Ep. 80 Perimenopause 101: What It Is, How It Feels, and What To Do

Perimenopause is one of the most misunderstood phases in a woman’s life.

It’s not just hot flashes.
It’s not just skipped periods.
And it doesn’t start the day your cycle disappears.

In this episode, we break down what perimenopause actually is, how it shows up in the body, and what you can do to support yourself through it.

If you’re in your late 30s or 40s and thinking,
“Why do I feel different?” — this conversation is for you.

What You’ll Learn:

✔ What perimenopause really means (and when it typically begins)
✔ Why progesterone is often the first hormone to shift
✔ The difference between early and late perimenopause
✔ Common symptoms beyond hot flashes
✔ Why your old routines may suddenly stop working
✔ Practical steps to stabilize your hormones during this transition

Common Signs of Perimenopause

• Shorter or heavier cycles
• Increased PMS
• Anxiety or irritability before your period
• Sleep disruptions (especially 3am wakeups)
• Brain fog
• Lower stress tolerance
• Midsection weight gain
• Feeling “off” despite normal labs

Perimenopause isn’t the beginning of decline — it’s a hormonal recalibration.

But it requires a different strategy.

What You Can Do

Inside this episode, we cover foundational shifts that make a real difference:

• Stabilizing blood sugar with adequate protein
• Adjusting workouts to support (not spike) cortisol
• Prioritizing nervous system regulation
• Supporting ovulation and progesterone naturally
• Getting the right labs interpreted through a functional lens

You don’t need to “wait it out.”
You need to support your body differently in this phase.

Ready for a Personalized Plan?

If you’re tired of guessing whether it’s stress, aging, or perimenopause — and want clarity about what’s happening in your body — this is exactly what I help women navigate inside The Balanced Hormone Solution.

We assess your symptoms, labs, stress load, and metabolism to create a clear, phased plan tailored to you.

🔗 Learn more here: www.tracyerinwellness.com

Perimenopause is not something to fear.

With the right strategy, it can be a powerful, grounded, and strengthening chapter.

You deserve to feel steady, clear, and supported through it. 💛

Transcript

Speaker 3 0:09

Welcome to the Balance Hormone Solution podcast. If you're a woman 35 plus feeling exhausted, struggling to lose weight, and wondering where your libido went, this is for you. I am Tracy Aaron, a functional medicine practitioner who helps women balance their hormones naturally without prescriptions, guesswork, or trendy nonsense, 'cause here's the truth: your symptoms aren't random. They're signals, and if you know how to listen, you can fix the root cause and start feeling like yourself again. If you're ready for real solutions, let's get to it.

