WHY PERIMENOPAUSE ISN’T JUST ABOUT HOT FLUSHES, SWEATS, AND LESS PERIODS

You’re probably not “too young” for perimenopause, even if your doctor says so…

Emma sat in her doctor’s office, exhausted, anxious, and feeling like her body was betraying her.

She wasn’t sleeping well. Some nights, she’d bolt awake at 2 AM, her mind racing. Other nights, she slept through but woke up feeling like she hadn’t rested at all.

Her periods were getting heavier, her mood swings were worse than ever, and her belly was expanding despite eating and exercising the same way she always had. (If anything, she was looking after herself better than she ever had before!)

When she finally brought up perimenopause, her doctor dismissed it.

“You’re too young,” he said. “Your periods are still regular, and you don’t have hot flushes. This is probably just stress.”

Sound familiar?

Many women in their late 30s and 40s go through years of symptoms before anyone acknowledges that perimenopause is the cause. The problem? Most doctors are still defining perimenopause by the symptoms that come from the absence of hormones - when in reality, the first signs of perimenopause are caused by relative hormone excess, not just hormone loss.

Confused at how you can have an excess and loss at the same time?! Let’s break down exactly what’s happening in your body, and why you don’t need to wait for a hot flush to do something about it.

PERIMENOPAUSE ISN’T A SLOW DECLINE - IT’S A HORMONE ROLLER COASTER

Like many women, you might assume that the journey to menopause is a gradual, step-by-step process where hormones slowly decrease until your period stops. While menopause is the final destination, perimenopause is the turbulent ride that gets you there.

Instead of a smooth decline, perimenopause is marked by erratic hormone fluctuations. Think of it like riding a bucking bronco or riding the scariest roller coaster you can imagine!

Imagine your hormones as a roller coaster. In your 20s and 30s, the track was steady, with predictable rises and falls. But now, it’s like the ride has gone off the rails. Some days, you feel completely normal. The next, you’re hit with crippling anxiety, bloating, and exhaustion. Your estrogen can surge to levels even higher than in your 20s, and then crash so low that you feel like you’ve aged 10 years in a heartbeat. These frequent fluctuations are why symptoms can come and go, change in intensity, or make you feel like a completely different person from one day to the next.

This is also why waiting for hot flushes as a sign of perimenopause is misleading, and misses an opportunity for you to support your body to adjust to the changes, so you can enjoy a smoother ride to menopause.

The early and mid-stages of perimenopause bring hormone fluctuations and changes that can disrupt your mood, sleep, metabolism, and energy levels - long before your cycle starts spacing out or disappearing.

THE ESTROGEN ROLLER COASTER

HOW ESTROGEN ACTUALLY CHANGES IN PERIMENOPAUSE

Estrogen is often thought of as the hormone that declines in perimenopause, and it does, but the reality is that it also fluctuates dramatically on its way down to that permanent low.

In your 20s and 30s, estrogen followed a more predictable monthly pattern - rising in the first half of your cycle, gradually decreasing after ovulation to it’s lowest again before your period - your body had time to adjust to the changes.

And to be frank, they weren’t as abrupt or big as they are in perimenopause, when this predictable rhythm disappears.

Sometimes, your estrogen surges higher than ever before, leading to:

• Bloating and breast tenderness
• Heavy, painful periods
• Increased anxiety and irritability

Other times, estrogen crashes very low, triggering:

• Brain fog and forgetfulness
• Fatigue and sluggish metabolism
• Poor sleep and waking up exhausted

This explains why one moment you feel fine, and the next, you’re blindsided by intense PMS, bloating, and mood swings. It also explains why women in perimenopause can feel both high and low estrogen symptoms at different times.

THE PROGESTERONE PLUMMET AND WHY IT MAKES EVERYTHING WORSE

While estrogen is fluctuating up and down unpredictably, progesterone is rapidly declining - or plummeting as I like to put it - making everything worse. This happens because progesterone is only produced after ovulation, and in perimenopause, you start having more anovulatory cycles - meaning no ovulation, no progesterone.

