13 proven perimenopause symptoms that confirm you’re not crazy


Clare Kelway DIHom BCHN®

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What is perimenopause?

Perimenopause refers to the hormonal upheaval years preceding a woman’s final menstrual period. Perimenopause is the most complex life stage a woman will go through. 

According to the Mayo Clinic, if you have a persistent change of seven days or more in the length of your menstrual cycle, you may be in early perimenopause. If you have a space of 60 days or more between periods, you’re likely in late perimenopause. It isn ’t a very well-understood stage, although functional medicine has greatly highlighted this season of life.

Today, many practitioners and healthcare providers are trained to identify perimenopausal symptoms and the chaos they can cause in a woman’s life. More importantly, there is help with lifestyle interventions, emotional support, and clinical nutrition strategies to steer you back on track to vitality and joy.

What effects will perimenopause bring to my life?

Perimenopause brings a heap of physical and emotional changes that can throw you completely off balance. From hot flashes and insomnia to mood swings and weight gain, these 13 proven perimenopause symptoms will help you identify if it’s just mid-life stress or something more. And these symptoms often start in your late 30s, so you are not suspecting or ready for anything resembling menopause.

Menopause is not a sudden shift in life, and it is like a slow train approaching the station, and you are wondering whether you want to get aboard or not. Whethe you want to jump aboard, you will be a passenger on this train. These unexpected physical, emotional, and mental changes can begin to show up in your 30s and 40s, for example, slower metabolism, mood swings, increased feelings of stress, less resilience, feeling “who cares” about sex, and difficulty sleeping.

My perimenopause story

If you are anything like me, I thought that my 30s and 40s would be plain sailing regarding my hormones. For the most part, I was blessed with 28-day cycles almost to the minute, but I suffered from infertility and emotional baggage that brought about a truckload of challenges. My youngest son was conceived when I was 43 years old, without any issue, so I was lucky that my female hormones didn’t shut up shop until my early 50s. These changes in your hormone levels can also cause a sudden spike in hormones resulting in a “surprise” baby so make sure you are taking precautions if you don’t want to add to your family. 

Most women are not as lucky as I was. For most of us, the body’s hormones shift somewhere between ages 35 and 50, and you feel the effects. 

13 proven symptoms of perimenopause:

13 common symptoms of perimenopause
  1. Mood swings and emotional instability – feeling way more sensitive to things that never fazed you before.
  2. Unexplained extra belly fat that exercise and regular eating isn’t getting rid of.
  3. Feeling more anxious than usual and wanting to withdraw from social connections. 
  4. Chronic low energy.
  5. Moderate to extreme difficulty sleeping.
  6. Inconvenient, uncomfortable, disruptive night sweats.
  7. Less patience for your children, or changes in your willingness to accommodate others in your life.
  8. Unpredictable menstrual periods.
  9. Very heavy cycles  – causing possible anemia side effects or very light cycles – almost no period at all. 
  10. Libido and sex drive almost completely missing despite a happy partnership.
  11. Brain fog or trouble focusing.
  12. Lapses in memory or forgetfulness, such as walking into a room and not remembering what you are there for!
  13. More frequent UTIs, and vaginal dryness. What is happening down there?

Let’s focus on a few of these symptoms that women frequently approach us at Metabolix Health for help with.

Hot Flashes and Night Sweats

perimenopause hot flashes

Hot flashes are common during perimenopause and may last for several seconds up to an hour. And it is sometimes even in the middle of an important meeting at work pouring beads of sweat down the inside of your shirt! UGH! Other symptoms include redness in the face, neck, and chest. Even more disruptive are night sweats. Waking up in a pool of sweat as your body tries to cool itself down can be incredibly disruptive to your sleep cycle and have a lasting impact on your energy levels throughout the day.

Changes in your menstruation cycle including heavy periods, irregular cycles, and skipped periods

Your sex hormone production of progesterone and estrogen begins to fluctuate and ovulation becomes intermittent. This can cause many changes in your menstrual cycle. Your periods may be irregular and heavy or light, or alternately both. Other hormones also start to fade or deregulate – your ovaries, thyroid, and adrenals start to work against you, not for you. Thyroid issues whether under-productive or over-productive are commonplace as women approach menopause in their 40s. 

