If you’ve been feeling more tired, more irritable, more anxious, or just off lately (and can’t quite put your finger on why) you’re not alone. Many moms chalk these changes up to stress, parenting, or getting older. But for a lot of women, there’s another factor at play: perimenopause.
This article is meant to explain what’s happening in a clear, practical way—without buzzwords or hype—so you can better understand your body and know when it might be time to ask questions or seek support.
This article was written with input from Amanda Fisher, PT, DPT, pelvic floor physical therapist and certified perimenopause/menopause coach, in collaboration with Brittany Marsh, Macaroni KID SE Kansas City, MO Publisher.
What Is Perimenopause?
Perimenopause is the stage leading up to menopause, when hormones begin to shift and fluctuate. Many women are surprised to learn that this phase can begin as early as the mid-30s and may last anywhere from 4 to 15 years.
Menopause itself is not a long process ... it’s a single point in time, defined as going 12 consecutive months without a period. Everything before that is perimenopause, and everything after is postmenopause.
While menopause is often associated with hot flashes, the hormonal changes involved can affect much more than your cycle.
Symptoms Moms Often Notice First
Hormonal changes during perimenopause and menopause can show up differently for every woman. Some common symptoms include:
Pelvic Health Changes
- Bladder leakage
- Constipation
- Pelvic organ prolapse
- Pain with intercourse
Whole-Body and Hormonal Symptoms
- Hot flashes or night sweats
- Vaginal dryness or changes in libido
- Anxiety, irritability, or mood swings
- Difficulty sleeping or waking during the night
- Brain fog and daytime fatigue
- Joint pain, thinning hair, or changes in cholesterol
- Increased risk of osteoporosis, heart disease, and muscle loss over time
If you recognize yourself in this list, it’s important to know these symptoms are real and commonly linked to changes in estrogen, progesterone, and testosterone.
What’s Going On Inside the Body?
During perimenopause, hormone levels don’t decline gradually, they fluctuate. Estrogen may spike and dip unpredictably, while progesterone, which has a calming effect on the nervous system, often starts declining in the 30s. Testosterone, which supports energy, focus, and libido, also decreases with age.
These shifts can affect mood, sleep, energy, pelvic health, and overall well-being.
Does Genetics Play a Role?
Genetics can influence when menopause begins and how symptoms show up. Talking with your mom, aunts, or older siblings about their experiences may provide helpful insight.
However, genetics aren’t the whole story. Other factors that can affect symptoms include:
- Smoking
- Ovarian surgery or hysterectomy
- Chronic stress and poor sleep
- Inflammation and blood sugar imbalances
Why This Stage Can Feel Especially Hard for Moms
Many women enter perimenopause during a demanding season of life ... raising children, managing work, caring for aging parents, and juggling household responsibilities. When hormone changes layer on top of ongoing stress, it can feel like your capacity is suddenly smaller.
That doesn’t mean you’re doing anything wrong. It means your body is navigating change.
You Don’t Have to “Just Push Through”
Perimenopause and menopause are natural, but that doesn’t mean you have to suffer through them. Support and education can make a meaningful difference.
Helpful approaches may include:
- Improving sleep and stress management
- Strength training and movement to protect muscles and bones
- Nutrition that supports steady energy levels
- Pelvic floor physical therapy
- Learning about hormone therapy and whether it may be appropriate for you
The best plan looks different for every woman, but understanding your options is a powerful first step.
What You Can Do Next
If this stage of life sounds familiar, consider starting with:
- Paying attention to patterns in your cycle, sleep, mood, and energy
- Having an open conversation with your healthcare provider about symptoms
- Seeking out trusted, evidence-based information
Your body isn’t failing you—it’s changing. And with the right information and support, you can move through this season feeling informed, capable, and supported.
