What is my body telling me in perimenopause?
The anxiety, the 3am waking, the fog, the body that changed on its own. Perimenopause isn't creating these. It's magnifying what's underneath. Let's find out what that is.
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Sound familiar?
- The anxiety arrived out of nowhere and doesn't match your life
- You fall asleep fine and then you're wide awake at 3am
- You've walked into a room and forgotten why, more than once
- Your body changed shape and nothing else about your life did
- You were told your bloods are normal and you're too young for this
- Some months you feel like yourself and some months you really don't
Understand what's driving your specific symptom
Pick the one that sounds most like you. Every answer gets read three ways.
What's actually happening What you've been toldWhy do I feel so anxious in perimenopause?
Progesterone makes a calming brain chemical. As progesterone starts dropping away, so too does the body's natural nervous system buffer.
your natural brake
Allopregnanolone works on the same brain receptors as anti-anxiety medication. It is made from progesterone.
Medically
Anxiety that arrives suddenly deserves a proper look first. An overactive thyroid mimics anxiety almost perfectly, and low iron and low B12 do too. Those get ruled out before anything is called hormonal. And even if one of them does come back abnormal, you may need medical support for the short term, and it is always important to look at what is driving it. That is where you look functionally.
Functionally
Progesterone's calming metabolite works on the same brain receptors as anti-anxiety medication, so when progesterone falls that natural brake goes with it. Blood sugar crashes add adrenaline on top, which is very often mistaken for a panic attack. This is where supporting your blood sugars, nourishment and rest can go a long way.
Energetically
A nervous system that has been holding a great deal for a long time has less left to hold with. This isn't you becoming a different person. It's what happens when the padding wears thin.
The hormones are only half of it. They're landing on a nervous system that had nothing spare. Same transition, very different experience depending on what your cells had to meet it with.
Why can't I sleep through the night in perimenopause?
Falling asleep and staying asleep are two different problems with two different causes. Waking at 3am is its own specific signal.
heart going
A small protein snack before bed resolves a surprising number of these.
Medically
Sleep apnoea is under-diagnosed in women and often shows up without any snoring, so it is worth ruling out rather than assuming hormones. Thyroid gets checked here too, since it disrupts sleep in both directions.
Functionally
Progesterone is sedating and oestrogen helps you fall asleep, so losing both changes your sleep architecture. The 3am waking specifically is typically a blood sugar dip triggering a cortisol release, which is why it feels like waking with your heart going. Other things like light sensitivity, body temperature and metabolism play a role too. This is why testing inside the cells is helpful.
Energetically
The woman who can't sleep can often be the one who can't stop. A nervous system that has never been told it's safe to let go doesn't suddenly learn how at bedtime.
Sleep is the first thing to go when the body is running short. It's also when your cells do their repairing. That loop is why sleep is almost never just about sleep.
Why do I have brain fog in perimenopause?
Oestrogen is a neurological hormone, not only a reproductive one. When it drops, your brain notices.
The most expensive organ you own, which is why it gets rationed first when supply runs short.
Medically
This is not early dementia and it is not anxiety, though it gets called both. Thyroid, B12, iron and blood sugar all produce the same fog and all need ruling out before it's put down to hormones.
Functionally
Your brain uses a fifth of your glucose, so blood sugar swings hit thinking before they hit anything else. Brain cells are also dense with mitochondria, which need B vitamins, magnesium and CoQ10 to make energy at all.
Energetically
The brain dimming rather than burning out. Often in women carrying an invisible load of remembering and planning for everyone else, which is a genuine metabolic demand that nobody counts.
Fog is an energy problem before it's a memory problem. When the supply runs short, the most expensive organ you own is the first thing rationed.
Why has my body changed in perimenopause when nothing else has?
Falling oestrogen changes how your body handles insulin, and insulin decides where fat gets stored. Nothing about your habits has to change for your body to.
Your habits did not change. The system processing them did.
Medically
Thyroid problems become more common in these years and cause exactly this, so a full panel matters rather than TSH alone. Fasting insulin is worth asking for too, because it shifts years before glucose does.
Functionally
Insulin sensitivity drops through this transition, so the same food produces a different result. Muscle falls away faster now, and muscle is where you burn things. Cortisol adds to it by parking fat around the middle specifically.
Energetically
A body changing shape at exactly the moment a woman has least in reserve to meet it. The frustration is real and it isn't vanity.
This isn't your metabolism failing. It's your metabolism running on less help than it used to have. What the cells are given decides what the body does with it.
Why is perimenopause harder for me than for my friends?
Because you don't arrive at perimenopause from nowhere. You arrive carrying whatever you were already carrying.
This is the difference between two women the same age, in the same transition.
Medically
There is real variation in how steeply hormones fall, and things like thyroid disease, surgery or early menopause change the picture genuinely. Those are worth knowing about rather than assuming.
Functionally
Your adrenals are meant to pick up some of the slack as your ovaries step back. If they have been running flat out for ten years, there is nothing spare to hand over. That is often the whole difference between two women the same age.
