Why Perimenopause Feel So Hard — And Why No One Prepared Us

Many women enter their late 30s and 40s without any clear guidance on what to expect from their bodies. Suddenly, they face unsettling changes: mood swings, restless sleep, unexpected anxiety, weight shifts, fatigue, and brain fog

(just to name some of the more common symptoms)

These symptoms often come on insidiously, gradually and without warning or explanation

leaving many women feeling confused and unprepared

This is perimenopause, the transitional phase before menopause.

Menopause is reached once a woman has gone 12 consecutive months without a menstrual period. This represents the cessation of ovarian follicular production and activity. Estrogen at this time is dramatically reduced. Everything past this point is called post-menopause. This typically occurs between the ages of 45-55

This article explores why perimenopause and menopause feel so difficult, why women have been left in the dark about what is really happening, and we will start to explore some steps we can take that can help.

Much more info about that will be coming soon!!

What Happens During Perimenopause

Perimenopause is not a slow, steady decline into menopause where levels of hormones just gradually get lower and lower. I wish! rather it is a period of intense fluctuations, with estrogen and progesterone levels rising and falling unpredictably sometimes week to week or even day to day! Causing intense swings and shifts in several systems in the body (which explains the wide range and inconsistency in symptoms that many women experience)

• Brain chemistry and mood regulation: Hormonal shifts can cause mood swings, irritability, anxiety, "brain fog" difficulty with focus and attention

  (declining estrogen is also connected to the increased risk for dementia in women who account for approx. 2/3 of those diagnosed with alzheimer disease)

• Sleep quality: Many women start to experience difficulty falling, staying asleep or waking consistently between 2-4am

• Metabolism and weight: Changes in insulin sensitivity and increased cortisol lead to weight gain (particularly in the belly!) or difficulty losing weight

• Inflammation and joint health: Increased inflammation may cause achiness, stiffness, worsening chronic pain or autoimmune conditions (such as rheumatoid arthritis, Hashimotos ect) as well as increases cardiovascular risks

  (heart disease is more common in women, and risks increase in menopause)

• Temperature regulation: Hot flashes and night sweats are common

• Stress response: The nervous system can become more sensitive, increasing feelings of overwhelm at home and work.

Why Did No One Prepare Us for This

Many women reach midlife confused or worried because the information about perimenopause and menopause has been scarce or misleading. Several factors contribute to this lack of preparation

Exclusion from medical research

For decades, women were excluded from clinical trials, a practice rooted in the desire to avoid the complexities associated with “hormonal variability.” Researchers often opted to use male subjects, believing that the hormonal fluctuations experienced by women could introduce confounding factors that would complicate the results of their studies. As a result of this exclusion, many health issues that predominantly affect women (including menopause, cardiovascular disease, and autoimmune disorders) have not been studied adequately. Furthermore, this oversight has perpetuated a cycle of women's health concerns being dismissed or inadequately addressed.

Limited medical training

Despite the fact that menopause is a process that affects approximately half of the population, medical training offers little if any education on this topic! If it is offered, the focus is on the physiological aspects without delving into the broader implications for women's health and well-being. As a result, they might not be equipped to offer comprehensive care or to engage in meaningful conversations with their patients about their experiences. This gap in knowledge can lead to misdiagnosis, inappropriate treatment recommendations, and a general feeling among women that their concerns are not being taken seriously

Cultural silence

Societal taboos and stigma surrounding aging (particularly in relation to women) discourage dialogue about these issues. Aging is often viewed negatively, associated with decline and diminished value especially for women. This perspective impacts how women perceive themselves and influences how society views them. At Mountain Light Wellness, I aim to create a more inclusive dialogue that thoughtfully acknowledges the realities of aging and empower women to embrace their experiences as they navigate this inevitable stage of life.

What Can Help During Perimenopause and Menopause

While the hormonal changes can feel overwhelming, there are practical ways to support your body and mind during this time (note I will cover these topics each in greater detail in subsequent articles)

Prioritize sleep!

Chronic sleep deprivation is associated with a higher risk of obesity, diabetes, and cardiovascular diseases

Prioritizing quality sleep is paramount for achieving a balanced and healthy life

Focus on nutrition

Regularly eating whole foods and prioritizing protein, fiber, and healthy fat supports metabolism and reduces inflammation

*reducing caffeine and alcohol helps with mood and sleep

Maintain and build muscle

Exercise improves mood, supports weight management, and strengthens joints

Muscle loss is both a consequence and key driver of rapid aging.

Nervous system regulation

Gentle practices that can reduce nervous system overload, such as yoga, breathing, meditation, somatic movement.

Seek guidance

Find a healthcare provider who is knowledgeable about peri/menopause, someone who is willing to talk about the connection between estrogen loss and bone, heart and cognitive health. They can offer guidance on hormone therapy, supplements and other treatments if appropriate.

Support

Connecting with other women who are navigating similar life changes allows women to feel less isolated during what can be a transformative time in their lives. To facilitate connection, consider joining Mountain Life Wellness on Facebook, a new online community dedicated to women's health and wellbeing during midlife. With this platform, I aim to provide a safe space for open discussion, where members can pose questions, share advice, and offer encouragement.

Changing the Conversation Around Midlife Women’s Health

The silence and stigma around perimenopause and menopause are changing. More research is emerging, and women are speaking more openly about their experiences. This shift helps create a roadmap for others to follow. Healthcare systems and providers are beginning to recognize the importance of increased education and support during this phase.

If you are feeling overwhelmed, confused, or dismissed, you are not alone! I help women every day better understand what is happening in their bodies, regain a sense of control, and feel more like themselves again. We all deserve clear information and compassionate care to navigate these changes confidently.

Why My Approach Is Different

Most women are used to health care that focuses on a single issue in one appointment. This is not said to discredit the doctors and nurses who work in the public system, this is a systemic issue! they do their best to support patients in a very challenging environment.

In my comprehensive assessment appointment we have the time to look at the whole picture  

My approach blends

Holistic, person-centered care

(mental health, trauma-informed practice, lifestyle patterns, relationships, stress physiology)

&

Evidence-based medical management

(may include when appropriate: labs, hormone therapy, non-hormonal options, thyroid support, medical weight management solutions and more)

• sleep, nutrition, energy patterns, and daily rhythms

• your medical history, medications, and lab findings

• hormone changes, metabolic health, thyroid, and inflammation

• your relationships and support system

• work demands and stress load

• trauma history and how your nervous system has adapted

• mental health, mood, and coping patterns

Because you are not a collection of symptoms.

You are a whole person with a story, history, unique physiology, and a life that shapes how you experience this transition.

When we integrate holistic and evidence based medical approaches, women get help that make sense and a plan that feels doable in the context of their real life. This is not about quick fixes or unrealistic expectations, it's about understaning what is going on and creating sustainable changes that help you feel like yourself again

If you would like more personalized support, you are welcome to book a Midlife Health Assessment

Comprehensive Health Assessment