When I reached my early forties and noticed changes in my body, I was shocked. Perimenopause? Already? Like many women, I thought menopause was something that happened in my fifties, so when the symptoms appeared at 44, I was completely unprepared. I remember sitting in my doctor’s office, convinced I was too young for this. He reassured me that I wasn’t.
Although it was unsettling to start perimenopause early, my doctor mentioned that he occasionally sees women in their sixties who are frustrated and wondering why they are still having periods. That definitely made me reconsider—imagine being over 60 and still dealing with that! (Yikes!) I also learned that the transition can last up to 10 years, so if you’re noticing changes and suspect perimenopause, you’re certainly not alone. I want to help you understand what’s happening and what to expect.
Perimenopause is the phase leading up to menopause, during which your body gradually decreases the production of important reproductive hormones like estrogen, progesterone, and even testosterone. Menopause officially begins when you haven’t had a period for 12 months, but perimenopause can last for several years before that, sometimes up to a decade. In my case, perimenopause started in my mid-forties, but for some women, it can begin as early as their late thirties or as late as their fifties, making it unpredictable for each individual.
Most discussions about perimenopause focus on the changes in estrogen and progesterone, but testosterone also plays a crucial role. While it’s often seen as a male hormone, women produce small amounts of testosterone, which affects energy levels, libido, and mood. As these three hormones begin to fluctuate and decline, you may experience a variety of symptoms, such as irregular periods, mood swings, or changes in energy.
During perimenopause, estrogen levels tend to drop unevenly, leading to the well-known hot flashes and night sweats. Progesterone, which helps regulate your cycle, also decreases, resulting in unpredictable periods and sometimes heavier or lighter bleeding than usual. Meanwhile, testosterone levels may gradually decline, causing subtle changes in muscle tone, energy, and sexual drive. These fluctuations can last from a few months to several years, depending on your body, and are the main cause of the common symptoms associated with “the change.”
It’s essential to understand that all three hormones—estrogen, progesterone, and testosterone—work together, and when they become unbalanced, it affects everything from your mood to your metabolism. If you’re in your forties and feeling a bit off, you might be starting perimenopause. The symptoms can vary widely from person to person, but here are some common signs to watch for:
These symptoms can come and go over time and may last for several years. Some days may feel perfectly normal, while others can feel like a rollercoaster, so it’s important to recognize these changes and understand that they are a natural part of the process.
Perimenopause involves more than just irregular periods and hot flashes; it can have lasting effects on your overall health. Understanding how perimenopause affects your body and taking steps to address these changes can help you maintain long-term health and well-being. As estrogen levels drop during perimenopause, your bone density may decrease, increasing the risk of osteoporosis. Estrogen is vital for keeping bones strong, so losing this hormone can weaken bones and raise the chances of fractures, especially in the hips, spine, and wrists.
Estrogen also helps protect your heart, so when levels decline, your risk for cardiovascular disease may rise. Lower estrogen can affect cholesterol levels, increase blood pressure, and reduce the elasticity of blood vessels, making heart health a crucial focus during perimenopause.
Many women notice weight gain during perimenopause, particularly around the midsection. This is mainly due to hormonal changes that slow down metabolism. The drop in estrogen makes your body more likely to store fat, while declining testosterone can lead to a loss of muscle mass. Together, these factors make it harder to maintain your previous weight, even if your diet and exercise habits haven’t changed.
As estrogen decreases, many women notice changes in their skin and hair. Skin can become drier, thinner, and less elastic, while hair may start to thin or become more brittle. This is due to the reduced production of collagen and natural oils that are typically supported by estrogen.
“Brain fog” is a common complaint during perimenopause. The decline in estrogen can affect neurotransmitters linked to memory and focus, making it harder to concentrate or remember things. Hormonal fluctuations during perimenopause can also lead to emotional changes such as irritability, anxiety, and depression. The ups and downs of moods can be challenging and may impact your mental well-being.
The drop in estrogen during perimenopause can affect the urinary tract and pelvic muscles, leading to urinary incontinence or increased urgency. Taking proactive steps to address the long-term health effects of perimenopause can help you stay healthy and feel better during this transition.
Fortunately, there are many ways to manage perimenopause symptoms and make this transition easier. If you think you might be entering perimenopause, it’s wise to talk to your doctor and have an open conversation about what you’re experiencing. I found that tracking my menstrual cycle with an app was incredibly helpful, especially as I approached that 12-month countdown to menopause. I even went 11 months without a period once, only for it to return unexpectedly, resetting the countdown! At that point in my journey, I was looking forward to never having another period, so it was quite frustrating.
You can also track other symptoms like hot flashes, mood swings, and sleep disruptions. This information provides your doctor with a clearer picture of what’s happening with your body. If you’re feeling uncertain about your situation, ask your doctor for a hormone test. For me, having my estrogen, progesterone, and testosterone levels checked was reassuring. It confirmed that I wasn’t imagining things or going crazy—it was perimenopause.
While blood tests aren’t always necessary, they can offer peace of mind and help validate what your body is experiencing. So, don’t hesitate to ask if you think it would help clarify your situation. Perimenopause in your forties, or at any age, can feel like a whirlwind of changes, but the more informed you are, the better prepared you’ll be to manage it.
Although the transition wasn’t easy for me, understanding what was happening and finding practical ways to cope with the symptoms made a significant difference. If you think you might be starting perimenopause, discussing it with your doctor and creating a personalized plan can help you feel more in control.
One of the best ways to support your health during perimenopause is by focusing on fitness and nutrition, which can help you manage symptoms and avoid the weight gain that often accompanies hormonal changes. Many women in the perimenopause and menopause stages of life have found great success with our 21-Day Fat Loss Challenge program. It’s specifically designed to help you lose weight, boost your energy, and reset your metabolism, all while fitting into a busy lifestyle.
Whether you’re just beginning your perimenopause journey or already navigating it, taking steps to prioritize your health with a program like this can make the transition much smoother.