Conscious Perimenopause: Hormones, Soul and Story with Dr. Ghiselle Panneflek
Perimenopause can affect sleep, sexuality, mood, cognition, relationships and work long before the final period. Dr. Ghiselle Panneflek, a medical doctor, GP trainer and creator of Conscious Perimenopause, joins Jo Sarah to explain why this transition deserves medical knowledge, cultural context and a deeper relationship with the body.
“My libido left the building, left the country.” — Dr. Ghiselle Panneflek
The Symptoms That Did Not Look Hormonal
When did you realize perimenopause was part of your story?
I was tired, but I could not sleep. My libido disappeared, and it felt bigger than wanting sex with another person. My sexuality and sensuality felt gone. Later I was diagnosed with burnout and depression.
Mainstream medical training had not given me the full hormonal picture. I studied hormones, yet it still took time before I understood that I was moving through the season before menopause.
“I feel like my whole feminine being is gone.”
What Perimenopause Actually Means
How do you explain perimenopause, menopause and postmenopause?
We live through hormonal seasons. Perimenopause is the transition leading toward the final menstrual period, and it can last several years. Menopause is identified after twelve consecutive months without a period, when another cause does not explain the change. Postmenopause describes the years after that point.
Symptoms and timing vary. Some women+ notice changes in their late thirties, and regular bleeding does not automatically rule out early transition. Symptoms may include:
Cycle changes or worsening premenstrual symptoms
Sleep disruption and fatigue
Mood changes, anxiety or difficulty concentrating
Hot flashes or night sweats
Changes in libido, vaginal comfort or urinary health
These experiences can have other causes, so assessment should remain individualized.
Why Culture Changes the Experience
What do culture and identity have to do with menopause?
A culture that values a woman+ mainly for youth, niceness or reproduction can make this transition feel like a loss of worth. Other cultures recognize the new season through wisdom, intuition and experience.
The pressure to stay accommodating also affects stress. A woman+ may look polished outside while feeling overwhelmed inside. This is why the social context belongs beside the biological conversation.
“We do not want to become the woman who puts boundaries.”
Listening to Rage, Sadness and Exhaustion
What does it mean to move through perimenopause consciously?
For me, consciousness means being awake with my head, body and spirit. I practiced this during a sabbatical in Curaçao. I sat on the beach, journaled, took solo walks and tried to witness the exact moment the sunrise moved from darkness into light.
I began treating emotion as information. Rage might point toward a crossed boundary. Sadness might reveal disappointment. Exhaustion might show where I had given beyond my capacity. These signals still need context, safe expression and professional support when appropriate.
“My rage is information.”
HRT Without Hype or Fear
Should every woman+ use menopausal hormone therapy?
I do not believe in one answer for everyone. Hormone therapy should be available as part of an informed conversation, particularly when symptoms are significantly affecting daily function or quality of life.
Benefits and risks depend on personal factors, including medical history, age, timing, symptoms, formulation and route. Current guidance continues to evolve, and clinicians should discuss alternatives and monitoring too.
Hormone therapy also has limits. It may support biological symptoms, while the emotional, relational and spiritual work remains. A treatment cannot decide which boundaries need changing or which life pattern has stopped serving you.
Preparing for a Better Clinical Conversation
What can someone do after being told they are too young?
Start by tracking the pattern. Record sleep, bleeding, mood, concentration, anxiety, libido and physical symptoms across several cycles. Note what affects daily life and what seems to improve or worsen the experience.
A recognized questionnaire such as the Greene Climacteric Scale may help organize symptoms, though it is not a diagnostic test. Bring your notes to a GP, gynecologist or menopause-informed clinician. Ask what else should be ruled out, what treatment options exist, and when referral is appropriate.
Perimenopause can be difficult, clarifying and deeply personal. The strongest care makes space for biology, lived experience and informed choice. Listen to the full Umaversity Podcast episode for Dr. Ghiselle’s story and practical guidance.
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