Written by
Louise W Lu, PhD, MPH, BMLS
Reviewed by
Michelle Ordner, Registered Nurse
Meet Yvonne. She’s 42. She eats clean, does Pilates, avoids sugar, and drinks herbal tea at night. But somehow, things are changing.
Her pants are tighter — even though her weight is “the same.” She wakes up at 3 a.m., every night. And little things that never bothered her — like her partner chewing too loudly — now make her snap.
She asks herself, "Is this stress? Am I getting old? Is this early menopause?" But when she brought it up during a check-in with her health coach, the response was simple and surprising:
“You’re likely in perimenopause.”
Jump to Section:
- What Is Perimenopause?
- What’s Actually Happening With Your Hormones
- Top 3 Symptoms: Belly Fat, Bad Sleep, and Big Feelings
- This Is Normal — But You Deserve Support
What Is Perimenopause?
Perimenopause is the natural transition leading up to menopause — but it’s not just about your period stopping. It can begin in your late 30s or early 40s, and for many women, it lasts several years, sometimes even a full decade.
This phase isn’t well understood by the public, and many doctors brush it off unless you’ve already stopped menstruating. But during perimenopause, your hormones fluctuate wildly, and that creates changes that affect your sleep, mood, energy, metabolism — and how you feel about yourself.
What makes perimenopause so tricky is that you still have periods, so it doesn’t look like menopause. But underneath the surface, your body is rewriting its hormonal playbook.
What’s Actually Happening With Your Hormones
Let’s walk through an example.
Think about Sarah, 39. She has regular periods, sleeps well, and feels calm most of the time. Her body is still cycling normally: her brain sends out FSH (follicle-stimulating hormone) to tell the ovaries to grow an egg. The ovary releases estrogen, which helps the body feel energized, focused, emotionally balanced, and keeps periods regular. Once she ovulates, she produces progesterone, which helps her sleep, soothes anxiety, and keeps her uterine lining stable.
Now fast forward five years. At 44, Sarah notices she hasn’t ovulated as often. Her estrogen levels start spiking unpredictably, and progesterone stays low more often because ovulation doesn’t always happen. Her brain starts releasing more FSH, shouting at the ovaries to respond — but the response is inconsistent.
Hormone Comparison: Normal vs Perimenopause
| Hormone | Normal Cycle | Perimenopause |
|---|---|---|
| Estrogen | Rises and falls in smooth waves | Fluctuates dramatically — high one week, low the next |
| Progesterone | Rises after ovulation, promotes sleep and calm | Often missing (due to skipped ovulation), leads to anxiety and poor sleep |
| Follicle-stimulating hormone | Brief spikes before ovulation | Chronically elevated as ovaries become less responsive |
What do these changes lead to? Emotional outbursts, fatigue, belly weight, forgetfulness, and feeling like your body is no longer yours.
Top 3 Symptoms: Belly Fat, Bad Sleep, and Big Feelings
1. Belly Fat (Even If You Haven’t Changed Your Diet)
Emily, 46, eats the same healthy meals and does her weekly workouts — but she’s gaining belly fat. That’s because lower estrogen means fat is now stored in the abdomen, not hips or thighs. Without progesterone to help regulate insulin, blood sugar swings and cravings increase. Add a slower metabolism? Weight gain becomes easier, even without overeating.
2. Bad Sleep That Wrecks Your Energy
Priya, 41, used to sleep like a rock. Now she wakes up at 2 a.m. drenched in sweat. Or worse, she can’t fall asleep at all. Progesterone is naturally calming, like nature’s sleep aid. Low levels lead to light, anxious sleep. Estrogen helps regulate body temperature and melatonin. When it drops, you wake up hotter and more restless.
3. Big Feelings Out of Nowhere
Laura, 43, suddenly finds herself crying during car commercials and snapping at her kids for dropping crumbs. Estrogen supports serotonin, the “feel good” brain chemical. Without it, mood stability takes a hit. Low progesterone removes the “calm and cope” hormone.
This Is Normal — But You Deserve Support
You are not broken. Your body is shifting into a new rhythm — and it needs new kinds of support.
- Eat for hormone balance: protein with every meal, more fiber, fewer ultra-processed carbs
- Build muscle: strength training twice a week helps metabolism, confidence, and insulin sensitivity
- Support your nervous system:
- Magnesium glycinate for sleep
- Ashwagandha or holy basil for calm
- Fish oil for mood and inflammation
- Prioritize sleep: go to bed before 11, wear a sleep mask, reduce screen time after dinner
- Track your cycle (even if it’s weird): understanding patterns reduces panic
- Ask for what you need: time alone, emotional support, fewer commitments during tough weeks
- Talk about it with other women: normalizing perimenopause reduces shame and increases options
And most importantly: talk about it. You’re not the only one. The more we normalise these changes, the more supported — and powerful — we become.
Coming Up Next: How to Spot the Top 10 Symptoms of Perimenopause
If you’ve been feeling “not quite right” and no one’s given you a clear answer yet — stay tuned. Next up:
“Is This Normal?” — 10 Signs You Might Be in Perimenopause (and What to Do About Them)
Because when you understand what’s going on, it’s easier to take action (and have some compassion for yourself along the way 💗).
Authors:
Michelle Ordner
Registered Nurse (RN)
Michelle's expertise spans healthcare, nutrition infusion, and menopausal care. She began her nursing career in New Zealand in 1991 and has since served 17 years in critical care across the USA. After returning to NZ, she trained in cosmetic medicine and stem cell therapy, and holds a UK certification in intravenous nutrition. Her work focuses on integrative care for menopausal health and wellness.
