Health

5 Signs of Perimenopause You Might Be Ignoring

Your hormone survival kit is here.

By Edie Horstman
how to keep a conversation going - friends talking_signs of perimenopause

Your periods are suddenly unpredictable. Your energy feels like it’s on a rollercoaster. You’re waking up drenched in sweat at 2 a.m. Is this stress—or am I in perimenopause? For better or for worse, your hormones are running the show. And you can either let them call the shots or take better control. Either way, navigating the symptoms of perimenopause is no cakewalk. With your sanity in mind, we’re breaking down exactly what perimenopause is, and science-backed strategies that actually work.

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Why do women experience perimenopause?

Although it can feel sudden, perimenopause is a gradual (and natural) stage in the female aging process. It typically begins in a woman’s 40s. During this time, the ovaries produce less estrogen and progesterone, which lead to a slew of changes: irregular periods, hot flashes, night sweats, and shifts in energy or mood. While the exact triggers of perimenopause aren’t fully understood, research points to a mix of genetic, environmental, and lifestyle factors.

It’s important to remember that perimenopause isn’t a disease, though! It’s your body’s way of transitioning toward menopause. In many ways, it’s a biological rite of passage.

What are common signs of perimenopause?

For some, perimenopause starts subtly (think small changes to your cycle or energy). For others, symptoms appear like a loud knock at the door—e.g., sudden hot flashes or sleep disruptions. On average, women enter perimenopause around age 44, but the range is wide.

Common signs of perimenopause include:

  • Irregular or unpredictable periods
  • Hot flashes and night sweats
  • Mood swings or anxiety
  • Trouble sleeping or insomnia
  • Decreased energy and motivation

Keep in mind that these aren’t universal symptoms. You may have all or some, or a few. Regardless, the goal is to recognize these symptoms of perimenopause early. That way, you can be proactive before they interfere with your life.

How to Know You’re in Perimenopause

Tracking your body is the first step. Note irregularities in your cycle, and observe shifts in mood, sleep, and energy. Some women benefit from hormone testing to see where their estrogen and progesterone levels are, especially if symptoms are severe. Remember: there’s no “perfect” timeline. Signs of perimenopause tend to sneak up gradually, so the key is awareness rather than comparison.

What Actually Helps: Lifestyle Foundations

Let’s talk nutrition, movement, and sleep.

1. Nutrition

If you only take away one tip, let it be this: eat your protein! As estrogen declines, muscle mass naturally decreases, making adequate protein essential. Aim for 1 gram of protein per pound of ideal bodyweight (here’s exactly how to do this). But along with protein, don’t forget fiber. Fiber-rich foods also help stabilize blood sugar and support gut health—both of which influence hormone balance. Lastly, keep up your calcium and vitamin D for bone health. Scroll for a sample meal plan that hits these marks.

2. Strength Training & Movement

If you’ve been a cardio queen for most of your life, it’s time to start lifting weights (and not just 3-5 pound hand weights). Strength training preserves muscle and bone density, boosts metabolism, and improves mood. Even simple bodyweight moves—squats, push-ups, planks—make a difference! There’s no need to stop steady-state cardio (e.g., walking), but lifting will give you the results cardio can’t. If you’re brand new to strength training, I highly recommend Evlo Fitness by Dr. Shannon Ritchey.

3. Sleep

To no surprise, poor sleep worsens perimenopausal symptoms (and this type of chronic stress can further disrupt hormones). Prioritize 7–9 hours of sleep and establish a wind-down routine to help regulate your hormones and reduce perimenopausal symptoms.

One-Day Meal Plan to Support Perimenopause

As mentioned, here’s a sample day designed to nourish your body, balance hormones, and support steady energy. It covers the key macros and micros important during perimenopause:

Breakfast: Greek Yogurt Parfait

Snack: Simple Protein Smoothie

  • 1 scoop vanilla protein powder + 1/2 frozen banana + dash of cinnamon + milk of choice (protein, complex carbs)

Lunch: Salmon & Quinoa Power Bowl

  • Baked salmon (protein, omega-3s, vitamin D)
  • Quinoa cooked in bone broth (protein, complex carbs, magnesium)
  • Roasted broccoli (calcium, fiber, magnesium, antioxidants)

Snack: Cottage Cheese with Pumpkin Seeds

  • Cottage cheese (protein, calcium)
  • Pumpkin seeds (magnesium, zinc, healthy fats)
  • Drizzle of raw honey

Dinner: Chicken & Vegetable Stir-Fry

  • Chicken breast or tofu (protein)
  • Sautéed mixed colorful veggies like bell peppers, carrots, and zucchini (fiber, micronutrients)
  • Brown rice (complex carbs)
  • Sesame oil + garlic/ginger for flavor

Bedtime snack: Herbal tea and an oatmeal cookie

Pin it smoked salmon savory breakfast bowl_signs of perimenopause

Supplements and Hormone Replacement Therapy: What The Science Says

Even with a strong nutrition and movement foundation, there’s no shame in seeking additional support. This can include targeted supplements and/or hormone replacement therapy (HRT). Keep in mind they’re most effective when built on the basics: consistent protein intake, strength training, sleep, and stress management.

Supplements

MB-1 probiotics, omega-3s, vitamin D, and magnesium have evidence supporting their use for gut health, inflammation, mood, and sleep. But they aren’t miracle cures! Think of them as complementary, not foundational.

Hormone Replacement Therapy (HRT)

HRT is a valid option for women experiencing significant symptoms. It’s important to consult a qualified healthcare provider to understand risks, benefits, and timing. And while HRT can be life-changing, remember that lifestyle habits—good nutrition, movement, stress management—form the foundation.

Quick Wins for Perimenopause

Perimenopause can feel unpredictable, but small, consistent habits make a big difference. By tracking your symptoms, prioritizing nutrient-rich meals, and staying active through regular exercise, you can remain proactive and feel more in control during this transitional stage.

Track Symptoms: Use a journal or app to track cycles, hot flashes, and sleep patterns—this helps you see trends and empowers conversations with your healthcare provider.

Meal Ideas: Include protein and fiber at every meal to stabilize energy. Nourish your hormonal pathways with any of these hearty salads!

Quick Strength Training: 15–20 minutes of bodyweight exercises, weights, or resistance bands at home to maintain muscle and boost mood.

Support, Don’t Stress: Supplements and hormone therapies are helpful, but they’re most effective when paired with strong lifestyle foundations.

Sleep & Wind Down: Aim for 7–9 hours and establish a nightly routine; consistent sleep helps regulate hormones and mood.

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Empower Yourself Through Perimenopause

To bring this full circle, perimenopause isn’t a problem to fix. It’s a natural, inevitable stage of life. And good news! Now that you’re armed with specific tools and strategies you can implement, you’ll make this transition so much smoother. Ultimately, the more informed you are, the more confident you’ll feel in navigating this chapter. Perimenopause doesn’t have to be a mystery. With the right mindset shift (and empathetic girlfriends!) it can be a fulfilling opportunity to take charge of your health, energy, and well-being.

Edie Horstman
Edie Horstman

Edie is the founder of nutrition coaching business, Wellness with Edie. With her background and expertise, she specializes in women’s health, including fertility, hormone balance, and postpartum wellness.