One of the most common things I hear from women around 40 is this:
“I just don’t feel like myself anymore.”
And yet, their periods are still coming. So they assume it can’t be hormones, and that it can’t be perimenopause.
But the truth is, perimenopause can absolutely begin in your late 30s to early 40s, and it often starts long before any obvious changes to your cycle.
In this episode, you’ll learn:
- The most common perimenopause symptoms age 40
- The first signs (often missed)
- How to tell if it’s hormones or something else
- What actually helps
Because this phase can feel confusing, and my goal is to give you clarity, not more overwhelm.
Not sure if what you’re experiencing is perimenopause or something else? Take my free quiz to find out what your body needs most right now, here.
When Does Perimenopause Actually Start?
Perimenopause doesn’t begin when your periods stop.
It begins with hormonal shifts, particularly a decline in progesterone, which can start in your late 30s or early 40s.
This means you can:
- Still have regular cycles
- Still be ovulating (sometimes)
- And still be in perimenopause
The First Signs of Perimenopause (Often Overlooked)
For many women, the first signs of perimenopause are not hot flushes. They’re nervous system symptoms.
These can include:
- Anxiety (new or worsening)
- Sleep issues, especially waking between 2–4am
- Lower stress tolerance
- Feeling wired but tired
- Subtle mood changes
This is largely driven by declining progesterone, which plays a key role in calming the nervous system.
As progesterone drops, your body becomes more sensitive to stress, physically and emotionally.
What Happens Next: Cycle Changes
As progesterone continues to decline, this is when we often start to see changes to the menstrual cycle.
These may include:
- Heavier periods
- Clotting
- Shorter cycles
- New or worsening PMS
Symptoms of PMS can include:
- Breast tenderness
- Mood swings
- Headaches
This is often described as oestrogen dominance, not because oestrogen is necessarily too high, but because progesterone is no longer there to balance it.
Is It Definitely Perimenopause?
Here’s where things can feel confusing.
Many of the symptoms associated with perimenopause also overlap with other underlying imbalances, such as:
Blood sugar dysregulation
- Anxiety
- Energy crashes
- Night waking
Thyroid dysfunction
- Fatigue
- Brain fog
- Low mood
Gut health issues
- Bloating, reflux, digestive discomfort
- Poor oestrogen metabolism
- Nutrient deficiencies
Circadian rhythm disruption
- Sleep issues
- Cortisol imbalance
- Mood instability
Chronic stress / nervous system dysregulation
- Increased sensitivity to stress
- Poor recovery
- Heightened anxiety
Perimenopause doesn’t exist in isolation, it amplifies what’s already going on in the body.
How to Tell the Difference
A simple way to start understanding what’s going on in your body is to look for patterns.
Ask yourself:
- When did these symptoms start?
- Do they follow a pattern with your cycle?
- Are they worse in the second half of your cycle?
- Have your stress levels, sleep, or diet changed?
A helpful rule of thumb:
- Cyclical symptoms → more likely hormone-related
- Constant symptoms → may point to underlying imbalances
- And very often… it’s a combination of both
If you’re feeling unsure where your symptoms are coming from, this is exactly why I created my free perimenopause quiz, it helps you pinpoint which areas your body needs support with most.
What Actually Helps
Perimenopause is a natural phase, but how you experience it is not fixed. It’s not a one size fits all.
Supporting your body through this transition can make a huge difference.
The key areas to focus on are:
- Blood sugar balance
- Nervous system support
- Sleep and circadian rhythm
- Nutrient status
- Gut health
- Hormone metabolism
You don’t need to do everything at once, but understanding where your body needs support most is key.
Want Personalised Support?
If you’re listening to this and thinking, “This sounds like me, but I don’t know where to start…”
I’ve created a free perimenopause quiz to help you understand which areas your body might be needing support with most right now.
It will guide you toward whether blood sugar, stress, sleep or something else may be driving your symptoms.
And if you’re ready for more personalised support, my 1:1 Perimenopause Health Assessment is also available.
Take the Free Perimenopause Quiz!
- Find your perimenopause stage, uncover your priority health pillars, and get instant steps to feel better, all in one free quiz, here.
Join the Midlife Thrive Membership here.
Other Resources & Support
- Download my free Perimenopause Blueprint Guide
- Watch the Thriving Through Perimenopause Masterclass
- Explore 1:1 personalised support
- Listen to more episodes about perimenopause hormones and midlife health on the Empowered Perimenopause Podcast.
- Mira Hormone Tracking At-Home Testing Kit: 20% Off Discount Code: 2FRANLIPAROTI20
All available via my website, or feel free to email or DM me on Instagram if you’re unsure what support you need.
Support for the Empowered Perimenopause Podcast
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