Specialty · Perimenopause & Anxiety
Your anxiety didn't
appear out of nowhere.
And it isn't
all in your head.
Anxiety that intensifies in your 40s often has a neurobiological driver that most providers miss. I find it. And I treat it with more precision than you've encountered before.
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1 in 3
Women experience significant anxiety during perimenopause. Most go undiagnosed.
87%
Of women with perimenopausal anxiety report their concerns were initially dismissed.
Yours
Is treatable. When someone finally identifies what's actually driving it.
Something has
changed — and no one can
explain it.
Most women who come to me don't arrive with the label "perimenopause anxiety." They arrive confused, frustrated, and wondering if something is seriously wrong.
The connection between what's happening hormonally and what's happening psychologically is rarely explained clearly. I explain it.
Sudden onset
"I've never been an anxious person. And then, seemingly overnight, I couldn't turn my brain off."
Sleep disruption
"I wake up at 3am with my heart racing. Exhausted and wired at the same time."
Escalating anxiety
"I've had anxiety before, but this is different. More intense, more physical. Nothing I've tried is touching it."
Cycle connection
"My anxiety tracks with my cycle. It's worse at certain points every month. No one takes this seriously."
Dismissed
"My doctor told me my hormone levels are normal. But I know something has changed. I can feel it."
Identity shift
"I don't recognize myself. I can't figure out if this is anxiety, depression, or something else entirely."
I handle the
psychological piece, Precisely
Perimenopause sits at the intersection of endocrinology and psychology. Your OB/GYN manages the hormones. I identify the anxiety, assess it thoroughly, and treat it with evidence-based precision — coordinating with your medical team so nothing falls through the cracks.
Most of my perimenopausal clients have been told their labs are normal, or that it's just stress. It isn't just stress. Estrogen fluctuation directly destabilizes the neurochemical systems that regulate anxiety. When that's identified and treated correctly, things change.
For referring clinicians: Kelly Romirowsky, PsyD (PA PS016435) specializes in anxiety and hormonal mental health in women. She provides diagnostic assessment, evidence-based treatment, and coordinated care. Available in Philadelphia, Narberth (opening soon), and via PSYPACT telehealth.
Welcomes clinical communication at DrKelly@therapyphiladelphia.com