What No One Told You About Perimenopause

Let’s be honest: most of us didn’t get the full story about menopause. You might have heard about it in passing—maybe even joked about hot flashes or mood swings—but few of us were truly prepared for what happens before menopause actually begins. This transitional phase, called perimenopause, can feel like your body is throwing curveballs. One day, everything feels normal. The next, you're waking up at 3:00 a.m. in a puddle of sweat, wondering what’s going on.

Yes, there are emotional shifts, a sense of disorientation, and moments of doubt. But there’s also something else emerging—a growing awareness of your strength, your needs, and your evolving identity. Perimenopause is as much an emotional and mental shift as it is physical. It reminds us that change is constant, and even in this in-between space, there's room to grow, reflect, and redefine what it means to be yourself.

So, What Is Perimenopause?

Perimenopause is the natural transitional phase leading up to menopause, when your ovaries gradually produce less estrogen and progesterone. It usually begins in your 40s, but for some, it can start as early as the mid-30s. This phase can last for several years and brings with it a host of changes—some subtle, others impossible to ignore.

You might notice irregular periods, sleep disruptions, sudden mood swings, or that familiar 3:00 a.m. wake-up call, drenched in sweat. One moment, you're feeling just fine; the next, you're anxious or inexplicably sad. If it feels confusing, you’re not imagining things. These are all real, physiological changes your body is going through.

Why Your Body Feels Like It’s Betraying You

During perimenopause, your hormone levels begin to fluctuate. Estrogen and progesterone production slows, but your brain—specifically the hypothalamus—keeps trying to stimulate your ovaries to produce more. The hypothalamus also regulates body temperature, which is why it can suddenly misfire and trigger hot flashes. The body responds by increasing blood flow and activating sweat glands, leaving you overheated, flushed, and reaching for the nearest fan (Brinton, Yao, Yin, Mack, & Cadenas, 2015).

But you're not powerless. Small lifestyle shifts can make a big difference in how you feel.

Supportive Strategies: Movement, Food, and Flow

A balanced diet and regular physical activity can help regulate hormones and support both mood and metabolism. Moderate movement—like walking, dancing, strength training, yoga, or swimming—can reduce stress, improve sleep, and support bone and heart health (Hao et al., 2022).

Here’s a simple day-long routine to get started:

• Morning: 10-minute walk or light stretching

• Afternoon: Strength and cardio combo (try squats, pushups, glute bridges, or a 10-minute dance workout)

• Evening: Gentle yoga or a 5-minute guided meditation (YouTube has great free options!)

  
  

Food matters too. Try incorporating hormone-supportive choices like:

• Tofu, edamame, soy milk

• Flaxseeds, chickpeas, lentils

• Leafy greens, fatty fish, low-fat dairy

• Pumpkin seeds, almonds, eggs, avocado, dark chocolate (yum!) (Erdélyi et al., 2023)

  
  

Also, try unplugging from screens an hour before bed—your sleep will thank you.

Relationships, Brain Fog, and Libido Changes (Oh My)

Perimenopause can sneak into your relationships like an uninvited houseguest who adjusts the thermostat and eats all your snacks—but with hormones. One minute you're cuddling; the next you're irrationally annoyed by how loudly your partner chews.

It’s common to experience libido changes, too—you may find yourself more interested in reorganizing your spice rack than anything romantic. And then there’s the brain fog: mid-sentence, your thoughts vanish into thin air. Frustrating? Absolutely. But with communication, patience, and a shared sense of humor, you and your partner can get through this time without resorting to separate zip codes.

Check in with each other. Educate one another. Let this time be a chapter of bonding, not just surviving.

Mental Health and Mindfulness

The emotional ups and downs of perimenopause can sometimes mirror symptoms of anxiety or depression. This is where health professionals can help distinguish between hormone-driven mood changes and clinical conditions (Silver, 2025).

In the meantime, you can support your mental well-being with practices like:

• Mindful breathing: Inhale for 4 counts, hold for 4, exhale for 6–8

• Progressive muscle relaxation: Tense and release muscles in sequence

• Guided imagery: Listen to calming audio to reduce cortisol and improve mood

• Journaling: Helps you process emotions and find clarity

• Apps: Try Headspace, Calm, or Insight Timer for sessions designed for women’s health

  
  

Creativity helps too. Take a class, write, paint, or garden. Small joys matter. And don’t forget—caffeine and alcohol can worsen hot flashes and disrupt sleep, so be mindful of your intake.

You’re Not Alone—And You’re Not Broken

Perimenopause is a natural stage of life, not a personal failure or a medical crisis. Yes, it can be uncomfortable, disorienting, even overwhelming at times. But it can also be empowering.

By understanding what’s happening in your body and embracing supportive practices, you can move through this season with resilience and self-compassion. You are not the same person you were—and that’s not a loss, but a transformation.

Perimenopause is not just a phase of endings. It’s a chance to evolve, to reconnect with yourself, and to step into the next chapter with clarity and strength.

If you or someone you know would like support on their journey with mental health, substance misuse, or gambling, do not hesitate to reach out to Gateway at 273-1170 or send us a message through our facebook page: Gateway to Prevention and Recovery, Inc. Our team is committed to helping individuals and families find the path to hope, healing, and greater health.

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Candi Martin, CHC, CLC, MS, is an Assistant Program Coordinator for the TSET Healthy Living Program. She has worked with adolescents and adults in a behavioral health setting for over 10 years. She has been in the fitness and industry for 15 years and is passionate about substance misuse prevention, education, and overall holistic well-being.