Perimenopause 101: What Every Woman Should Know (But Was Never Told)

Hot flashes. Mood swings. Trouble sleeping. A few extra pounds that won't budge. If you’re in your late 30s to mid-40s and wondering, “Is this perimenopause?”—you’re not alone.

Perimenopause is the time leading up to menopause, when your ovaries begin to produce less estrogen and progesterone. This hormonal shift can last anywhere from 4 to 10 years and typically starts between ages 35 and 45, though it varies widely.

You’re officially in menopause only after 12 consecutive months without a period—but the transition begins much earlier than many women expect.

Common Signs of Perimenopause

  • Irregular periods (shorter, longer, heavier, or missed altogether)

  • Sleep disturbances

  • Increased anxiety or irritability

  • Night sweats or hot flashes

  • Weight gain, especially around the midsection

  • Brain fog or difficulty concentrating

  • Changes in libido or vaginal dryness

  • Breast tenderness or bloating

A 2021 study in BMC Women’s Health found that over 75% of perimenopausal women experience life-disrupting symptoms, but many go unrecognized or untreated.¹

During perimenopause, estrogen levels fluctuate wildly—often spiking high one month and dropping low the next. Meanwhile, progesterone gradually declines, which can lead to mood instability, heavy periods, and sleep issues.

This hormonal chaos affects multiple systems—metabolism, mood, skin, and even gut health. It’s not “all in your head.” It’s biochemical.

How to Support Your Body in Perimenopause

1. Balance Blood Sugar

Unstable blood sugar can worsen hormonal swings. Focus on protein-rich meals, fiber, and healthy fats to support metabolic and mood stability.

2. Prioritize Restorative Sleep

Poor sleep worsens hormone dysregulation. Aim for 7–8 hours of quality rest, and consider magnesium, adaptogens, or guided breathwork if you're waking up frequently.

3. Incorporate Strength Training

Muscle mass naturally declines in perimenopause. Resistance training helps protect bone density, boost metabolism, and support insulin sensitivity.

4. Consider Hormonal Support

Depending on your symptoms and health history, bioidentical hormone therapy or targeted supplements may help restore balance and improve quality of life.

5. Work with a Provider Who Listens

Perimenopause care should be personalized. It’s not just about hormones—it’s about you.

References

Kling, J. M., et al. (2021). Perimenopausal symptomatology and treatment gaps in midlife women. BMC Women's Health, 21, 82.

Santoro, N., et al. (2021). The menopause transition: Signs, symptoms, and management options. Endocrine Reviews, 42(6), 662–706

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