And, to confuse matters even further, the brain becomes less responsive to the hormones that your body does still produce. Put it all together and you are likely on a roller-coaster ride of surprising, erratic, and downright confusing emotional and physical symptoms!

Skipped periods are also possible during perimenopause but they can indicate other issues such as PCOS or be a side effect of certain medications such as hormonal birth control. It is always a good idea to consult with your healthcare provider if you suspect any of these changes may be caused by underlying conditions. 

Mood Swings and Irritability

mood swings and irritability in perimenopause


As your hormones fluctuate in perimenopause, you may experience dramatic changes in mood. You may also feel general irritability or low self-esteem. These changes are often caused by an imbalance in the body’s hormones that manifest as depression and anxiety.

Taking steps to manage stress can often help alleviate some of these symptoms, but finding ways to nourish your whole self through exercise, nutrition, and other treatment methods is key for helping reduce the severity of mood swings during menopause.

Memory Problems & Brain Fog

Memory problems and brain fog are two of the most common perimenopause symptoms. The mental atigue you’re experiencing could be caused by an imbalance in your hormones, which can affect your concentration and reasoning abilities.

You may find yourself having difficulty focusing during conversations or struggling to stay organized. Taking steps to manage stress and utilizing techniques like yoga, meditation, mindfulness, and journaling can help support a healthier balance of hormones.

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Anxiety & Depression

And in addition to the sweats and menstrual fluctuations, you may be feeling a lot more anxious about life and your family than you ever have before. The morning cup of coffee seems to leave you with heart palpitations. Feelings of depression and anxiety are some of the most common emotional symptoms associated with perimenopause.

You feel like you have been betrayed by your own body. These symptoms can range from mild feelings of sadness to severe clinical depression. You may notice that you’re feeling more irritable and overwhelmed, or need more time to recover after a stressful experience. If these feelings persist for two weeks or more, it’s important to seek professional help and create a plan for managing your mental health.

Some reasons why women may feel more anxiety can be due to these factors:

  • Loss of fertility – either you haven’t started your family or you don’t feel like you have completed your family and your fertility is no longer optimal.
  • Your career is at its peak demand as you are striving to reach the pinnacle.
  • Your kids are hormonal teens and you are facing empty-nest syndrome.
  • Your parents are aging and you know that you will need to figure out how to take care of them in their elderly years in addition to your normal, stressful life. 
  • Society’s focus on youth and beautiful-looking women – the Tiktok and Instagram effect of youth. 

No wonder you are feeling less self-confident and irritable. At least 70% of women will experience additional irritability during this time of life.

Belly bloat and belly fat

Even that figure-hugging black dress is bulging around the waist – you have belly fat where you never had it before and then you realize that you feel belly bloat that worsens as the day goes on. Your kid even asked you if you are expecting another baby! Yikes!

Sleep disturbances, problems falling asleep or staying asleep

sleep issues in perimenopause

If hot flashes weren’t enough during the day they often follow up with tossing and turning at night accompanied by night sweats that leave many women feeling exhausted after waking up – especially with irregular sleep patterns resulting from insomnia throughout their perimenopausal stage.  Fluctuating hormones, especially progesterone can affect your sleep cycle. 

Progesterone is a sleep-inducing hormone. 

Foods that you used to eat, may now cause you to wake up at night. You may become less tolerant to alcohol, spicy foods, and certain nightshades, a food group known to cause issues in perimenopause.  Then your sleep is disrupted, your body’s ability to recover and rejuvenate is lessened, affecting your entire daily performance, brain fog, and energy levels.

The key reason that women consult us is due to sleep problems. Statistics estimate that 80 percent of us experience insomnia at some stage in perimenopause and menopause.

Lifestyle changes in perimenopause

Lifestyle changes can play a big role in helping you navigate these years in a smoother, less erratic fashion.  You won’t always need to jump on bio-identical hormones although these may be a helpful tool to smooth the waters. 

Perimenopause work at Metabolix Health

At Metabolix Health, we work with you on your gut health, hormone health, lifestyle habits, and emotional health BEFORE we jump on the hormone bandwagon. Functional Medicine is about connecting the dots and the symptoms of your overall health.

