Before hitting your 40’s, you probably never even thought about perimenopause. Maybe you’ve never ever heard of it. You may know menopause is lurking somewhere in the future, but you still feel pretty good and can deal with all that later, right? RIGHT??!! Then one day you have increasing brain fog, worsening sleep, your periods become different and suddenly you’re here, reading all about perimenopause and what it means. 

 

Perimenopause is often a mystery to many women. Commonly misunderstood, perimenopause is not just a prelude to menopause—it’s an extended phase of significant hormonal changes that affect not only your reproductive hormones but also other systems in your body, such as your thyroid, adrenal, and insulin sensitivity. It can last anywhere from 8 to 10 years, and during this time, you might notice some changes in your body that can be concerning or downright confusing.

During this transition, your ovaries begin the process of shutting down estrogen production. This leads to significant swings in estrogen and progesterone, often leading to symptoms of estrogen dominance. Did you know that menopause has not officially arrived until you have gone one full year of not having a period? The average age for menopause in the US is 51 – dealing with perimenopause symptoms for potentially a whole decade is significant, and yet we hardly hear anything about it!

If you’re nearing your 40s or already in your 40s, pay attention to these signs and symptoms of perimenopause. Understanding these changes can help you manage them more effectively and make informed decisions about your health. Let’s dive into the top 10 signs you may experience as you transition through perimenopause. Disclaimer: I’ll be suggesting supportive supplements for many of the symptoms associated with Perimenopause. Join my Fullscript Dispensary for 25% off medical grade supplements!

1. Irregular Periods

One of the earliest signs of perimenopause is a shift in your menstrual cycle. If you’ve had a predictable cycle for years—like your period always arriving on a specific day—suddenly, you may notice that your period is either a little earlier or later than usual. Some women experience a cycle that’s as much as a few days off, while others may notice their periods become heavier or last longer.

In early perimenopause, your cycles tend to get shorter. In later perimenopause, they begin to space out. 

Why does this happen? Hormonal fluctuations are largely to blame. When estrogen and progesterone levels fluctuate, they can interfere with your cycle. You might even experience anovulatory cycles, meaning you bleed, but you don’t actually ovulate. This can lead to lower progesterone levels, which can cause irregular periods and even some spotting. A great herbal supplement for boosting progesterone is Vitex (chaste tree berry). This helps support progesterone production and eases the transition into menopause. 

2. Breast Tenderness

Many women going through perimenopause experience breast tenderness. This is typically caused by an imbalance between estrogen and progesterone. Estrogen dominance—when estrogen levels are too high compared to progesterone—can result in fluid retention, which can cause your breasts to feel tender, swollen, and achy.

Managing this discomfort may include trying evening primrose oil or castor oil massage. Additionally, incorporating a more anti-inflammatory diet and reducing sugar, alcohol, and processed foods can help support your hormones and ease the tenderness. You can take supplements containing DIM or I3C short term (2-3 months) if symptoms of estrogen dominance persist. 

3. Hot Flashes

Hot flashes are another common symptom of perimenopause. These sudden waves of heat can occur at any time of the day or night, often leading to heavy sweating, flushed skin, and an uncomfortable feeling of heat. Hot flashes often happen when estrogen levels drop, causing your body temperature regulation to go haywire.

To manage hot flashes, try to keep your blood sugar stable and look into adaptogens, vitamins, and minerals that support your adrenal and thyroid functions. Bioidentical hormone replacement therapy (HRT) may also be an option, but it’s essential to track your symptoms and work with a practitioner to determine the best approach for you.

4. Vaginal Dryness

Vaginal dryness can be an uncomfortable symptom of perimenopause, caused by decreasing estrogen levels. This dryness can lead to itching, irritation, and painful intercourse. While this symptom can be embarrassing for many women, it’s important to address it.

Lubricants and vaginal moisturizers, such as those containing hyaluronic acid, can offer relief. Don’t hesitate to seek out herbal supplements, homeopathic remedies, or bioidentical hormones to help maintain healthy vaginal tissue during this phase.

