Dott.ssa Serena Anzilotti
La Tua Specialista Femminile
Menopause Care
PERIMENOPAUSE
THE THRESHOLD THAT ASKS YOU TO CHANGE, NOT TO GO BACK
There comes a moment in a woman’s life when something begins to change.
Your cycle may become different.
Longer, heavier, more irregular.
You may start missing periods.
Your sleep may no longer be what it used to be.
You may begin to sleep less, sleep poorly, or wake frequently during the night.
It may become harder to maintain your weight.
You may feel more tired, as though you are no longer able to fully recharge.
Your body may begin to change more quickly.
Your mood may become more variable.
Your temperature may feel unpredictable.
And even your relationship with your body may begin to change.
And then the question comes:
“What is happening to me?”
And immediately after:
“How can I go back to the way I was?”
But perhaps this is not the question to begin with.
Because you have arrived at another THRESHOLD OF THE FEMININE.
You have already crossed others.
Your first period.
Perhaps pregnancy.
Birth.
The postpartum period.
Other transitions, other transformations.
A threshold is that space between worlds, where one phase of life is coming to an end and another is beginning.
And it is not an illness.
It is a physiological transition.
YOUR BODY IS NOT BETRAYING YOU
For too long, menopause has been portrayed as something to fight.
As though, once a woman reaches a certain age, her body suddenly stops functioning properly.
As though hot flushes, disrupted sleep, changes in the menstrual cycle, changes in the body and fluctuations in mood were simply the price women have to pay for being women.
I see it differently.
Your body is not betraying you during perimenopause either.
Your body is changing.
Your hormones change.
Your rhythms change.
Your needs change.
The demands placed on your body change.
And our task is not to stop this change.
It is to learn how to understand it and accompany it.
THERE IS NO ONE-SIZE-FITS-ALL PERIMENOPAUSE
This is one of the first things I want you to understand.
Not every woman experiences perimenopause in the same way.
Not every woman has hot flushes.
Not every woman experiences the same menstrual changes.
Not every woman develops sleep difficulties.
Not every woman experiences this phase with the same level of discomfort.
And above all:
not everything that happens during perimenopause should automatically be attributed to perimenopause.
This distinction matters.
Because sometimes a woman comes to me after hearing:
“It’s normal. You’re in perimenopause.”
Or:
“There’s nothing you can do. It’s your hormones.”
But a generic explanation does not always mean that the woman herself has been understood.
The stage of life matters.
But so does how we arrive at it.
Our history.
Our lifestyle.
Our sleep.
Our nutrition.
Our movement.
Our stress.
Our metabolic health.
Our physiology.
The habits we have built over the years.
And everything our body is communicating to us.
That is why my question is not:
“How can I help you put up with menopause?”
My question is:
“How is this particular woman moving through this transition?”
INSTAGRAM IS FULL OF ADVICEBUT YOU ARE NOT AN ALGORITHM.
Every day, you can find hundreds of pieces of advice about perimenopause on social media.
What to eat.
What to eliminate.
Which supplement to take.
How to exercise.
How to sleep.
How to manage hot flushes.
How to lose weight.
How to “rebalance your hormones.”
Useful information can certainly be a starting point.
But there is one question that is often missing:
“Is this advice actually right for me?”
Because what helps one woman may not be what another woman needs.
And, above all, because a thirty-second piece of content does not know your story.
It does not know your cycle.
It does not know how you sleep.
It does not know your habits.
It does not know your level of stress.
It does not know what has changed in your life over the past few years.
It does not know your body.
Information matters, Personalisation matters just as much.
This is exactly where my work begins.
Not by adding yet another piece of advice to your list.
But by stopping.
Observing.
Asking questions.
Connecting the signals.
Understanding the context.
And recognising which aspects deserve attention and which should not automatically be attributed to perimenopause.
AND THIS IS WHY I ALSO CREATED WOMEN’S GROUP MEETINGS
Because there is something else I have observed throughout these years.
Women need information But they also need to talk to one another.
To discover that a feeling they thought was unique to them may not be.
To hear different experiences.
To ask questions.
To share.
To feel less alone in a transition that is so often experienced in silence.
That is why I also organise meetings for women going through perimenopause and this new phase of life.
These are not simply meetings where I speak and women listen.
They are spaces for education, sharing and female awareness.
We talk about the body.
About change.
About the menstrual cycle.
About sleep.
About lifestyle.
About the questions that emerge during this phase.
And, above all, we learn to distinguish between:
what we can observe,
what we can support,
and what deserves further assessment with the appropriate healthcare professional.
Because knowing your body also means learning how to ask better questions.
A THRESHOLD IS NOT SOMETHING YOU SIMPLY ENDURE, IT IS SOMETHING YOU CROSS.