We will not just consider hormones. This is the work of your medical doctor who will provide a band-aid approach for you – may be effective short-term but guaranteed to cause long-term additional challenges and misery. e work with you adrenal health, gut health, and detoxification pathways before adding progesterone, estrogen, etc. 

If you are not making the necessary lifestyle changes your body is asking for, then adding in hormones is merely a short-term bandaid. 

We recommend coaching to help you make the habit changes that will produce the long-term changes you are seeking. 

Your body is changing and we want to work with you on making the adjustments to your life to reflect these changes. This NEVER, (and I repeat NEVER)  means depriving yourself of fun and joy in life.  

It means making adjustments that will serve you and help you to feel like a complete woman again: sexy, slender, and ready to take on the world instead of irritable, moody, and overweight. 

We can’t make these decisions for you but we can help you with your journey to better health.  We have either journeyed this already or we are also going through this journey ourselves so we know how it feels.  

For those of you seeking insights right now and not ready to take the next step to schedule a FREE call, here are a few tips for you to get started with your symptoms.

Reduce daily stress


Stress is a normal part of life but most of us suffer from very high levels of cortisol stress. You can reduce your stress by focusing on meditation, yoga, and other parasympathetic activities. Intense exercise is not the solution. This will just add to your stress levels.

Those extra pounds you are carrying around your middle may be caused by your stress levels so figuring out how to reduce your stress is vital and one of the first steps to improving your quality of life and reducing the effects of perimenopause.

Yoga reduces stress by raising serotonin (the “happy” brain chemical that controls emotions, sleep, and appetite). Deep breathing is another beneficial habit for reducing cortisol and improving stress levels.

Focus on your daily food intake

No question that if you focus on a nutrient-dense diet, your perimenopausal symptoms will improve. What are you eating and supplementing?  Consider increasing your vitamin C intake which is helpful for collagen and progesterone production in your body. 

Green vegetables contain a surprising amount of vitamin C, bell peppers are high in vitamin C as well as citrus fruits. I recommend you add a buffered vitamin C powder to your daily regime. You can always add this to a protein shake if this is something you do on a daily basis. 

Reduce your sugar intake

Sugar is the one ingredient that is the basis for all diseases today.   And it is in everything and everyone seems to be addicted to it.  Sugar is extremely addictive. Eating too much sugar causes insulin resistance where your insulin is no longer sensitive and causes your body to store fat which is the start of pre-diabetes. 

The earlier you start focusing on this, the better your menopausal season will be and the more joy and happiness you will experience during this period of life. Sugar also spikes your cortisol levels and causes other hormone disruptions.  It is not your friend!

Reduce caffeine intake

Work on reducing your caffeine intake. Caffeine spikes cortisol levels. Lessening your intake of caffeine can be helpful for fewer hot flashes and better sleep at night. 

Enjoy quality social connection with others

Spend quality time with friends and family. Time with your girlfriends is really important for women. It can bring joy, companionship, an mutual experiences and lowers your cortisol levels opening the door for better progesterone production. High cortisol levels block progesterone receptors, making the problems from lowered progesterone even worse.


With awareness and a few simple adjustments, you can navigate perimenopause with grace and joy. While perimenopause may be a hormonally complex season of life, with the right interventions and shifts in your lifestyle habits, it does not need to be an emotional roller-coaster. 

For more information and help, schedule a free perimenopause assessment call with a member of our team.  We look forward to talking with you.

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Clare Kelway Experienced Functional Medicine practitioner specializing in natural health solutions.

Clare Kelway

Functional Medicine Practitioner

Metabolix Health Clinical Director, Clare Kelway BS DIHom HHP BCHN® is recognized as an expert in functional metabolism. She is a  Functional Medicine practitioner with decades of experience in natural health solutions.  She specializes in optimizing your metabolism, hormones, and gut health. Her own health turnaround in her 30s led to her career in functional medicine. She is the Founder of Metabolix Health, a virtual functional medicine practice in Erie, Colorado. A lifelong learner and researcher, her passion is helping clients reverse their health issues in the simplest way. She is a candid, direct communicator who clients often refer to as a “breath of fresh air”. She champions their journeys and says her reward is watching her clients restore their health and regain their vitality for life.