Perimenopause in the Sandwich Generation: A Perfect Storm—Why ‘Good Enough’ Is Your Best Strategy

By Shadi Gholizadeh, PhD, MPH

“I used to handle everything. Why am I suddenly unraveling over the smallest things?”

In my clinical work with high-achieving women, this is one of the most common—and misunderstood—questions I hear.

These are women who are excelling in their careers, managing households, leading teams, raising kids, and coordinating care for aging parents. On paper, they are thriving. And yet, something shifts in midlife.

Cognitive fog creeps in. Sleep becomes elusive. Stress tolerance drops. And the old playbook—pushing through, over-preparing, taking on more—suddenly stops working.

This isn’t a breakdown. It’s a biopsychosocial inflection point. And if you know how to navigate it, it can be the most powerful pause of your adult life.

The Midlife Pressure Cooker

Perimenopause often collides with the peak of what we call the Sandwich Generation: the phase of life when women are simultaneously launching children, advancing professionally, and coordinating care for older family members.

It’s a perfect storm. But not a random one. Biologically, you’re shifting. Psychologically, your values are clarifying. Socially, you’re carrying more than most people see.

And when the pressure builds, the impulse is often to optimize. To do more, better. But the women I work with who thrive during this transition don’t double down on perfectionism—they pause with purpose.

‘Good Enough’ Isn’t Settling—It’s Strategy

Perimenopause has a way of stripping away what no longer fits. The endless hustle. The people-pleasing. The silent carrying of everyone else’s needs.

And here’s what I’ve seen, over and over again:

When women stop treating this as something to push through and start treating it as a signal to realign, that’s when the boldest decisions get made.”

They step into leadership with more clarity. They pivot careers. They speak up. They say no. They finally prioritize sleep, movement, connection—not because a podcast told them to, but because their body demands it and their values align with it.

This isn’t about discipline. It’s about discernment.

The Truth About Lifestyle Shifts

Yes, the lifestyle piece matters. Most women will need to adjust how they sleep, eat, move, and recover in this season. But not in the name of “optimization.”

Not as another relentless to-do list. Not to shrink or silence yourself.

These changes matter because your physiology is different now—and when you treat your body with curiosity and care, you reclaim the bandwidth to live with intention.

What I’ve seen clinically is that lifestyle shifts are most successful when they’re values-aligned. When they’re tied to what actually matters to you—not to someone else’s version of productivity or youthfulness.

This Isn’t a Crisis—It’s a Recalibration

If you’re noticing that your old strategies aren’t working, it’s not a sign you’re losing ground. It’s a sign you’re ready for a different kind of strength.

Not reactive. Not retreating. But thoughtful. Aligned. Decisive.

That’s what the most powerful version of “good enough” really is:
A system that supports bold, values-led living in a body and life that are evolving.

What We’re Building Inside MOMOPAUSE

At MOMOPAUSE, we support women in navigating this exact terrain—with nuance, evidence, and respect for the lives they’ve built and the ambitions they still hold.

This isn’t a place for pressure or performative self-improvement. It’s a space for realignment. For clinically grounded tools, expert guidance, and conversations that honor the complexity of midlife.

We don’t sell perfection. We build capacity.

Explore MOMOPAUSE

We’ll be here when you’re ready to stop performing and start leading—on your terms.