Aging is something most women dread. We’ve been taught that getting older means losing our beauty, our sexy, and becoming vessels of our former selves. When paired with the fear and stigma surrounding perimenopause, it’s no wonder many women feel blindsided when the signs begin.
The truth is: aging and perimenopause are inevitable (at least so far). They are not a death sentence to your vibrancy. This is where creating awareness around what’s happening—both in your life and in your body—can empower you to take care of yourself in ways that strengthen, not diminish, your vitality.
Many symptoms of perimenopause could seem like they’re entirely due to life stressors—careers, family, and everything in between. And while life is certainly a factor, these symptoms are often life + our bodies changing. Recognizing this intersection is key to understanding and addressing what you’re experiencing.
When Does Perimenopause Begin, and What’s Happening to Your Body?
Perimenopause can last for 10, 12, or even 15 years, typically starting around your 40s but absolutely can start earlier. It’s a phase of hormonal fluctuation that precedes menopause (defined as 12 consecutive months without a period—although this definition in isolation is incredibly dated and does not nearly cover what should be addressed). During this 10-15 year timespan prior to menopause, your body’s production of estrogen and progesterone becomes more erratic, and these hormonal shifts can manifest in various ways:
Changes in Your Cycle: Shorter, longer, or skipped periods.
Physical Symptoms: Hot flashes, night sweats, headaches, joint pain, skin changes, vaginal dryness.
Psychological Symptoms: Low mood, anxiety, poor concentration, changes in sex drive, disrupted sleep, and memory lapses.
It’s important to note that perimenopause does not always come with obvious symptoms. Some women may feel symptom-free, but that doesn’t mean they’re in the clear. Hormonal fluctuations during this phase can still affect various systems in the body, often in ways that aren’t immediately apparent.
Digestive System: Hormonal changes can slow digestion or lead to bloating, discomfort, and changes in bowel habits.
Immune System: Shifts in estrogen can impact immune function, making you more susceptible to infections and even autoimmune conditions being triggered.
Thyroid Function: The thyroid is sensitive to hormonal changes, and imbalances can mimic or exacerbate perimenopausal symptoms.
Body Fat Distribution: You might notice changes in how fat is distributed on your body, particularly around the midsection. While it may feel like this change happens overnight, it’s actually the result of long-term shifts in hormonal balance.
These changes often overlap with a stage in life where your plate is already overflowing. Careers are demanding. Family responsibilities are mounting. You might be navigating teenage drama, aging parents, or climbing professional ladders. It’s easy to normalize feeling “off” or chalk it up to external stressors. Unfortunately, societal messaging and medical gaslighting can make it even harder to advocate for yourself.
Why Misdiagnoses Happen
Psychological symptoms like anxiety and depression are frequently treated in isolation, with little investigation into hormonal or physiological root causes. While antidepressants or anti-anxiety medication might help in some cases—and they 100% may be required—not looking at the larger picture can mean missing the interconnected systems at play. For example, sleep medications like trazodone may be prescribed to help women get the rest they desperately need, which is undeniably beneficial. However, if we ignore other symptoms, underlying causes, and a person’s lifestyle—like constantly writing things off as a ‘busy month’—we risk overlooking deeper imbalances. (looking at you "it's just a busy month" and you say that every month except January).
Additionally, there is no single test or lab that definitively diagnoses perimenopause that does not have context attached. It’s a clinical diagnosis that requires looking at your full health history, biofeedback, cycle tracking, and lab work—all together.
Navigating Perimenopause
For the record “Reversing perimenopause” is not a thing (at least not yet). Perimenopause isn’t a "problem" to be “fixed”; it’s a time to be navigated.
You have way more control than you think, and with the right tools, you can turn this phase into a time of growth and empowerment.
This is your PRIME! You are freaking unstoppable—balancing careers, families, relationships, and personal growth with grace and grit. And while this article focuses on perimenopause, it’s important to note that all women including teens ARE absolutely laying the groundwork for hormonal health, overall well-being, while also balancing all the things. We know it because we have seen it through all the women of all ages we have worked with! Building resilience and understanding your body is possible at any age.
Now, back to my beautiful ladies of perimenopause-- this isn’t the beginning of the end; it’s the start of a powerful new chapter where you can thrive like never before. I'd like to provide a few actionable steps to get you thinking and perhaps started:
1. Track Your Cycles and Symptoms
Start with tracking your menstruation. Pay attention to your period’s timing, flow, and changes, as well as physical and emotional symptoms. Apps or journals can help you notice patterns. You can then assess are there changes.
