🌿 Could You Be in Perimenopause — and Not Know It?

Many women assume that perimenopause begins only when their periods stop or hot flashes start. But the truth is more subtle: you might already be in perimenopause even if your cycle still looks “regular” or your symptoms feel vague.

Recognizing this transition early gives you the power to respond proactively — before things feel chaotic or out of control. Let’s walk through how perimenopause often hides in plain sight, the signs to watch for, and what steps you can take now to support your body.

What Is Perimenopause?

Perimenopause is the transitional phase leading up to menopause. It begins when your ovaries gradually start producing less estrogen and progesterone, even though you haven’t yet gone 12 months without a period.

Because hormone levels fluctuate — rather than decline in a straight line — symptoms can come and go. Some months feel “normal,” while others bring new surprises.

Most women experience perimenopause for four to eight years before reaching full menopause.

Why It’s Easy to Miss

Perimenopause can be sneaky. Here’s why it often flies under the radar:

• Symptoms overlap with everyday life. Fatigue, mood shifts, brain fog, and poor sleep often get blamed on stress, parenting, or “just getting older.”

• Periods can continue. Many women still menstruate regularly, though flow or timing may subtly change.

• Hormones fluctuate constantly. One “normal” blood test doesn’t rule out perimenopause — levels can swing daily.

• Cultural conditioning. We tend to think menopause happens later, so earlier hormonal changes often go unnamed or dismissed.

Because of this, many women live in perimenopause for years without realizing what’s really happening.

Signs of Perimenopause

The Common Ones

• Irregular or changing menstrual cycles

• Hot flashes and night sweats

• Trouble falling or staying asleep

• Mood swings, anxiety, or low mood

• Vaginal dryness, urinary changes, low libido

• Memory lapses or “brain fog”

The Sneaky Ones

• Skin sensitivity or changes in hair/nails

• Digestive shifts like bloating or gas

• Weight gain (especially around the midsection)

• Joint aches or muscle tension

• Fatigue that lingers even after rest

• Changes in cholesterol, blood sugar, or metabolism

If you notice a cluster of symptoms — especially involving mood, sleep, cycles, and cognition — hormones are likely playing a role.

Functional Testing: Looking Beneath the Surface

Because hormone levels are in flux, one blood draw rarely tells the full story. Functional and integrative practitioners often use more dynamic testing:

• 🩸 Comprehensive Hormone Panels – Saliva or dried urine (like the DUTCH test) capture shifts in estrogen, progesterone, and metabolites across your cycle.

• 💫 Metabolic & Lipid Panels – Track glucose, insulin, and lipids to assess how estrogen is influencing metabolism.

• 🌿 Thyroid & Adrenal Testing – Evaluate thyroid function and cortisol rhythm, which often fluctuate during hormonal transitions.

• ✨ Micronutrient & Inflammation Markers – Deficiencies in vitamin D, magnesium, and B vitamins can worsen symptoms; CRP or cytokines reveal inflammation.

• 🦠 Gut & Detox Panels (Optional) – The gut and liver process hormones, so imbalances here can amplify symptoms.

• 🗓️ Symptom Tracking – Tools like the Menopause Rating Scale help visualize changes month to month.

Why Early Support Matters

Left unaddressed, perimenopause can:

• Disrupt sleep, mood, and focus

• Accelerate bone and muscle loss

• Increase cardiovascular and metabolic risk

• Intensify vaginal or urinary symptoms

• Drain energy and quality of life

Early awareness helps you build hormonal resilience — instead of playing catch-up later.

What You Can Do Right Now

You don’t have to wait for labs to take action. Start with foundational care:

🌿 Track your symptoms. Note cycle length, flow, mood, energy, and sleep patterns.
🥗 Nourish your body. Focus on anti-inflammatory, whole-food meals rich in protein, fiber, and healthy fats.
😴 Protect your sleep. Create calm routines and reduce evening screen time.
🧘‍♀️ Regulate stress. Gentle movement, acupuncture, chiropractic care, and breathwork calm cortisol and support hormones.
💊 Nutrient support. Magnesium, omega-3s, B-vitamins, and vitamin D are foundational.
👩‍⚕️ Partner with a practitioner. A clinician trained in functional medicine can personalize testing and guidance.

Even small steps in these areas can make a noticeable difference.

The Bottom Line

Perimenopause isn’t a sudden switch — it’s a gradual transition that can start earlier than most women realize. Understanding your body’s cues gives you the power to support it rather than fight against it.

If your symptoms sound familiar, you’re not “just tired” or “getting older.” Your hormones are changing — and you can work with them.

💛 Ready to get clarity and feel like yourself again?
Let’s identify what your body needs and create a personalized plan for balance. Book your consultation today. https://drsharla.com/book-now

References

1. Santoro, N., et al. (2016). Perimenopause: From Research to Practice. PMC.

2. Cunningham, A. C., et al. (2025). Perimenopause Symptoms, Severity, and Healthcare Implications. Nature Review.

3. Crandall, C. J., Mehta, J., & Manson, J. E. (2023). Management of Menopausal Symptoms: A Review. JAMA.

4. Metcalf, C. A., et al. (2023). Cognitive Problems in Perimenopause: A Review. PMC.

5. Harvard Health Publishing. (n.d.). Perimenopause: Rocky Road to Menopause. Harvard Health.

6. Rupa Health. (n.d.). A Functional Medicine Menopause Protocol: Comprehensive Testing, Nutrition, and Supplements. Rupa Health.