Am I in Perimenopause? The Top 5 Signs Your Body Is Changing
If you have stumbled upon this article at 3am and are wide awake struggling to fall back asleep... perimenopause may be to blame. Before I go into all the details, you may be wondering, "What the heck is perimenopause?!" Let me take a moment to define that.
Perimenopause is the transition of the female body from being of reproductive age to no longer releasing egg cells to reproduce. That's the simple definition — more on that later. The key word here is transition. This transition usually takes many years, and it comes with a range of symptoms that can catch many women completely off guard.
Clue #1 — Hot Flashes, Hot Flushes, or Night Sweats (Vasomotor Symptoms)
The preferred medical term is "hot flush" — and for good reason. It feels like a wave of heat rising upward from your torso toward your hairline. You might experience prickly sensations, redness on your skin, dizziness, or a feverish feeling. A flush may be over in one minute, or it may last five minutes. You may have two or three occur back to back.
What's happening physiologically is this: because estrogen levels are declining, estrogen is no longer able to help regulate body temperature. Your body becomes sensitive to even minor temperature fluctuations. Blood vessels dilate and blood rushes to the skin in an attempt to cool the body down. You feel waves of heat, redness, sweating, and an elevated heart rate. The feeling subsides once your body cools off.
Many women in their 40s are surprised to learn that hot flashes and hot flushes can begin years before their last period — this is key symptom of perimenopause.
The first time I experienced hot flushes, I felt feverish and thought I had COVID. Three tests later, it became very clear what was actually going on.
Night sweats are exactly what they sound like: intense sweating at night, with or without hot flushes. You may sweat through your pajamas, onto your sheets, or notice you sweat more on one side than the other. Yes, really.
How I Can Help:
Listen, empathize, and validate your experience.
Help you understand the "why" behind your vasomotor symptoms.
Explore what these changes mean for you personally.
Help you determine the severity of your symptoms and support you in discussing them with your medical practitioner.
Provide you with recommended labs to request from your provider.
Work with you one-on-one to identify which areas of your life need support and how best to improve your quality of life through this transition — so you feel empowered, educated, and vibrant.
Clue #2 — Weight Gain (The Meno Belly)
This kind of weight gain feels sudden, or happens for seemingly no reason. You have been following your normal exercise regimen and eating well — for the most part — and all of a sudden you notice increased weight around your mid-section. This is the "meno belly" symptom of perimenopause, and it is one of the biggest concerns among women in their 40s.
It is not you. You are not broken. The appearance of the meno belly simply means that your body needs a new strategy. What used to work for you with regard to nutrition and exercise is now outdated. Perimenopause weight gain around the middle is your body asking for something different — and there is a lot you can do about it.
How I Can Help:
Begin with a thorough screening and assessment of your current lifestyle habits.
Start an ongoing conversation about your current exercise routine.
Develop a perimenopause-friendly exercise program tailored specifically for you.
Work with you one-on-one to monitor your progress and modify as needed.
Have an honest conversation about your current nutrition.
Create a nutrition plan that supports your bone, brain, muscular, and nervous system health.
Clue #3 — New Anxiety, Depression, or Panic Attacks
Perimenopause anxiety is real, and it is more common than most women realize. Women with higher levels of anxiety are more likely to experience hot flushes — and women are more likely to feel anxious when having a hot flush, because the sensation of a racing heart and sudden sweating can itself trigger a panic response.
I do not want to create more anxiety by discussing this, but it is important to know: these symptoms are very likely connected to perimenopause and the hormone changes your body is experiencing. Supporting your nervous system is essential during this transition — not optional.
How I Can Help:
Listen, empathize, and validate your experience without judgment.
Help you create a personalized emotional support menu.
Develop supportive sleep and stress-recovery behaviors.
Work with you one-on-one to practice mindfulness and stress relief behaviors.
Refer you to other necessary healthcare providers as needed.
Clue #4 — Trouble Sleeping and Fatigue
The 3am wake-ups. Difficulty falling asleep. Difficulty staying asleep. Waking up too early and not feeling rested when you do. Perimenopause insomnia affects many women — and if this sounds familiar, know that it is not in your head.
Your reproductive hormones also play a significant role in regulating your sleep. When those hormones decline or fluctuate — as they do throughout the perimenopause transition — your sleep is directly impacted.
If you want to support your daytime functioning and energy during perimenopause and beyond, sleep must become a PRIORITY. That means paying close attention to your sleep rituals, building supportive habits, and actively avoiding behaviors that disrupt your rest — especially during the busiest seasons of your life when you need quality sleep the most.
How I Can Help:
Help identify your specific sleep disruption triggers.
Create better sleep hygiene habits that support your natural circadian rhythm.
Work with you one-on-one to monitor your progress and modify as needed.
Help you see the bigger picture of what else may be impacting your sleep quality.
Clue #5 — Sexual Dysfunction and Vaginal Changes
Are you dealing with one UTI after another? Recurring UTIs are actually a recognized symptom of perimenopause. Hormonal changes alter the pH of the vagina, creating a less acidic environment that makes you more susceptible to infection.
You may also be experiencing irritation or pain during sex. This happens because declining hormone levels cause the walls of the vagina to become thinner and drier, leading to pain, micro-tears, and irritation. These symptoms are collectively known as the genitourinary syndrome of menopause (GSM). Vaginal dryness during perimenopause is one of the most underreported symptoms — partly because it is uncomfortable to talk about. But there is help available, and you deserve to have a healthy and comfortable sex life.
How I Can Help:
Provide a safe, non-judgmental space for your questions.
Provide referrals for appropriate screenings if needed.
Share evidence-based tips and strategies to help you maintain a healthy and vibrant sex life.
You Are Not Alone — And You Don't Have to Figure This Out by Yourself
Perimenopause is not a disease, a weakness, or something to simply push through. It is a powerful transition — one that deserves real attention, personalized support, and a guide who truly understands what you are experiencing. Whether you are wide awake at 3am, frustrated by a body that feels unfamiliar, or simply searching for answers, know this: what you are feeling is real, it is valid, and there is a path forward. If you recognized yourself in any of these five signs, I would love to connect with you. Together, we can create a plan that helps you move through this transition feeling informed, empowered, and more like yourself than ever.