Progesterone is your calming hormone. It balances estrogen, supports sleep, and helps you handle stress. But progesterone is only produced after ovulation - and in perimenopause, you start having more anovulatory cycles. No ovulation means no progesterone.

This sudden drop in progesterone is why you might feel more anxious, overwhelmed, and reactive than ever before. It’s also why stress and busyness feels harder to manage and why you wake up at 3 AM with your heart pounding for no reason.

RELATIVE ESTROGEN EXCESS: THE ROOT OF MANY EARLY PERIMENOPAUSE SYMPTOMS

Even though estrogen is declining while its fluctuating wildly, progesterone is declining faster. This creates a hormonal imbalance called relative estrogen excess, where estrogen is too high in relation to progesterone - even if overall estrogen levels are lower than in your younger years. It’s possible to have a relative estrogen excess, even when you’re really close to menopause!

This relative estrogen excess leads to some of the most frustrating perimenopause symptoms, including:

• More intense PMS and mood swings. Without enough progesterone to calm the nervous system, you may feel constantly irritated, anxious, or emotionally overwhelmed.
• Heavier periods and increased pain or cramping. Higher estrogen levels can cause the uterine lining to build up more than usual, leading to longer, heavier, and more painful periods.
• More allergies, intolerances, migraines, and headaches. Without enough progesterone to keep your immune system on track, you may notice you’re more reactive to scents, chemicals, or foods.
• Brain fog and forgetfulness. While estrogen surges can cause mood instability, it’s actually low estrogen days that are responsible for brain fog, memory lapses, and difficulty concentrating.

WHY DOCTORS DISMISS WOMEN WITHOUT HOT FLUSHES

Most doctors are still trained to think of menopause as a time when estrogen is low across the board. But perimenopause is different - it’s not just about hormone decline, it’s about hormone instability.

This means that many women with regular periods and no hot flashes are told they can’t be in perimenopause - despite struggling with anxiety, brain fog, bloating, mood swings, and extreme fatigue.

Women who still have regular periods and no hot flashes are often told they can’t be in perimenopause, despite struggling with:

• Anxiety, brain fog, bloating, mood swings, and extreme fatigue.
• Unexplained weight gain despite eating the same way they always have.
• Worsening PMS and heavier periods.

Women are often:

• Prescribed antidepressants instead of having their hormones evaluated
• Told to “just eat less and move more” when weight gain feels completely out of their control
• Dismissed until they finally start skipping periods - which can be years after perimenopause symptoms first appear

If you’ve been told your symptoms are just “stress” or that you’re too young for perimenopause, you’re not imagining things. This phase of life is real, it has a name, and there are real strategies to manage it.

WHAT YOU CAN DO NOW (INSTEAD OF WAITING FOR HOT FLASHES)

You don’t have to wait until your periods become irregular or you start experiencing hot flashes to take action. Understanding what’s actually happening in your body is the first step to making the right adjustments.

To start feeling better, you need to:

1. Recognise the key hormone shifts at play. It’s not just estrogen decline - it’s also progesterone, testosterone, melatonin, and metabolic dysfunction that are part of the problem.
2. Stop following diet advice that doesn’t work for perimenopause. Your hormones and metabolism have changed, and what worked in your 30s to keep you ‘healthy’ likely isn’t working now, because it doesn’t work with your changing hormones.
3. Learn how to support your body through this transition. There are ways to smooth out the hormone fluctuations, reduce the relative estrogen excess, and help your body adapt to the changes, so you can feel calm, in control, and comfortable in your body and clothes again.

This is exactly what I teach inside my free training:

👉 Why You’re Gaining Weight After 40: The 4 Hormone Shifts You Can’t Ignore

In this on-demand training, I walk you through:

• The real reasons weight gain happens in perimenopause, and why it’s not just about calories in/out
• The four hormone shifts that make weight loss harder and trigger frustrating symptoms
• The strategy you need to work with your changing hormones and body - without extreme diets or workouts - to help it better adjust to the changes of perimenopause, so you feel amazing in your body again.

Perimenopause doesn’t have to feel like a battle. You just need the right information and strategy to work with your body (not against it).

👉 Click here to access the free training now.