Is It Perimenopause?

You’re not imagining it. The sudden fatigue that hits like a truck mid-afternoon. The mood swings that feel out of character. The nights you can’t sleep, the workouts that don’t feel the same, the bloating that seems to come out of nowhere — even though your labs are “normal” and you’re technically “not in menopause yet.”

It’s possible that what you’re experiencing is perimenopause — and you’re not alone. Perimenopause is the transitional phase before menopause, and it can begin as early as your late 30s or early 40s. But here’s the kicker:

Most women don’t realize they’re in it.

That’s because the signs can be subtle, slow, and easy to attribute to stress, age, parenting, or “just being tired.”

In this post, we’re going to break down:

• What perimenopause is (and when it starts)

• 8 symptoms that often go overlooked

• Why many women are misdiagnosed or dismissed

• What you can do — including nutrition, movement, testing, and support

This isn’t about fearing the transition. It’s about recognizing the signs so you can work with your body instead of fighting it,

What Is Perimenopause?

Perimenopause is the window of time (typically 4–10 years) when your hormones start to shift before your final period. Menopause is officially diagnosed when you’ve gone 12 months without a period — but perimenopause is where most of the symptoms begin.

The hormonal shifts are not linear or predictable. Estrogen levels can spike and dip wildly. Progesterone production declines earlier than estrogen, creating an imbalance known as estrogen dominance — a common trigger of symptoms.

Yet many women are told, “You’re too young for menopause,” or “Your labs are normal,” leaving them confused, frustrated, and unsupported.

8 Subtle Symptoms of Perimenopause (That Most Women Miss)

1. Mood Swings, Irritability, or Heightened Anxiety

You might feel more reactive to stress, unusually emotional before your period, or just “not like yourself” emotionally. You may swing between feeling overwhelmed and feeling flat — all within the same day.

🧠 Why it happens: Progesterone (a calming hormone) begins to decline in your 30s, while estrogen fluctuates, affecting serotonin and dopamine. The result? Mood instability, anxiety, and a shorter fuse.

2. Sleep Disturbances

You’re tired but wired. Falling asleep is harder, or you wake up at 2–3am with your mind racing and can’t fall back asleep.

🌙 Why it happens: Hormonal changes affect your circadian rhythm and melatonin production. Cortisol may rise at night, and low progesterone reduces your ability to relax.

3. Hot Flashes and Night Sweats

You wake up drenched in sweat. Or suddenly feel flushed, overheated, and uncomfortable — even in a cold room.

🔥 Why it happens: Estrogen plays a major role in regulating body temperature. As levels fluctuate, your hypothalamus (the brain’s thermostat) becomes more sensitive, triggering sudden heat surges or chills.

Note: Hot flashes aren’t just a “menopause thing.” They often begin in perimenopause — and can happen even when your cycle is still regular.

4. Weight Changes Without Lifestyle Changes

You're gaining weight (especially around the midsection) even though nothing’s changed in your diet or exercise routine.

⚖️ Why it happens: Estrogen and progesterone impact hunger, fullness, and muscle loss.

5. Digestive Upset

Bloating, constipation, or reflux becomes more frequent — especially around your cycle.

🥦 Why it happens: Hormones impact gut motility and microbiome balance. Estrogen affects bile production, which influences digestion.

6. Cycle Changes (Even if You're Still Regular)

Your periods may become heavier, shorter, longer, or more erratic. But they can also remain “regular” while symptoms build behind the scenes.

🩸 Why it happens: Ovulation becomes less consistent, which means less progesterone. Estrogen can spike without balance, making periods more symptomatic.

7. New or Worsening Joint Pain

Your knees ache after a walk. Your hips feel tighter. You're recovering more slowly from workouts.

💪 Why it happens: Estrogen has an anti-inflammatory effect and supports joint and connective tissue health. As it fluctuates, so does joint comfort.

8. Crashes in Energy and Motivation

Afternoon slumps hit harder. Your drive to move, cook, or plan feels dulled. You're mentally foggy or physically zapped — especially around your cycle.

⚡ Why it happens: Estrogen affects mitochondrial function (your cells’ energy production). Fluctuations = less consistent energy.

Why These Symptoms Are So Often Missed

Because:

• Most providers don’t screen for perimenopause unless you're 50+

• Standard labs may look “normal” even when you feel off

• Symptoms are often misattributed to depression, anxiety, thyroid issues, or “just being busy”

• You’ve been taught to just push through — instead of pause and investigate

But your lived experience matters. You deserve to have your symptoms heard, validated, and addressed — not dismissed.

What You Can Do

✅ Track Your Symptoms

Start paying attention to patterns across your cycle and month. Track:

• Sleep

• Mood

• Cycle length and intensity

• Energy

• Appetite/cravings

• Stress levels

Patterns tell the story that labs often don’t.

✅ Consider Functional Lab Testing

At Honor Your Body, we often recommend:

• Hormone testing

• Full thyroid panel (TSH, Free T3/T4, Reverse T3, antibodies)

• Blood sugar and insulin

• Cortisol patterning

• Nutrient levels (Vitamin D, B12, magnesium, iron)

Note: Most conventional blood tests won’t capture the full picture. We help you interpret results through a midlife lens.

✅ Adjust Nutrition & Movement

• Add protein: Helps balance blood sugar, stabilize mood, and support hormone detox

• Include fiber: Promotes estrogen clearance and gut health

• Strength train: Preserves muscle, balances blood sugar, improves joint stability

• Honor rest: Over-exercising increases cortisol and symptoms

This isn’t about dieting harder. It’s about supporting your changing physiology.

✅ Support Nervous System Regulation

• Gentle daily movement

• Breathwork or meditation

• Sleep rituals

• Magnesium glycinate at night

• Prioritize boundaries and connection

Your nervous system sets the stage for hormonal resilience.

Q&A: Perimenopause Clarity

Q: How do I know if I’m in perimenopause if my periods are regular? Perimenopause is about hormonal function, not just your cycle. You can still ovulate (and bleed regularly) while experiencing significant changes in hormone ratios.

Q: Should I get on hormone therapy? That depends. For many women, lifestyle changes and targeted supplementation are enough in early perimenopause. But HRT can be a safe, effective tool — especially when guided by a practitioner who understands your full picture.

Q: What if my doctor says I’m fine? Advocate for yourself. Bring symptom logs. Seek providers who take a holistic view. You are the expert in your body’s experience.

Final Thoughts

If you’ve felt off lately but can’t quite name why — trust that whisper.

Perimenopause isn’t just hot flashes and skipped periods. It’s a real hormonal transition that deserves real support. You don’t need to wait until you’re “in menopause” to start caring for your hormones. In fact, the earlier you start, the better you’ll feel — now and later.

Need Support?

Inside the Honor Your Body program, our team of women’s health experts (including a licensed nurse practitioner, registered dietitian, exercise physiologist, and therapist) helps you:

• Identify and manage perimenopause symptoms

• Order and interpret the right labs

• Build a personalized plan based on your unique needs

• Feel like yourself again — with support and science, not shame

✨ Book a hormone consultation or join the group today. You don’t have to go through this season alone.