Let's Clear Something Up First

If someone had asked me at 38 whether I was in perimenopause, I would have laughed. I was nowhere near menopause. My period was still showing up — mostly. I was still me. Whatever perimenopause was, it was a future problem.

Except it wasn't a future problem. It was already happening. I just didn't know it — because nobody had ever actually explained it to me.

That's what this post is about. Not the sanitized, pamphlet version you might get handed in a waiting room. The real version. The one I wish someone had sat me down and explained a decade ago, because it would have saved me years of confusion, frustration, and quietly wondering what the hell was wrong with me.

First, Let's Talk About What Menopause Actually Is

Most of us have heard the word menopause thrown around our whole lives, usually attached to jokes about hot flashes or "the change." What we rarely hear is a clear, honest explanation of what it actually means.

Menopause itself is technically a single moment in time — the point at which you have gone twelve consecutive months without a period. That's it. That's the clinical definition. After that point, you are postmenopausal. The average age in Canada and the US is around 51.

Perimenopause is everything that comes before that moment. It's the transition. The process. The years during which your body is shifting from its reproductive hormonal patterns toward a new baseline. And it doesn't last a few months — it can last anywhere from four to twelve years. For many women, it begins in their late 30s or early 40s, quietly and without fanfare, often long before anyone thinks to connect the dots.

What's Actually Happening in Your Body

Here's the short version of the science — and I promise to keep it real, not textbook.

Your ovaries have been producing estrogen and progesterone on a fairly predictable cycle since puberty. As you move into your late 30s and 40s, your ovarian reserve — the number of eggs your ovaries have left — begins to decline. As that happens, the hormonal signals that regulate your cycle start to get irregular. Progesterone tends to drop first. Then estrogen starts fluctuating — sometimes spiking higher than it ever did before, sometimes dropping. It's not a clean, steady decline. It's erratic. Unpredictable. Which is exactly why the symptoms can feel so all over the place.

On top of that, other hormones get pulled into the disruption. Cortisol — your stress hormone — becomes harder to regulate. Insulin sensitivity changes, which affects how your body processes carbohydrates and stores fat. Thyroid function can be impacted. Sleep-regulating hormones shift. Even your gut microbiome responds to the change in estrogen levels.

This is not a small thing happening in one corner of your body. This is a systemic hormonal transition that touches virtually every system you have.

The Three Stages — and Why They Matter

Perimenopause isn't one flat experience. It has stages, and understanding where you might be can help you make sense of what you're feeling.

01 Early Perimenopause

Why Don't We Know This Already?

This is the part that genuinely frustrates me, so I'm just going to say it plainly.

Women's health has been historically underfunded, understudied, and undertreated. For decades, much of what we knew about cardiovascular health, mental health, and hormonal health was derived from research conducted primarily on men. The symptoms of perimenopause were dismissed as emotional, exaggerated, or simply part of aging — something to endure, not address.

Medical education hasn't kept pace either. A significant number of general practitioners receive minimal training on menopause and perimenopause. Appointments are short. Hormone panels aren't always run. And when a woman in her early 40s walks in with fatigue, weight gain, and mood changes, the conversation often circles back to stress, sleep hygiene, or antidepressants — without ever touching hormones.

I'm not saying this to make you angry at your doctor. I'm saying it so you understand why you might not have known this already, and why advocating for yourself in these conversations matters so much.

So How Do You Know If You're In It?

Honestly? There's no single definitive test. Hormone levels fluctuate so much during perimenopause that a single blood draw can look completely normal even when you're deep in the transition. Diagnosis is largely clinical — meaning it's based on your symptoms and your history, not just a number on a lab report.

That said, tracking your symptoms matters enormously. The more clearly you can articulate what you're experiencing — when it started, how often it happens, what makes it better or worse — the more useful that information is to a provider who is actually listening.

Some of the most common early signs include changes in your cycle, worsening PMS, sleep disruption (especially waking between 2 and 4am), increased anxiety or irritability that feels out of proportion, brain fog, unexplained weight gain especially around the midsection, and a general sense that your body is operating differently than it used to.

Sound familiar? You're not alone. And now you have a framework for what might actually be going on.

This Is Just the Beginning

We are going to go deep on every single one of these pieces in future posts — the hormones, the symptoms, the strategies, what the research actually says about nutrition and training and sleep and supplementation for women in this transition. You are going to leave this blog more informed than most people in a clinical setting, and that knowledge is going to change how you show up for yourself.

For now, I just want you to sit with this: what you're experiencing has a name. It has a physiological explanation. And it is absolutely, 100% something you can work with — not against.

You were never falling apart. You were just missing the map.

— Sheena 🖤