Perimenopause

You’d forget what you walked into the room for. Your period, usually right on time, suddenly comes early, or late, or not at all.

You feel a little more tired than usual, maybe a bit more emotional, or just off in a way that’s hard to explain.

You chalk it up to stress, to work, to “maybe I just need more sleep.”
But the changes keep coming. 

And somewhere between the hot flashes, the midnight wake-ups, and the weird tension in your body… you start to wonder, “Is something going on with me?”

This is where many women find themselves right at the beginning of perimenopause. It doesn’t arrive with a loud announcement. It slips in quietly, often while you’re still juggling a million things. And suddenly, your body starts asking for a bit more care, a bit more attention.

You’ve probably heard of menopause, the time when your period stops for good.
But before that happens, your body goes through something called perimenopause.

It’s a natural transition, where your hormones start shifting, especially estrogen and progesterone even though your period hasn’t ended yet. Some months it shows up late, other times it’s heavier than usual. You might not notice it right away, or you might feel like something’s different but can’t explain why.

That’s perimenopause. A quiet shift that often begins in your 40s (sometimes earlier), and brings changes in your mood, sleep, energy, and body.

The word “peri” means “around”, so perimenopause is just the time around menopause. Nothing’s wrong with you. Your body is simply changing, asking to be listened to in a new way.

Perimenopause often begins much earlier than most women expect — it’s definitely not something that only happens after 50.

Perimenopause typically starts 8 to 10 years before menopause, usually in your early to mid-40s, but it can begin as early as your mid-30s.

The North American Menopause Society (NAMS) notes that most women first notice hormonal shifts between the ages of 40 and 44. Other studies report the average onset age is around 47.5, though this can vary greatly from person to person. 

During perimenopause, your body goes through two key phases. Understanding these can help you make sense of the changes happening over time.

✅ Early Perimenopause

• Your cycles are still happening somewhat regularly, but you may start noticing slight shifts.

• For example:

- Your period might arrive more than 7 days earlier than usual.

- You might skip a month occasionally, then return to your normal rhythm.

• Other early signs may include mood changes, lighter sleep, and feeling more fatigued than usual.
  -> In simple terms: your body is quietly starting to shift, but nothing feels extreme yet.

✅ Late Perimenopause

• Your cycles become much more irregular.

• A key sign is that your period goes missing for 60 days or more before returning.

• Symptoms tend to intensify during this phase hot flashes, poor sleep, vaginal dryness, brain fog, and more.

• This is the phase leading you toward menopause, when periods stop for good.
  -> Simply put: your body is getting closer to the finish line; it’s the last stretch before menopause officially begins.

Perimenopause typically lasts about 4 years, though it can be shorter (just a few months) or stretch up to 10 years, depending on your body and health.

Even if no one talks about it much, these shifts are real, and understanding them is the first step to feeling better.

During perimenopause, your hormones don’t just decline quietly. They fluctuate, rising and falling in ways that your body isn’t used to. These unpredictable shifts are what trigger most of the symptoms you feel.

1. Estrogen & Progesterone: Your body's mood and cycle managers

During perimenopause, your ovaries are slowly winding down hormone production.

• Estrogen levels swing unpredictably—sometimes high, sometimes low.

• Progesterone (the hormone that supports sleep and calm) kicks in less often as ovulation becomes irregular.
  → These ups and downs are what trigger most symptoms.
  
  

2.  Fluctuations, not drops

Hormones don’t just drop—they fluctuate wildly, especially estrogen.

• One day you feel good; the next you feel anxious, foggy, or sleepless.

• Mood swings and brain fog often come during these unpredictable shifts.
  
  Research shows 45–68% of women experience depressive symptoms in this phase due to hormone instability.
  
  

3.  Hot flashes and restless nights: When your body just won’t settle

Hot flashes and night sweats happen in about 75–80% of women in perimenopause 

These heat waves often disrupt sleep, leading to fatigue, irritability, and worsening mood.

4.  Mood, memory & focus

• Mood changes are similar to PMS but without the timing—happening any time, even when you’re not menstruating.

• Sleep loss and hormone drops together contribute to memory lapses and concentration issues, known as "brain fog".
  
  

5.  Skin, hair, libido & bladder changes

As estrogen declines:

• Vaginal and skin tissues lose moisture—leading to dryness or discomfort

• Hair may thin, libido can drop, and urinary urgency or UTIs may increase due to tissue thinning and weakened pelvic support
  
  

These symptoms aren’t random or “just in your head.” 

They’re signals from your body telling you that it’s changing, adapting, and calling for a different kind of care.

Up next, let’s talk about what actually helps. 🌿

1. Eat balanced, estrogen-supportive meals

Choosing whole, nutritious foods helps support mood, metabolism, and hormone clarity.

• Eat lean protein, fiber-rich veggies, and whole grains

• Add plant-based phytoestrogens daily—like tofu, soy milk, flax seeds—to gently support estrogen levels
  
  

2. Move your body regularly

Consistent movement helps with hormone balance, mood stabilization, and sleep quality.

