Perimenopause 101: How to Identify Symptoms and Support Your Body

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How Do I Know I'm in Perimenopause? A Guide for Women Over 40

Perimenopause can be a confusing and often overwhelming time for many women. If you're over 40 and noticing changes in your body, emotions, or overall well-being, you might be wondering, “How do I know if I’m in perimenopause?”

You’re not alone—many women are navigating these same waters, trying to understand their shifting hormones, why their belly fat won’t budge, and how to take better care of themselves.

What is Perimenopause?

Perimenopause refers to the transition period leading up to menopause, which can start as early as your late 30s or early 40s. It typically lasts for several years—sometimes up to a decade—before you officially reach menopause, which is when you haven't had a period for 12 consecutive months. During this transition, your hormone levels fluctuate significantly, causing symptoms that can sometimes feel overwhelming or unexpected.

I know this journey well because I’ve walked through it myself. When I first started experiencing perimenopausal symptoms, I felt like I was going crazy. I didn’t have the support, education, or understanding I needed, and it left me feeling like a wreck. 

But here’s what I want you to know: You are not crazy. And you don’t have to navigate this season alone.

Perimenopause Symptoms by Age: What to Expect

Early Signs of Perimenopause (Late 30s to Early 40s)

One of the first questions I often get from clients is, “How do I know I’m in perimenopause?” In your late 30s or early 40s, some of the early signs of perimenopause can feel subtle but still significant. These symptoms can sneak up on you, often making you wonder if something else is going on.

Here are some early signs to look out for:

- Increased anxiety or mood swings

- Trouble sleeping, even if you’re exhausted

- Shorter or irregular menstrual cycles

- Digestive changes, including bloating or constipation

- Hair thinning or loss

- Skin changes like dryness or acne

You might also notice that what used to work for you, like your go-to way of eating or exercise routine, no longer has the same effect. Your body is changing, and it’s trying to tell you something.

Mid-Stage Perimenopause (Mid to Late 40s)

By the time you hit your mid-40s, perimenopause symptoms can start ramping up. Your periods might become more erratic, and you’ll likely notice more pronounced physical and emotional changes.

At this stage, women often experience:

- Hot flashes and night sweats: Waking up drenched in sweat or suddenly feeling flushed during the day.

- More intense PMS: Mood swings and irritability can hit harder than ever.

- Weight gain, especially around the belly: A lot of my clients in this age group feel frustrated with stubborn belly fat that won’t seem to budge.

- Low energy: Fatigue can become a daily battle, making staying motivated with your health goals harder.

- Cognitive changes: Brain fog and memory issues may start to creep in.

This is also the time when many women feel completely overwhelmed by life—career pressures, family responsibilities, aging parents—and the hormonal shifts only intensify the stress.

Late Perimenopause (Late 40s to Early 50s)

In the later stages of perimenopause, you’re getting closer to menopause, and the symptoms might feel even more intense. If you’re not tracking your cycle, it might feel like a roller coaster ride. 

Here’s what to expect in late perimenopause:

Skipped periods: You might go months without a period, only to have one come out of nowhere.

Severe mood swings: You could feel like you’re on an emotional roller coaster, with highs and lows that can leave you feeling out of control.

Muscle and joint pain: As estrogen declines, some women experience new aches and pains.

Sexual health changes: A decrease in libido or vaginal dryness might become more noticeable.

Even though these changes can feel overwhelming, there’s hope and plenty of support available. This season doesn’t have to feel like the end of the road—it’s just a new chapter.

How to Support Yourself During Perimenopause

Listening to what it needs and adjusting your habits as your body transitions is important. 

Taking care of yourself in perimenopause is paramount to ensuring you don’t feel like you’re losing control.

Here are some practical steps you can start taking today:

Nourish Your Body with the Right Foods

Midlife nutrition is crucial for keeping your hormones in balance. I always recommend focusing on:

• High-protein meals: Aim for 25-30 grams of protein per meal to support muscle mass and metabolism.
• Healthy fats: Opt for fats like MCT oil, avocado, walnuts, and olive oil, which are crucial for hormone health.
• Fiber: Load up on vegetables and low-glycemic grains to help with digestion and maintain steady blood sugar levels.
• Hydration: Drink plenty of water to stay hydrated, which can help manage bloating and keep your energy levels up.

Move Your Body with Purpose

Exercise during perimenopause isn’t just about burning calories—it’s about maintaining strength, flexibility, and mental well-being. I recommend a mix of:

STRENGTH TRAINING: To build muscle and boost metabolism. Building muscle is key to belly fat loss as well.

MOBILITY WORK: Like Pilates or yoga to keep joints healthy and maintain flexibility.

WALKING: Gentle daily movement helps with mood, energy, and overall well-being.

Remember, it’s about consistency, not intensity. Don’t overdo it—your body needs rest and recovery, too.

Prioritize Sleep and Stress Management

Sleep disturbances often accompany perimenopause, so it’s essential to create a calming bedtime routine.

Consider:

1. Limiting screen time: Turn off electronics an hour before bed to help your brain wind down.
2. Creating a relaxing environment: A cool, dark room with soft blankets and calming scents can make a big difference.
3. Saying “no” more often: Overcommitting leads to stress, which worsens perimenopause symptoms. Create space for yourself to rest and recharge.

When to Seek Help

While it’s possible to manage many perimenopause symptoms through lifestyle changes, some women may need extra support. I did! If you’re experiencing severe symptoms like intense mood swings, debilitating hot flashes, or extreme fatigue, it may be time to consult a professional who specializes in midlife health. 

Hormone Replacement Therapy (HRT) and Bioidentical Hormones

Hormone replacement therapy can be a game-changer for some women. There’s a misconception that you can’t start HRT if you’re still in perimenopause—not true! Working with a practitioner who understands midlife hormone changes is crucial.

They can help you explore options like:

- Progesterone: Known for its calming effects and support for better sleep.

- Estrogen: Helpful for managing hot flashes and vaginal dryness as well as being protective.

Just be sure to find a provider who specializes in women's midlife health, such as a functional or integrative practitioner.

Navigating perimenopause can be tough, but you don’t have to do it alone. The most important thing I want you to remember is you are worth taking care of. I talk to so many women who are exhausted, overwhelmed, and just trying to survive day by day. But the truth is, you can thrive in this season.

Make self-care a priority—whether it’s better nutrition, more rest, saying “no” to obligations that drain you, or seeking professional support. You’ll be better equipped to support those around you when you support yourself well. Let this be the season where you start focusing on you, so you can feel strong, vibrant, and healthy for years to come.