This is at the heart of my approach.
I do not want to teach you to fight change, I want to teach you how to recognise it.
You are not a victim of transformation.
But you do not need to become the controller of your body either, trying to control every response it gives you.
You can learn to work with your physiology.
To observe.
To understand.
To adapt.
To support.
To listen.
Because what worked for you at thirty may no longer be what your body needs today.
A new physiology brings new needs.
And we can learn to recognise them.
WHEN THE BODY CHANGES, THE QUESTION CHANGES TOO
Many women arrive at perimenopause looking for a quick solution.
“How can I sleep better?”
“How can I stop the hot flushes?”
“How can I avoid gaining weight?”
“How can I feel like myself again?”
These are legitimate questions.
But we can add a deeper one:
“What is happening in my body and in my life right now?”
Because understanding the context changes the way we can care for what we are experiencing.
And perhaps the question can become:
“How can I care for the woman I am becoming?”
MY APPROACH
As a Midwife and Female Health Specialist, I work with the woman as a whole, integrating listening to the body with a broader perspective on lifestyle and wellbeing.
The journey begins with your story.
🌙 Your menstrual cycle and how it is changing.
🌙 Your sleep.
🌙 Your nutrition.
🌙 Your movement.
🌙 Your stress.
🌙 Your habits.
🌙 The signals your body is expressing.
🌙 And the stage of life you are moving through.
My role is not simply to tell you what you should do.
It is to help you ask better questions of your body and your health, while also recognising when it is important to involve other healthcare professionals.
Because an informed woman is not a woman who rejects medicine.
She is a woman who can participate more consciously in her own health choices.
WHERE DO WE BEGIN?
WITH THE TONGUE PROTOCOL
Before your consultation, I will ask you for photographs of your tongue, face and abdomen, together with other information that will allow me to begin understanding your story.
The tongue is one of the tools within my method.
It is part of the picture, not the whole picture.
Its observation is integrated with:
your history,
your face,
your abdomen,
your physiology,
your habits,
your sleep,
your nutrition,
your menstrual cycle,
and your everyday life.
**Observe.
Listen.
Connect.
Understand.
Accompany.**
This is how a personalised journey begins.
YOUR PERSONALISED HEALTH PROTOCOL
Your first consultation becomes the starting point for a journey built around the woman in front of me.
Her history.
Her physiology.
Her individual needs.
Depending on your individual situation, your journey may include:
✔ personalised nutritional guidance
✔ practical everyday strategies
✔ personalised routines and supportive tools
✔ practices inspired by the disciplines that form part of my training
✔ exercises
✔ strategies to support your changing physiological balance
✔ ongoing observation of your progress
There is no identical formula for every woman.
There is the woman in front of me.
THE JOURNEY CONTINUES
The first consultation is only the beginning.
Because the body is constantly changing.
We therefore continue to observe your evolution, gather new information and, when appropriate within your journey, update your personalised protocol.
The protocol must be able to change with you.
Because our goal is not to create another cage of rules.
It is to build awareness.
AND THERE IS ANOTHER PART OF THE THRESHOLD WE RARELY TALK ABOUT
Perimenopause is not only about the body.
It can also be a time when a woman begins to ask herself:
Who am I now?
What do I want?
What do I no longer want?
Which relationships nourish me?
Which habits no longer belong to me?
How much space do other people's expectations still occupy in my life?
For much of their lives, many women have learned to care for others.
And this phase can also become an opportunity to learn to care for themselves.
Not out of selfishness.
But because choosing yourself can also be an act of health.
For me, perimenopause represents a transformation.
🌙 It can be a time of maturity.
🌙 Of awareness.
🌙 Of freedom.
🌙 Of finally knowing who we are.
🌙 Of understanding what we truly want.
🌙 Of letting go of what no longer belongs to us.
Relationships.
Habits.
Fears.
Expectations.
A new season of life does not necessarily have to be a season to fight.
🌙 It can be a season to understand.
To inhabit.
To cross.
That is why I call it:
THE SECOND SPRING
Not because everything is always easy.
But because every spring brings transformation.
A new season.
New energy.
A new possibility.
YOU DO NOT HAVE TO GO BACK TO THE WOMAN YOU WERE.
YOU CAN LEARN TO KNOW THE WOMAN YOU ARE BECOMING.
If you feel that something in your body is changing and you do not simply want to collect yet another piece of advice from social media, we can begin with something much simpler:
stopping and listening to your story.
You can begin with an individual consultation or, when available, join one of my meetings for women going through perimenopause, where you can learn, share and gain clarity alongside other women.
You cannot avoid the threshold.
But you can learn how to cross it.
Serena Anzilotti
Your Female Health Specialist
Serena Anzilotti
All about Female Health