• Aim for ~150 min of moderate exercise/week, plus strength training twice weekly

• Yoga, Pilates, walking, or light weights help reduce hot flashes, support weight, and ease stress
  
  

3. Prioritize better sleep routines

Good rest is critical for hormonal balance and energy.

• Set a consistent bedtime, avoid screens before sleep

• Keep your bedroom cool, use breathable bedding

• Use calming practices like deep breathing or journaling if waking in the night
  
  

4. Manage stress gently every day

Stress hormones can amplify perimenopause symptoms—find tools that help you reset.

• Try meditation, walking in nature, mindful breathing, or meditative movement

• Herbs like ashwagandha or rhodiola might assist—but talk to your provider if needed

5. Use gentle supplements when needed

Some supplements may help, but should be used thoughtfully.

• Magnesium glycinate: Calms nerves, supports sleep

• Omega-3s, Vitamin D, B‑complex, probiotics: Support mood, gut health, inflammation control

• Black cohosh, DIM, Maca, Ashwagandha: May ease hot flashes or mood imbalance
  
  

6. Simple habits that bring comfort

• Clean breathable layers: dress in layers to manage sudden heat

• Reduce caffeine, spicy foods, and alcohol—these can trigger hot flashes or sleep issues

• Use water- or silicone-based lubricants or moisturizers for intimate dryness
  
  

These practices are all about supporting your shifting body naturally, gently, and consistently. You deserve care that listens to your unique rhythm.

While supplements can’t “fix” hormonal changes, some may gently support your body during the transition—especially when paired with good sleep, movement, and nutrition.

Here are some that are commonly used:

• Magnesium glycinate – helps with sleep, anxiety, and muscle tension

• Vitamin B6 & B-complex – supports mood and energy

• Vitamin D – helps with bone health and hormone balance

• Omega-3 fatty acids – supports brain, heart, and mood regulation

• Ashwagandha – may reduce stress and help with fatigue

• Black cohosh – often used for hot flashes and night sweats

• Maca root – supports libido and overall vitality

• DIM (Diindolylmethane) – supports estrogen metabolism

• Probiotics – help with gut health and estrogen detox

According to The North American Menopause Society (NAMS), these supplements may offer mild symptom relief but always talk to your healthcare provider before starting any new supplement.

Perimenopause is a natural part of life but that doesn’t mean you have to suffer in silence. If your symptoms are disrupting your daily life, or something just doesn’t feel right, it’s completely okay (and encouraged!) to talk to a doctor. You don’t need to wait until things get “bad enough.” You deserve support.

Here are some signs that it might be time to check in with your healthcare provider:

• Heavy or irregular bleeding (especially if it lasts more than usual or stops abruptly)

• Ongoing anxiety or low mood that affects your daily routine

• Frequent sleep problems that leave you exhausted

• Hot flashes or night sweats that disrupt your comfort

• Painful intimacy or vaginal dryness that’s affecting your well-being

• Unexplained weight gain even without major lifestyle changes

• Thinning hair, joint pain, or very dry skin

• If you’re curious about hormone therapy (HRT) or want natural treatment options

Checking in with your doctor during perimenopause can help rule out other causes, guide treatment options, and give you clarity about what’s going on inside your body.

You don’t need a diagnosis to deserve support. Sometimes, just one honest conversation with a kind doctor can make a world of difference. 💛

1. Mayo Clinic. Perimenopause - Symptoms and causes. Mayo Clinic. Published March 13, 2024. https://www.mayoclinic.org/diseases-conditions/perimenopause/symptoms-causes/syc-20354666
    

2. Mayo Clinic. Perimenopause – Diagnosis and treatment. Mayo Clinic Staff. Published May 25, 2023. https://www.mayoclinic.org/diseases-conditions/perimenopause/diagnosis-treatment/drc-20354671 Mayo Clinic
   
   

3. Cleveland Clinic. Perimenopause (overview: age, stage, symptoms, treatment). Cleveland Clinic. Accessed August 5, 2025. https://my.clevelandclinic.org/health/diseases/21608-perimenopause Cleveland Clinic+1
   
   

4. Mayo Clinic News Network. Women’s wellness: Facts about menopause (includes perimenopause symptoms list). Published July 24, 2024. https://newsnetwork.mayoclinic.org/discussion/womens-wellness-facts-about-menopause/ Mayo Clinic+8newsnetwork.mayoclinic.org+8newsnetwork.mayoclinic.org+8
   
   

5. Mayo Clinic News Network. Menopause Transition: What’s Normal? (perimenopause symptoms prevalence ~80 %). Published March 25, 2015. https://newsnetwork.mayoclinic.org/discussion/menopause-transition-whats-normal/ newsnetwork.mayoclinic.org
   
   

6. Cedars‑Sinai Health Library. Perimenopause (symptom list, diagnosis, treatment). Cedars‑Sinai. Accessed August 2025. https://www.cedars‑sinai.org/health-library/diseases-and-conditions/p/perimenopause.html cedars-sinai.org