits per day and more than 1.5m viewers.”

During her research she encountered perimenopausal women who have never in their lives had a history of anxiety before, now suffering.

“This comes out so left of field for them — they had no exposure to it at all, and they can’t go into the supermarket because they physically aren’t able, or they can’t drive on the motorway because they get a panic attack, or they get completely anxious around their health, the health of their family or social engagements. I think that’s the scariest part — that it comes out of nowhere.”

View this post on Instagram

Excerpt from The Best Friend's Guide to Anxiety: Why Anxiety and Why At Menopause? The surprise we have found since starting My Second Spring back in 2013, is the very high incidence of women experiencing debilitating levels of anxiety associated with the menopausal years. Four years on, anxiety continues to be one of the main concerns for many of the 6,000 women checking in with My Second daily from all around the world. In today’s warp speed world, women are experiencing anxiety at very different levels and we have gained a great insight into the feedback and comments from our valued followers over the last few years. On a personal level, we have either experienced anxiety ourselves or helped family and close friends through periods of anxiety. So it seemed a clear calling to us to put together a guide for women at this often-vulnerable life stage. Our aim is to provide a down to earth understanding of what anxiety is, to provide clear proven techniques to reduce anxiety and to reassure women, through our case stories, that they are not alone, nor are they going mad! We don’t propose an anxiety cure, but rather focus on a more mindful, aware state where anxiety is no longer the dominant response. We hope the tools will reach far and help those fellow women who are travelling the ups and downs of perimenopause and beyond.😍

A post shared by Wellness Warrior ( on

She finds that health anxiety, social anxiety and panic attacks are the biggest aspects.

“Once the social anxiety starts you are caught in a catch-22 situation — your mind can spiral things out of control; your confidence takes a hit and if you are having hot flushes it’s difficult to be sitting in a situation. And a lot of women still aren’t open enough to talk to their friends about it and in ways they are probably trying to hide the fact they are having a hot flush and then they start to avoid situations and slowly their world becomes smaller,” she says.

I see a lot of women withdrawing into themselves and it’s very sad to see. I’ve spoken to some who were gregarious and outgoing and within a year or two they are faced with extreme social anxiety.

To make perimenopause an easier journey it’s important to educate yourself about your maintenance and knowing about what your symptoms are and how to deal with them. The physical, mental and emotional symptoms can continue up to 55 and sometimes longer.

“The average would be 55 and menopause is like a birthday — it’s the anniversary of a full 12 months without a period. After that date, you are post-menopausal so everything before that 12-month anniversary is your perimenopause and slowly women are getting to understand that,” she says.

The 47-year-old mum of three boys is herself in the throes of perimenopause: “It started very slowly in my mid-40s. It’s a bit like an iceberg with a few tiny symptoms coming up, but underneath there is a hell of a lot going on with the hormones. Where I would have really noticed it was the return of PMT which I hadn’t had for years; then bloating and mood swings before my periods and then flooding. Right now I manage it very well.”

View this post on Instagram

Yoga is the exercise of choice for many women at midlife – the multiple benefits are well documented for the mental and physical body. You can make it as simple or challenging as you want and above all aim to fit it into your daily routine so that it works for you. I do about 15-20 minutes of yoga first thing in the morning and use yoga stretches after running too. I keep it simple, sometimes I use poses I already know, sometimes I will refer to a YouTube video or a just depends what I am in the mood for. People often get confused by the yoga terminology and the important thing is to find the type of yoga that suits you best....the different styles are as follows: 💖Hot Yoga: Great for releasing the feel-good endorphins while working out in a temperature of 105F. If hot flushes are bothersome at this point in time avoid this one! 💖Ashtanga is a strenuous yoga practice and is especially good for building core body strength. 💖Power Yoga: a good combination of yoga and gym type exercises. If injured or stiff I would avoid this one. 💖Vinyasa/Dynamic Yoga is ideal for runners, it moves from posture to posture. 💖Hatha is the gentlest form of yoga and includes breathing exercises, meditation and relaxation. 💖Restorative Yoga is a gentle practice, focusing on gentle stretching and relaxation. 💖Iyengar is again holding poses for longer periods often using props. Provides great stretching. Whether it's at home, in your local community centre or gym, Yoga really is a fabulous exercise both for you body and your mind and a great addition to anyone's life.

A post shared by Wellness Warrior ( on

Women first need to open up, so we can help ourselves — and each other.

“Some of my friends are even funny about liking my Facebook page about perimenopause,” says Catherine.

Why might women be so coy? “I think it’s probably again that unfortunately it’s not openly talked about enough yet and that’s going back to the taboo around it all. I think part of it is about ageing – with some of my friends I would notice that they definitely want to keep their heads in the sand — ‘I’m still young; I’m not going there’ — I would see that a lot.” and

The e-book The Best Friend’s Guide to Anxiety: A Practical Toolkit for Moving Beyond Anxiety and Menopause, by Catherine O’Keeffe, price €12, can be bought from the website

More in this Section

Capturing the castle: Johnstown Castle in County Wexford is well worth checking out

How nature can work wonders for body and soul

Making Cents: Consumer guide to entering PcP car loan contracts

Podcast Corner: An introduction to podcasts

Latest Showbiz

Kim Kardashian West shares new pictures from White House visit

Michael Jackson’s legacy endures 10 years on from his death

Judi Dench says failing eyesight saved her from fear during crocodile encounter

Elisabeth Moss: The Handmaid’s Tale is shockingly relevant

More From The Irish Examiner