Understanding Perimenopause: What’s Happening Inside Your Body and How It Affects You

If you’re in your late 30s or 40s, you may have noticed changes in your body and mood that you can’t quite explain. Maybe your energy dips, your sleep feels off, or your emotions feel like a rollercoaster. You might even feel “less like yourself.” The truth is, many of these changes are caused by perimenopause, the transition phase before menopause, and understanding what’s happening can help you navigate it with more clarity and confidence.

What Is Perimenopause?

Perimenopause is the period when your hormones, especially estrogen and progesterone, start to fluctuate as your body prepares for menopause. It typically begins in your late 30s or early 40s and can last several years. Unlike menopause, where your periods stop entirely, perimenopause is marked by irregular cycles, which can feel unpredictable and confusing.

The Key Hormones: Estrogen, Progesterone, and Testosterone

Estrogen

Estrogen normally plays a big role in keeping your body working well. It helps regulate your menstrual cycle, supports strong bones, and keeps your skin, hair, and vaginal tissue healthy. It also helps balance your mood and brain function, so you can think clearly and feel more steady. When estrogen is at the right levels, your body runs more smoothly overall.

During perimenopause, estrogen levels start to fluctuate. They can be high one day and low the next. This rollercoaster can cause all sorts of changes in your body and how you feel. Because your hormone levels aren’t as steady as they used to be, your body may react in ways that feel new or unexpected.

Common symptoms linked to low or fluctuating estrogen include hot flashes, night sweats, vaginal dryness or discomfort, mood swings like irritability or anxiety, trouble sleeping, and brain fog or forgetfulness. These changes are a normal part of perimenopause, even though they can feel frustrating or confusing at times.

Estrogen normally:
• Regulates your menstrual cycle
• Supports bone health
• Keeps skin, hair, and vaginal tissue healthy
• Helps balance mood and brain function

During perimenopause, estrogen levels fluctuate, sometimes high, sometimes low. Symptoms linked to low or fluctuating estrogen include:
• Hot flashes and night sweats
• Vaginal dryness or discomfort
• Mood swings, irritability, or anxiety
• Trouble sleeping or staying asleep
• Brain fog or forgetfulness

Progesterone

Progesterone is one of your body’s key hormones, helping to keep things in balance. It works alongside estrogen, prepares your body for pregnancy, promotes calm and restful sleep, and supports bone health. When progesterone is at the right level, your cycles, mood, and sleep all tend to feel more stable.

During perimenopause, progesterone usually starts dropping first, which can make your cycles unpredictable. This shift can affect your sleep, leaving you waking up unrefreshed, and can make your mood feel off, even if nothing else in your life has changed.

Low progesterone can show up in several ways. You might notice irregular or heavier periods, trouble sleeping, feeling more anxious or “on edge,” or more intense PMS-like symptoms. These changes are part of the hormone transition happening in perimenopause, even though they can feel frustrating or surprising.

Progesterone normally:
• Prepares your body for pregnancy
• Balances estrogen’s effects
• Promotes calm and restful sleep
• Supports bone health

During perimenopause, progesterone drops first and can become irregular. Symptoms linked to low progesterone include:
• Irregular or heavier periods
• Trouble sleeping or waking up unrefreshed
• Increased anxiety or feeling “on edge”
• PMS-like symptoms intensifying

Testosterone

Testosterone isn’t just a male hormone; it plays an important role in women too. It supports libido and sexual arousal, keeps muscles strong, boosts energy, and contributes to confidence, motivation, and mental clarity. When testosterone levels are balanced, it’s easier to feel strong, focused, and like yourself.

During perimenopause, testosterone slowly declines, which can affect many parts of your life. You might notice lower sexual desire, fatigue, less motivation, or difficulty maintaining muscle tone. It can also impact your confidence, leaving you feeling mentally slower or less sharp than usual. These changes are normal, but they can still feel frustrating.

Testosterone normally:
• Supports libido and sexual arousal
• Contributes to muscle mass, strength, and energy
• Supports confidence, motivation, and mental clarity

During perimenopause, testosterone slowly declines. Symptoms linked to low testosterone include:
• Low libido or reduced sexual desire
• Fatigue and low motivation
• Muscle weakness or difficulty maintaining tone
• Feeling less confident or mentally sluggish

How These Hormonal Shifts Affect Your Life

When these hormones are out of balance, it’s not just your body that changes; it’s your mood, energy, and sense of self. Many women notice feeling less like themselves, dealing with heightened stress or anxiety, struggling with low energy, and seeing changes in their body like weight gain around the midsection, thinning hair, or skin changes. Emotional ups and downs, irritability, or sadness can also be part of the picture. Understanding these shifts helps you see that it’s all connected and gives you a roadmap for taking care of yourself during perimenopause.

Navigating Perimenopause

Perimenopause is a natural time of transition, and understanding your hormones can make a huge difference in how you experience it. Knowing what’s happening in your body helps you recognize that many changes like mood swings, low energy, or sleep troubles—are normal. It also helps you identify which hormone might be responsible for certain symptoms, making it easier to support yourself and reduce frustration or self-blame.

Practical ways to navigate this stage include tracking your cycle and symptoms through journaling to see patterns, prioritizing sleep with a consistent routine, moving your body through strength training, yoga, or walking, and managing stress through meditation, breathing exercises, or therapy. Seeking guidance from a healthcare provider who understands perimenopause can provide testing, supplements, or strategies tailored to your needs.

Remember, perimenopause is not the end of your vitality. Understanding your hormones and how they affect your body, mind, and energy gives you the tools to approach this stage with awareness, self-compassion, and confidence. With the right knowledge and support, you can navigate perimenopause feeling empowered rather than frustrated.