Perimenopause is the phase leading up to menopause, often beginning in a woman's 40s but sometimes as early as the late 30s. While many expect the usual signs—like hot flashes and irregular periods—some symptoms can be more subtle yet equally impactful. Perimenopause is often referred to as a "second puberty" because of the unpredictable hormonal fluctuations that affect not just your cycle but also your emotions, sleep, and how you see yourself.
Unlike puberty, which is widely acknowledged and supported, perimenopause is rarely talked about, leaving many women feeling unprepared and confused when symptoms begin to appear. Understanding the early, silent signs of perimenopause can help you take proactive steps to support your body through this transition.
Here are four lesser-known yet significant signs of perimenopause that every woman should be aware of:
1. Anxiety and Mood Changes
Hormonal shifts during perimenopause can significantly impact mental health, often leading to increased anxiety, mood swings, and even depression. Many women don’t realise that their heightened emotional state is linked to their changing hormones, instead attributing it to stress, work, or personal challenges.
Why It Happens
Oestrogen and progesterone play crucial roles in regulating mood by influencing neurotransmitters like serotonin and dopamine. During perimenopause, these hormones fluctuate unpredictably, causing mood instability. As oestrogen drops, the brain’s ability to produce serotonin (a “feel-good” neurotransmitter) also declines, leading to increased feelings of anxiety, sadness, or irritability.
How It Feels
- Feeling more anxious than usual, even about minor things.
- Increased irritability or emotional outbursts.
- Panic attacks, sometimes occurring for the first time in life.
- Feeling overwhelmed or more prone to stress.
What You Can Do
- Support your nervous system: Magnesium, B vitamins, and adaptogenic herbs can help regulate mood.
- Practice stress management: Meditation, deep breathing exercises, and gentle movement like yoga can be beneficial.
- Get enough healthy fats: Omega-3 fatty acids support brain health and mood stability.
- Seek support: If symptoms become unmanageable, working with a naturopath or therapist can help.
2. Sleeplessness and Insomnia
Many women in perimenopause struggle with disrupted sleep, even if they have never had sleep issues before. Sleep disturbances can be frustrating and exhausting, affecting energy levels, mood, and cognitive function.
Why It Happens
- Progesterone declines: This hormone has a calming effect and promotes sleep, so when levels drop, women may struggle to fall asleep or stay asleep.
- Oestrogen fluctuations: Oestrogen helps regulate body temperature and melatonin production. When it fluctuates, it can lead to night sweats and difficulty staying asleep.
- Increased cortisol levels: Perimenopause can heighten stress hormone production, leading to nighttime wake-ups (often around 3-4 AM).
How It Feels
- Difficulty falling asleep, even when exhausted.
- Frequent nighttime wake-ups, often sweating or feeling restless.
- Waking up too early and being unable to fall back asleep.
- Feeling groggy and unrested in the morning.
What You Can Do
- Limit stimulants: Reduce caffeine and alcohol, particularly in the evening.
- Create a bedtime routine: Dim the lights, avoid screens, and establish a wind-down ritual - check out The Foundation of Health for in depth routines!
- Use herbal support: Herbs can do wonders for helping the body prepare for sleep - as always, we recommend having a script tailored to your exact needs by one of our expert naturopaths!
- Balance blood sugar: Eating a small protein-rich snack before bed can prevent blood sugar dips that contribute to nighttime wake-ups.
3. Heavy Periods
Many women expect irregular periods in perimenopause, but they may not anticipate how heavy and intense their periods can become. Instead of gradually tapering off, periods often become unpredictable and much heavier before they start to decline.
Why It Happens
- Oestrogen dominance: When oestrogen levels are high relative to progesterone, the uterine lining builds up excessively, leading to heavier periods.
- Irregular ovulation: The body may not ovulate consistently during perimenopause, causing hormonal imbalances that trigger longer, heavier cycles.
- Fibroids or endometrial thickening: These conditions can become more common in perimenopause and contribute to heavier bleeding.
How It Feels
- Periods that last longer than 7 days.
- Heavy bleeding that requires frequent tampon or pad changes.
- Large blood clots or sudden “flooding” episodes.
- Increased cramping or discomfort.
What You Can Do
- Balance your hormones: Reducing stress, stabilising blood sugar, and supporting liver detoxification can help regulate oestrogen levels.
- Increase fiber intake: Fiber helps the body metabolise and eliminate excess oestrogen.
- Support iron levels: If periods are heavy, incorporating iron-rich foods (like leafy greens, red meat, and lentils) can help prevent anemia.
- Consider herbal medicine: Herbs with astringent actions can help regulate menstrual flow and prevent heavy, flooding periods - get in touch with our naturopaths for a tailored herbal script!
4. Body Image and Weight Gain
One of the most frustrating aspects of perimenopause is unexpected weight gain, especially around the abdomen. Even women who maintain the same diet and exercise habits often find their body composition changing, which can impact self-confidence.
Why It Happens
- Declining oestrogen levels: Oestrogen helps regulate metabolism and fat distribution. As levels drop, the body tends to store more fat, particularly around the midsection.
- Increased insulin resistance: Many women experience blood sugar dysregulation, making it easier to gain weight and harder to lose it.
- Muscle mass decline: Loss of oestrogen contributes to muscle loss, which slows metabolism.
How It Feels
- Noticing weight gain, particularly around the belly.
- Feeling bloated or puffy.
- Clothes fitting differently, even if body weight hasn’t changed significantly.
- Struggling with self-image and body confidence.
What You Can Do
- Prioritise strength training: Building muscle helps maintain metabolism and supports bone health.
- Eat a protein-rich diet: Protein helps stabilise blood sugar and maintain muscle mass.
- Reduce refined sugars and processed foods: These can contribute to blood sugar imbalances and increased fat storage.
- Practice body kindness: Perimenopause is a time of change, and it’s important to shift the focus from weight loss to body support.
Embracing the Changes
Perimenopause is often seen as a loss, but it can also be a time of transformation. Just like puberty, your body is undergoing a significant transition, and understanding these changes can help you navigate them with confidence.
By making small lifestyle adjustments, focusing on nutrition, and supporting your hormones naturally, you can move through perimenopause feeling empowered rather than overwhelmed.
If you're struggling with perimenopausal symptoms and want a holistic approach to feeling your best, book a 1:1 consultation with one of our naturopaths. Together, we’ll create a personalised plan to support your hormones, mental health, and overall well-being during this new phase of life.