5. Heavy Bleeding

While your periods might become irregular, some women experience heavy bleeding as a sign of perimenopause. If you find yourself soaking through pads or tampons quickly, or if your flow lasts for more than a week, it’s essential to address it with your doctor. Heavy bleeding could be due to fibroids, polyps, or even more serious conditions like endometriosis.

If you experience worsening symptoms, such as fatigue, pale skin, or hair thinning, it’s time to get a professional evaluation to rule out any underlying issues. Early detection is crucial to effective treatment and recovery.

6. Low Libido

A decline in libido is common during perimenopause. Hormonal shifts, particularly drops in estrogen, progesterone, and testosterone, can reduce sexual desire. However, the decrease in libido is not just due to hormones—it may also be caused by fatigue, stress, and a lack of intimacy in your relationships.

While supporting your hormone levels is essential, it’s also important to address the emotional and mental factors that can affect your desire. Taking time for self-care, reducing stress, and maintaining open communication with your partner can help improve intimacy during this transition. Try an herbal blend to help boost your libido if you are struggling in this area. 

7. Sleep Problems

Sleep disturbances are prevalent during perimenopause. Whether you struggle to fall asleep or find yourself waking up in the middle of the night, these issues can be related to hormone fluctuations, particularly with the decline in progesterone. Vitex, otherwise known as Chasteberry, can help with progesterone production during this transition. 

Other factors, such as elevated cortisol levels from stress or unstable blood sugar, can also contribute to poor sleep quality.

To improve sleep, focus on maintaining stable blood sugar throughout the day and establishing a calming bedtime routine. Supplements like magnesium glycinate and Valerian root can help relax the body and support restful sleep. However, lifestyle changes—such as reducing caffeine and screen time before bed—are often the first step to improving sleep quality.

8. Mood Changes

Perimenopause can bring about a rollercoaster of emotions. Many women experience irritability, anxiety, or even depression as their hormones fluctuate. The mental fog, forgetfulness, and cognitive issues can also add to emotional distress, making you feel more overwhelmed than usual.

Supporting your hormones, managing your stress, and maintaining a balanced lifestyle can help mitigate mood swings. Exercise, fresh air, and adequate nutrition are essential for emotional stability during this phase. It’s also vital to address any underlying mental health issues, as perimenopause can sometimes exacerbate conditions like anxiety or depression. Herbs such as Ashwagandha can help balance your mood. 

9. Muscle and Bone Weakness

Did you know that after age 30, we lose 1% of bone density per year? As estrogen levels decline, so does muscle mass and bone density. Perimenopause can be a time when many women experience muscle weakness and bone loss, which can lead to an increased risk of fractures or falls.

Incorporating weight-bearing exercises into your routine—such as strength training, Pilates, or yoga—can help maintain bone density and muscle strength. Proper nutrition, including adequate protein, calcium, magnesium, and vitamin D, is also crucial for supporting your muscles and bones during this transition.

10. Fatigue

Fatigue is one of the most pervasive symptoms of perimenopause. Even after a good night’s sleep, you may still feel exhausted and drained. This tiredness can be linked to hormonal imbalances, thyroid issues, and lifestyle factors like stress or poor nutrition.

If you’re feeling persistently fatigued, it’s essential to address your diet and lifestyle. Ensure you’re consuming enough protein, eating balanced meals throughout the day, and managing your stress levels. Additionally, getting proper blood work done to assess your thyroid and other hormones can be helpful in identifying any underlying causes of fatigue.

Conclusion

Perimenopause often creeps in before we realize what has happened! The most common complaint I hear about women suffering from perimenopause symptoms is “I don’t feel like myself”. It is more important now than ever to dial in sleep, nutrition and fitness so that you can return to being “you”. If you are in California and interested in having your hormones tested via a DUTCH test, order here or shoot me an email and we can chat! 

Check out some of my other posts related to perimenopause:

The best herbal remedies for perimenopause and menopause symptoms

The best supplements for women over 40

Disclaimer 

These statements have not been evaluated by the Food and Drug Administration. This is not intended to diagnose, treat, cure or prevent any disease. This information is for educational purposes only, please consult with your medical provider before implementing anything new into your daily regimen.