Body Image During Perimenopause: Beyond Toxic Positivity

Your Body Is Changing, and That's a Complicated Thing to Sit With

Weight redistribution around the midsection. Changes in skin texture. Shifts in muscle tone and strength. Hair that thins or grows in unexpected places. A body that responds differently to food and exercise than it did five years ago.

Perimenopause brings physical changes that are real, visible, and often unwelcome. And the cultural messaging around those changes tends to fall into two unhelpful camps: panic-inducing warnings about weight gain, or relentlessly cheerful prompts to love every part of yourself no matter what.

Neither of those serves you very well. What you actually need is something more honest.

The Body Positivity Movement's Gaps

Body positivity, at its best, pushes back on harmful beauty standards and the idea that your worth is tied to your appearance. That's genuinely valuable. The problem comes when it gets applied in a way that dismisses real experiences.

Being told to love your body during a time when your body is changing in ways you didn't choose, and may not have wanted, can feel invalidating. It can feel like you're supposed to just be fine with something that genuinely affects how you feel in your skin.

Allowing grief about body changes doesn't mean you've failed at self-acceptance. It means you're human, and you're having an honest response to a real transition.

Grief Is a Legitimate Response to Change

Grief shows up in unexpected places. It can show up when you notice that clothes fit differently. When you look in the mirror and don't quite recognize the face looking back. When you feel fatigue that limits activities you used to do easily.

None of that grief requires you to hate your body. But suppressing it in the name of positivity doesn't make it go away. It tends to find other outlets, often in more damaging behavior patterns around food or exercise.

Giving yourself permission to acknowledge loss, including the loss of the body you had, is not the opposite of self-acceptance. It's actually part of getting there.

The Physiology Behind the Changes

Understanding what's driving physical changes doesn't erase the feelings, but it can reduce the shame spiral. Most of what happens to the body in perimenopause is driven by specific hormonal shifts, not by personal failure.

Declining estrogen changes where the body stores fat, shifting it from the hips and thighs toward the abdomen. Cortisol sensitivity increases, which means stress has a more direct effect on fat storage. Muscle mass decreases more easily because anabolic hormones, including testosterone and growth hormone, also decline. Sleep disruption further affects cortisol, appetite hormones, and metabolism.

All of this is biology, not a consequence of something you did wrong. You can work with your biology more effectively once you stop blaming yourself for it.

What Body Neutrality Offers Instead

Body neutrality is a different framework from body positivity. It doesn't ask you to love your body or feel great about it every day. It asks you to work toward seeing your body as the functional entity it is, separate from how it looks.

In body neutrality, your body is the thing that lets you move through the world, hug the people you love, do work that matters, and feel pleasure. Appearance is a feature of that body, not its defining quality.

This is often more achievable during perimenopause than trying to generate positive feelings about changes you didn't ask for. Neutral can be enough. Neutral still leaves room for good days and hard days without requiring either extreme.

Movement as Celebration, Not Punishment

The way many people relate to exercise intensifies during perimenopause. The impulse to control a body that feels out of control can turn exercise into something punitive: burning off what you ate, making up for gained weight, fighting aging.

That relationship tends to backfire. Exercise driven by self-punishment is harder to sustain, more likely to cause injury, and can increase cortisol rather than relieve it.

A more durable approach is asking: what does my body enjoy? What movement makes me feel stronger, clearer, or calmer? Strength training, in particular, is genuinely one of the best things for a perimenopausal body, not because it will make you look a certain way, but because it preserves muscle mass, supports bone density, and improves insulin sensitivity. Doing it because your body feels capable and strong is a different experience than doing it as penance.

Practical Tools for a Better Relationship With Your Body

A few things that research and clinical experience suggest actually help.

Move away from the mirror as a measure of how you're doing. How your body feels, what it can do, how much energy you have, how well you're sleeping, these are more meaningful metrics during a transition than how your reflection looks on any given day.

Notice language. The way you talk to yourself about your body shapes how you feel about it. You don't have to flip to wholesale praise. But phrases like "my body is changing" land differently than "my body is ruined."

Address what can be addressed. Some perimenopause body changes are more manageable than people realize. Vaginal dryness is treatable. Sleep disruption has effective interventions. Muscle loss responds to strength training. Treating yourself as someone whose symptoms deserve real solutions is its own form of self-respect.

When It Goes Deeper Than Body Image

For some people, perimenopause brings up or intensifies a long history with disordered eating or body image issues. If that's true for you, the hormonal volatility of this transition can make those patterns significantly harder to manage.

This is not something to navigate alone. A therapist who works with disordered eating and understands hormonal transitions can provide support that a general self-help approach can't. It's also worth knowing that perimenopause-related depression and anxiety are real, and they can amplify negative body image in ways that aren't just about your body.

PeriPlan's mood and symptom tracking can help you see whether body image struggles cluster with specific hormonal patterns in your cycle, which can be useful information for both you and a therapist or provider.

This content is for informational purposes only and does not replace medical advice. Always consult your healthcare provider about your specific situation.