Let’s talk about something most of us weren’t taught in health class—perimenopause. If puberty was the hormone-fueled entrance into womanhood, then perimenopause is the graceful, if sometimes bumpy, transition out of the reproductive years.

So what exactly is perimenopause?

Perimenopause is the phase before menopause when your hormones—particularly estrogen and progesterone—start fluctuating. It can begin in your late 30s to early 40s and last anywhere from a few months to over a decade. Unlike menopause, which is officially diagnosed after 12 consecutive months without a period, perimenopause is marked by unpredictable cycles, mood shifts, and physical changes that can feel both subtle and dramatic.

Perimenopause is the phase before menopause when your estrogen and progesterone hormones start fluctuating

Understanding the Journey

Perimenopause isn’t a one-size-fits-all experience. For some, it's a gentle shift; for others, it’s a full-blown hormonal upheaval. Common signs include irregular periods, hot flashes, night sweats, sleep disturbances, mood swings, anxiety, brain fog, and changes in libido.

Dr. Kelly Culwell, a board-certified OB/GYN, emphasizes that many women mistake perimenopausal symptoms for other health issues, leading to misdiagnoses: “You’d be surprised how many women come in thinking they have thyroid issues or depression, when in reality, their hormones are just shifting.”

Common signs include irregular periods, hot flashes, night sweats, sleep disturbances, mood swings, anxiety, brain fog, and changes in libido.

The Emotional Landscape

Beyond the physical, perimenopause can significantly impact mental health. A study by University College London found that women in the perimenopausal stage have a 40% higher risk of depression compared to those who are premenopausal. Dr. Mary Claire Haver, author of The New Menopause, notes, “Women often feel like they’re losing control, not realizing their brain chemistry is being impacted by fluctuating estrogen. That emotional dissonance can feel isolating.”

Managing Perimenopause: A Multifaceted Approach

This isn’t about “fixing” your body—it’s about supporting it through change. Here’s how:

Nutrition: Add a tablespoon of ground flaxseeds to your morning smoothie—flax is packed with phytoestrogens that can help ease hot flashes. Try tofu stir-fries or snack on edamame for a soy-rich protein boost. High-quality milk and dairy products support calcium levels, which become crucial as estrogen drops.

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Nutrition plays an important role when navigating perimenopause.

Exercise: A brisk 30-minute walk five times a week can work wonders for mood and sleep. Strength training twice a week—think light dumbbells or resistance bands—helps counteract muscle loss and supports bone density.

Mindfulness: Carve out 10–15 minutes daily for meditation with apps like Insight Timer or Headspace. Even simple breathwork before bed can calm the nervous system. Gentle stretches and journaling can be grounding during emotionally intense days.

Supplements: Black cohosh, evening primrose oil, and magnesium glycinate are often used to help with hot flashes, anxiety, and sleep. Dr. Haver also recommends omega-3s and vitamin D for brain and bone health. But always check in with your physician before adding anything new to your regimen.

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READ: The Wisdom of Konenki: How Japanese Women Embrace Menopause With Grace

Embracing the Transition

Perimenopause isn’t the end of vibrancy—it’s a recalibration. As Dr. Jerilynn Prior, a Canadian endocrinologist (M.D., specializing in menstrual cycles and the effects of hormones on women's health), explains, “Perimenopause is not just a hormonal drop; it's a dynamic shift that asks us to pay attention and recalibrate how we care for ourselves.”

Knowing what to expect during this season of your womanhood gives you the power to enter it gracefully. 

So yes, this phase might come with foggy mornings, fiery nights, and emotions that feel like a tide. But it’s also a call to tune in, slow down, and embrace this powerful transition with wisdom, humor, and a bit of lavender oil on your pulse points.

Because you? You’re just getting started in a new phase of your womanhood. And you have the power to enter it gracefully.