We have several blogs on this and HERE is a Menstrual Cycle Check List
2. Ask About Family History
Talk to your mom, aunt, or sisters about when they started experiencing perimenopause (if they even are aware) as well when/how was their menopause transition. While genetics aren’t everything, they can offer insights.
3. Optimize Your Lifestyle
Nutrition: Are you eating enough, or are you under-fueling? A question we ask every client on intake is "when was the last time you went 6 whole months continuously without trying to diet or cut your calories ONCE" (this answer alone may be enlightening). Prioritize whole foods, protein from a protein source at every meal, and micronutrients like magnesium, salt, potassium and B vitamins.
Exercise: Incorporate strength training in your week along with full rest days. I love a good sweaty session but just remember just because you are exhausted from a session doesn't necessarily mean it was a productive session. Also, team 'no days off' is horse shit.
Sleep: Address sleep disruptions with strategies like consistent bedtime and wake-up routines. This should not, nor does it need to, be a 21-step process that leaves you more stressed out. Avoid alcohol and screens before bed—stop doom-scrolling! Use social media; don’t let it use you. Simplify your approach and focus on creating an environment that encourages restful sleep. A word to the wise opening up a discussion about finances or taxes 60 minutes pre-bed is likely not going to serve you--all this to say protect your energy. I like to use the feature "downtime" on my iphone it shuts down all apps until a time I set--makes me think twice about do I really need to be in this app.
We have a resource dedicated to Sleep HERE with tons of great tips and herbal support suggestions.
4. Get the Right Labs at the Right Time
Run labs timed with your cycle. A good rule of thumb: test hormones 7–10 days before your next period (if you still have one). Labs might include estradiol, progesterone, FSH, LH, a full thyroid panel, fasted insulin and more.
Some providers may suggest that you don’t need labs because your hormones change naturally over time. While this is true—hormones do fluctuate—it’s not a reason to skip testing. Remember, as I’ve said before, we can’t just rely on symptoms to tell the whole story. Many women might feel asymptomatic yet be experiencing inflammation in ways they’re not aware of, such as blood sugar dysregulation. Others may find their hormone levels are surprisingly low, putting them at risk for issues like osteoporosis down the line. Lab work helps us identify these concerns early, providing the opportunity to take action before they snowball into larger health challenges.
5. Challenge Medical (and even coaching) Gaslighting
If you’re dismissed by your provider, don’t be afraid to push back or seek a second opinion. It’s important to understand that advocacy requires communication, but communication does not require conflict. It is entirely within your provider’s right to hold a line on what they know and feel confident practicing—and that is okay! However, this is why we at Fortify Health Coaching are so adamant about education. We want our clients to feel equipped to have thoughtful discussions with their providers, to understand the provider’s rationale, and to identify when their concerns are being dismissed without reason.
Dismissal without explanation should raise red flags, but discomfort with newer information is different—and guess what? That’s okay, too. This is where meaningful discussions can happen, but it may also be the moment to seek a second opinion. A fresh perspective can help you weigh your options and make an educated decision that resonates with your health needs and personal values. Advocacy is about owning your power (maybe even finding it).
6. Seek Community and Education
Perimenopause can feel isolating, especially if your experience differs from those around you. Just because what you’re going through is different doesn’t make it wrong (or right). You’re not alone. This phase of life can be challenging, but it’s also an opportunity to connect with other women who understand, educate yourself about what’s happening, and seek support from a coach or practitioner well-versed in perimenopause. Having a strong healthcare team that listens, supports, and collaborates with you is a critical part of your journey toward empowerment and well-being.
Peri-F***ing-Menopause Isn’t Ready for YOU!
Perimenopause is a rite of passage, not a death sentence. By understanding what’s happening to your body and taking steps to support it, you can navigate this phase with resilience and strength. You are not powerless—you are in transition, and transitions can be a time of profound growth.
Start by listening to your body and trusting your instincts. Take notes, ask questions, and demand better care when needed. Perimenopause isn’t here to take you down; it’s here to help you step into your next, most powerful chapter.
This is a delicious time to own the sexy, vibrant, and total badass that you are.
If you are a coach that would like to learn how to help your clients navigate this time or an individual who'd like personal guidance. We are here to help!