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Perimenopause symptoms no one warns you about and how to deal with them

Edie Horstman by Edie Horstman
April 7, 2026
in Lifestyle
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Perimenopause symptoms no one warns you about and how to deal with them

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Most women don’t realize they’ve entered perimenopause until something seems disabled. Everything starts to become more sensitive (your mood, your cycle, your sleep, etc.), and the things that “worked” no longer arise in the same way. For many women, this transition begins without a clear explanation, around their early 40s. Although this is a stage that every woman eventually reaches, it can seem a bit taboo. And most of what you find online is either too clinical or disconnected from the reality of daily life. What is often missing? A practical understanding of what is happening And how to support your body in a way that truly helps you.

Image above by Michelle Nash

Pin itCamille Styles spring_perimenopause symptoms

What exactly is perimenopause?

Perimenopause is the transition phase leading to menopause, and it can start earlier than most women think, often in their late 30s or early 40s. During this time, hormones begin to fluctuate. Estrogen doesn’t just decrease steadily: it increases and decreases unpredictably. Progesterone tends to decline more steadily. And these changes can influence everything from mood to metabolism sleep. This phase can last from a few years to more than a decade, so understanding the signs of perimenopause getting started can make a big difference in your daily energy and behavior.

Common Symptoms of Perimenopause

When we think of menopause, we usually think of hot flashes. But perimenopause symptoms are often more subtle and can appear in ways that are easy to ignore. Some of the most common ones I see in practice include:

  • More intense PMS or new mood swings related to perimenopause
  • Irregular cycles or changes in cycle length
  • Sleep problems, including waking up in the middle of the night
  • Increased anxiety or feeling more “nervous”
  • Low stress tolerance
  • Changes in body composition, especially weight gain during perimenopause around the midsection
  • Brain fog or reduced concentration

Essentially, these are all signals from your body that your hormonal landscape is changing.

Why weight gain and stress are more intense

One of the biggest frustrations I hear from customers is: “I’m doing the same things I’ve always done, but my body reacts differently.” This is particularly true when it comes to weight gain during perimenopause and stress. As progesterone declines and estrogen fluctuates, your body may become more sensitive to stress. This often manifests as higher baseline cortisol levels, or what people call perimenopausal cortisol problems. And cortisol matters here.

Chronically elevated cortisol can:

  1. Make it harder build or maintain lean muscle mass
  2. Increase fat storage, especially around the stomach
  3. Disrupt sleepwhich then further impacts hunger and metabolism

So it’s not just about “eating less” or “exercising more”. In fact, pushing harder often backfires during this phase.

What helps during perimenopause

This is where I like to move the conversation away from self-improvement and towards what is (scientifically) favorable. In my coaching sessions, I strive to help women build a foundation that stabilizes blood sugarsupports hormones and reduces unnecessary stress on the body. But beyond the basics, there are a few less talked about changes that can make a noticeable difference during this phase.

1. Start your day with light

One of the most neglected hormonal health pieces are your circadian rhythmand it plays a direct role in how your body regulates cortisol, sleep, and even mood. Going outside within 30 minutes of waking up, even for 5 to 10 minutes, helps anchor your internal clock for the day. It signals your body when to be alert, when to relax, and supports more stable overall energy. It’s simple, but I’ve seen it make a significant difference for women who feel tense at night and tired in the morning!

2. Front-load proteins earlier in the day

Cortisol naturally peaks in the morning, which is part of the reason you wake up and get moving. But without enough protein Early in the day, blood sugar levels may become more unstable, leading to low energy levels, food cravings, and increased feelings of nervousness. A useful goal here is to aim for approximately 30 grams of protein at breakfastideally about an hour after waking up. It might look like eggs with cottage cheese on sourdough and greens, a protein smoothieor Greek yogurt with added protein. It sets the tone for more stable energy and fewer fluctuations throughout the day.

3. Train strength consistently

Muscles become extremely important during perimenopause. It’s not just about how your body looks; it’s about how your body works. Muscle supports insulin sensitivity, metabolic health, bone density and overall hormonal balance. And as estrogen begins to fluctuate, maintaining lean muscle mass becomes more difficult, which is why it’s even more important now. I generally recommend strength training 2-3 times per week (provided you are close to “failure” with your sets), combined with lower intensity movements like walking. More is not better here! Consistency is.

4. Don’t Neglect Key Nutrients

This is something I see often as a nutrition consultant. Women do all the “right” things, but they still feel bad. Sometimes it comes down to nutrients. For example, creatine is starting to gain more attention for its role beyond muscles, including cognitive function, concentration, and even mood, all areas that can be affected during this phase (most women do well with 3-5 grams/day). I also pay attention to nutrients like zincwhich plays a role in hormone production and can influence things like PMS symptoms, skin, and overall mood. It is not a question of adding a long list of supplementsbut it’s about recognizing that as your body changes, your needs may change as well.

Eat in a way that supports blood sugar

Focus on blood sugar, keeping stable glucose is one of the most underrated pieces of the puzzle when it comes to supporting perimenopause, and it’s something I focus heavily on with clients in this phase. In practice, this means preparing meals that are high in protein, supported by fiber, and supplemented with healthy fats and carbohydrates so that you don’t have to experience constant peaks and crashes throughout the day.

Perimenopausal Protein and Fiber Macros

A useful starting point: aim for approximately 25 to 35 grams of protein per mealwhich generally brings you between 90 and 120 grams per day depending on your needs. This supports muscle and satiety, all of which become more important as hormones change. Fiber is just as important here. I generally recommend working towards 25 to 35 grams of fiber per day. Fiber helps slow glucose absorption, supports gut health, and plays a role in estrogen metabolism.

Be selective about wellness trends

If there’s one reformulation that I come back to with my clients, it’s this: perimenopause is not your body “breaking” or “rebelling.” It’s your body that asks for different some kind of support. And often what helps the most is mastering the basics: eating enough protein, lifting weights, getting more sleep, and managing stress in micro, sustainable ways. This is also where it helps to take a more thoughtful approach wellness trends. After all, a lot of advice is about doing more or restricting more. Here’s how to build habits that will guide you through this phase (and beyond).

Eddie Horstman
Eddie Horstman

Edie is the founder of the nutritional coaching company, Wellness with Edie. With her experience and expertise, she specializes in women’s health, including fertility, hormonal balance and postpartum wellness.

The position Perimenopause symptoms no one warns you about and how to deal with them appeared first on Camille Styles.

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