The 12 Most Common Questions Women Over 40 Ask About Perimenopause

1. What is perimenipause, and how is it different from menopause?

Perimenopause is the transition into menopause, when hormones like estrogen and progesterone start fluctuating and symptoms show up (irregular cycles, night sweats, mood changes). Menopause itself is a single milestone: when you’ve gone 12 months without a period.

2. What are the early signs of perimenopause?

Common early symptoms include irregular cycles, hot flashes, brain fog, anxiety, and sleep issues. Cortisol often plays a role here, when it stays high, it disrupts sleep, energy, and mood, making everything feel worse.

3. When does perimenopause usually begin?

Most women start noticing changes in their 40s, but it can begin in the mid-30s. Everyone’s timeline is different. Keeping a symptom journal helps connect patterns with lifestyle triggers (stress, alcohol, caffeine).

4. Why is weight gain so common during perimenopause?

Lower estrogen shifts how your body stores fat, while muscle mass naturally declines with age. Add cortisol (the stress hormone) into the mix, and fat tends to stick around your midsection. The good news: strength training, protein, and stress management can all help.

5. Why can’t I sleep like I used to?

Nighttime cortisol spikes keep your brain “tired but wired.” That’s why you can feel exhausted but still lie awake replaying every thought. Supporting circadian rhythm and calming cortisol at night is one of the most effective ways to reclaim deep sleep.

6. Can perimenopause affect my mental health?

Absolutely. Hormonal shifts (plus high cortisol) can lead to mood swings, anxiety, or low motivation. You’re not imagining it, because t’s biological. Support, therapy, and stress-lowering practices can make a real difference.

7. Can I still get pregnant during perimenopause?

Yes. Fertility declines, but ovulation can still happen unpredictably. If you don’t want a surprise pregnancy, keep using contraception until your doctor gives you the all-clear.

8. What’s happening with my sex drive?

Many women notice changes in libido during perimenopause. Lower estrogen, vaginal dryness, stress, and disrupted sleep all play a role. Supporting hormones and cortisol balance can help your body feel more responsive again.

9. How does perimenopause affect my bones and heart health?

Declining estrogen affects bone density and cardiovascular health. Movement, calcium, vitamin D, and stress reduction all support long-term resilience. Cortisol also impacts both — another reason to keep stress in check.

10. What lifestyle changes make the biggest difference?

Small steps matter most: regular movement (especially strength training), quality sleep, balanced meals with protein, and lowering daily stress loads. Even five minutes of mindfulness or walking outside can help reset cortisol.

11. Should I consider supplements or HRT?

Both can play a role. HRT may help with specific symptoms, while hormone-free supports (like Rebalance) help regulate cortisol and circadian rhythm naturally. Many women combine approaches. Ultimately, it’s about finding what works for you.

12. When should I see a doctor?

Any time symptoms interfere with daily life, sleep, or emotional health, or if you notice irregular bleeding. Having a trusted healthcare partner matters. You don’t have to tough it out alone.

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