Energetically
Most women arrive here having given twenty years mostly to other people. Perimenopause is frequently the first time the body refuses to keep going without something coming back the other way.
Every life stage is a different beach. The seabed underneath is the same four fundamentals every time. Perimenopause doesn't change the seabed. It just takes away enough water that you finally see it.
Is there a blood test for perimenopause?
Not a reliable one, and this is exactly where most women get stuck.
A blood test takes one reading. Test on the wrong day and it reads perfectly normal.
Medically
Perimenopause is a clinical diagnosis, made on your symptoms and your cycle, not a laboratory one. FSH and oestradiol swing so much through this transition that a single normal result rules nothing out. Nobody should be waiting for an abnormal number before helping you.
Functionally
What can be measured usefully is everything underneath: a full thyroid panel rather than TSH alone, iron, vitamin D, fasting insulin, and the mineral pattern your cells are actually working with.
Energetically
Being told you're too young, or that your bloods are fine, when you know something has shifted. That does its own quiet damage to how much you trust your own read.
The test that helps isn't the one hunting for perimenopause. It's the one showing what your cells have to get through it with.
Am I too young for perimenopause?
Perimenopause usually starts in the mid-40s and it can start in the late 30s. It lasts four to eight years, sometimes ten.
Symptoms often begin years before your cycle changes at all.
Medically
Under 40 with these symptoms, primary ovarian insufficiency needs ruling out properly rather than being assumed to be early perimenopause. That is a real condition with real consequences and it deserves investigating.
Functionally
Symptoms can start years before your cycle changes at all, which is why still having regular periods rules nothing out. The transition begins in the fluctuation long before it shows up in the calendar.
Energetically
Being dismissed as too young while your body is clearly telling you otherwise is one of the most common experiences women describe here. It costs years.
Your age tells you roughly where you are. It doesn't tell you what your body has to work with, and that second part is what decides how this actually feels.
Is HRT the only option for perimenopause?
HRT helps a great many women and it is a genuine conversation to have with your doctor. It also isn't the whole of it.
Hormones are the message. What your cells have to answer with is the other half.
Medically
Whether HRT is right for you is a medical decision, made with your own doctor, based on your history. Nobody should be talking you into it or out of it from a webpage.
Functionally
What HRT can't do is replace what your cells are short of. Thyroid, iron, blood sugar and mineral status still need looking at, and many women find HRT works better once they have been.
Energetically
This transition asks for something most women have never been given permission for, which is less output and more coming back in. That isn't something you can take.
Hormones are the message. What your cells have to respond with is the other half, and that half never arrives from outside.
Nobody has looked inside your cells
Your symptoms are your cells telling you they're short of something.
A blood test reads what's travelling around in your blood. That's what it's built for and it does it well. It was never designed to look inside the cell, which is where your body actually builds hormones, makes energy and settles inflammation.
So the thing driving your symptoms can be sitting inside your cells while every test you've had comes back clean. Nothing was missed. Nobody looked there, because that isn't what those tests do.
A hair test reads what actually made it inside the cell, across three months. That's where your pattern is.
What is circulating in your blood
This morning, one moment
Finding disease, and it is very good at it
Yes. That is its job.
What’s inside your cells
The last three months, the whole season
Finding what is running short before it has a name
No. It is a screening tool, not a diagnostic test.
They answer different questions. One is not better than the other, and you want both.
And the pattern is the point. Not another list of things it might be. The specific combination that's yours, because that's the bit that tells you what to actually do.
A hair test is a screening tool, not a diagnostic test. It doesn't diagnose perimenopause, thyroid disease or anything else, and it doesn't replace your doctor. It shows the layer nobody has looked at. Female Fundamentals practitioners are trained to listen to your body differently, by looking at the pattern underneath your symptoms.
Get started →A hair tissue mineral analysis plus two 1:1 appointments with a Female Fundamentals practitioner. Details on the next page.
Dr Anthea Todd
Dr. Anthea Todd, D.C. founded Female Fundamentals™ after observing her female patients’ struggles in the complex healthcare system. Her mission is to simplify and add fun to female healthcare.
With a background in chiropractic, a dual master’s in women’s health medicine and reproductive medicine, and expertise in functional medicine, functional neurology, cardiometabolic health, gastrointestinal health, immune-hormonal health, bioenergetics, and neuro-emotional technique, she’s reshaping women’s health.
Her goal is to empower women and professionals to see their bodies as the solution, not the problem, emphasising that the magic we seek is within. Author of the best-selling What’s My Body Telling Me?
Most approaches make you pick a lane. Medical, or functional, or energetic. Female Fundamentals is the first to read all three together. Helping you use the body, not bias, to listen to what your symptoms are telling you that you need.
Other Fundamentals
Your body isn't the problem
When you have reached a medical dead end, this is where you come. A practitioner who knows where to look.
Get started →A hair tissue mineral analysis plus two 1:1 appointments with a Female Fundamentals practitioner. Details on the next page.
Written by Dr Anthea Todd, author of What's My Body Telling Me?
Educational information only. It does not diagnose, treat or cure any condition, and it does not replace advice from your doctor.