Speaker 0:49

Hello, and welcome back to the Balanced Hormone Solution podcast. Today we're gonna talk about something very basic, but something that I believe is wildly misunderstood, perimenopause. Because somewhere along the way, women were taught that perimenopause equals hot flashes and missed periods, and if you're not having those, then you must not be there yet. But here's the truth, perimenopause is so much more than that, and for many women, it starts years before they realize what's happening. So today, we are answering three questions. Number one, what even is perimenopause? And number two, how do you know if you're in it? And number three, what can you actually do to support your body through it? All right, so let's go with number one. What is perimenopause? Well, perimenopause simply means around, peri, around menopause. It's the transitional phase leading up to menopause, which is officially diagnosed... The clinical definition is menopause is the state where 12 cons- you have gone 12 consecutive months without a period Technically, if you define it that way, which our medical system does, menopause is one day in time. So you're pre-menopause and post-menopause. But we just kinda call it, we lump it into a season, menopausal, and that works, too. But perimenopause, that around menopause, the time before then, can begin as early as your mid to late 30s. Everybody hits this magic date of menopause on their own timeframe. And yes, there are lots of factors to go into that. In fact, that would be an interesting episode, to really cover what makes perimenopause actually transpire in our lives. What are the physiological features that happen in our bodies that either make it happen early or late? What does it even mean to be early or late, right? We'll get to that on another one. That's kind of interesting to me. But for now, I want you to know that perimenopause can begin as early as your mid to late 30s, and it typically lasts around five to 10 years. Okay? So typical menopause happens somewhere around 51, right? Or i- in Western Indo- industrialized cultures, it's around age 51, is what we know. So go 40... Uh, 10 years before that, what are we at? 41. So somewhere around age 41, you can begin to notice these shifts in your body, and, uh, this is the time, uh, where your ovulation is becoming less consistent, right? So ovulation is that, um, crescendo part of your cycle that allows you to make a baby, and this season of your life is coming to a close, right? We're moving out of our childbearing years. Puberty, moving into, that's con- that would be like a, a first perimenopause. Not me- perimenopause. We'd have to change the words, but puberty is like we're coming into the childbearing years, and the perimenopause is like we're moving out of the childbearing years. So initially, in those prepubescent years, our ovulation is just starting to come online. We're getting breasts. We're getting pubic hair. These shifts are beginning to happen in our body, and our body is learning to ovulate. And at this stage, on the other end, our body is unlearning, or closing the door. We're like, boom, we're done. Had a nice run, but we're done with that and we're ready to move on to the next thing. So your ovulation is becoming less consistent. And when that ovulation's becoming less consistent, your progesterone is becoming inconsistent as well, and that's the first big shift. So estrogen doesn't just decline steadily like progesterone does. It, it fluctuates. It... If you pan out or you step back, you will see an overall decline of estrogen, but it's not a steady decline. It's a dip and a rise, and a dip and a rise, and a dip and a rise, over and over and over until it reaches its new low normal. But that dip and the rise, the dip and the rise, dip and the rise, boom, there's your hot flashes, which is why this is I'm getting involved in lots of rabbit trails here in my thinking, but which is why women run to HRT because what estrogen patches and these types of things do is they keep estrogen at a certain higher level so they don't experience the dips anymore, which is what is causing that, um, hot flash. Anyway, so this estrogen is fluctuating over time. Sometimes it's high, sometimes it's low, sometimes it can be both within the same month, which is why you feel crazy. So perimenopause is less about hormone depletion at first, 'cause you're still working with all your hormones. They're just shifting now. It's more about that hormone unpredictability. That unpredictability is exactly what's creating all of these symptoms that you might be experiencing in your life right now. So how do you know if you're in perimenopause? Well, this is the question that I hear constantly, because many women are still having regular periods, okay? But there are some early signs that I see clinically, and here's a list of them. Number one is our, our cycles do shorten. Let's say you regularly had a 28-day cycle, now you're down to 26. Maybe your regular cycles were 32, and now you're down to 30 or 28. So your cycle begins to shorten over time, and your periods might get heavier. You might experience more clots. Not necessarily any more cramping, but you're gonna get clottier periods. Really heavy on day one, almost nothing on day three, right? When you're used to maybe a five-day cycle. Increased PMS. That rage and irritability that used to last one day before your period might extend itself and might be more severe right before you do get your cycle. Breast tenderness increases. This is a good sign. This is a... the progesterone decrease in our body. Might get more anxiety right before your cycle hits. New sleep disruptions. Whoa, hello, waking up at 3:00 AM wondering why you're staring at the ceiling again. That magnesium not working so well anymore. Why is that glass of wine doing this to me? I used to be able to drink three. What's the problem? These sleep disruptions are definitely a sign of perimenopause. The increased irritability right before your period or all cycle long. Again, this is the, the decra- decreased progesterone. Progesterone makes us feel happy and calm, so without as much of that flowing through us, we can find ourselves raging a little bit more readily. Brain fog. Ever walk into a room and not know where you put your keys or why you were in that room or do you call your children by the wrong name? Yeah, okay, that's not just me. Well, heart palpitations. This is common, too. Actually, a lot of women get scared about this, and this is a very common sign of perimenopause. And yes, it is alarming. It's like, why? What's happening? Because, you know, number one, um, cause of death for women is cardiovascular disease, so when something starts to happen to our heart, we start to get a little bit nervous, for good reason. But these heart palpitations can really take us by, um, surprise, and it is a regular and normal, natural part of perimenopause. I'm not saying it's not something to look to... That it's not something you don't wanna look into, but it is a part of this symptom picture. How about that belly fat? You used to have an hourglass shape and now you're looking pretty straight. You used to have a waist and your dresses don't look the same anymore. That weight gain around the midsection? Yeah. Thank you, perimenopause. Lower stress tolerance. What used to, uh, make you maybe a little upset now throws you for a total loop and you start wanting to rage. Something like traffic or something being late or, oh, I don't know, a thousand things can go in our day not the way that we planned, and you just feel like you lose it more now than you did before. It's just this overall sense of, like, feeling not like yourself. So the, uh, the biggest sign, right, it's like you're doing the same things you've always done, and they're not working anymore, right? Your workouts don't give you the same results. Your stress feels harder to recover from. Your usual coping strategies, they're falling flat now. So women get a little nervous, and they go to the doctor, and they're told, "Your labs are normal. Oh, you're too young for that," or, "It's just stress." But if you are in your late 30s or 40s and noticing these shifts, perimenopause may absolutely be part of the picture, and here is something important. It's not a diagnosis of dysfunction. Let me say it louder for those in the back. Let me shout it for the rooftops. It is not a diagnosis of dysfunction It's a transition. It's a normal, natural, biological shift that your body is meant to do. But transitions do require support, right? So let's go into what's actually happening in your body now, and I'm gonna simplify this for you 'cause this can get a little crazy with human physiology and biology. But the hallmark of early perimenopause is just this declining and this inconsistent progesterone. Right? As I mentioned before, progesterone's your calming hormone. It's supporting your sleep, your mood stability, your fluid balance, and it helps buffer the effects of estrogen. We do want them both. In fact, we're really glad when they travel together and they play nicely. But when that ovulation becomes less predictable, that progesterone drops first, and that's why a lot of... many of these early symptoms look like that anxiety or the sleep disruption. The PMS gets, you know, more intense, heavy, clotty periods. Now, later, estrogen fluctuations will become more dramatic, which can contribute to things like hot flashes and skipped periods, et cetera. But long before hot flashes show up, your nervous system is noticing the change. And if you're already stressed, you're already coming out of years of yo-yo dieting, undereating, over-training maybe, or just running on empty. You've put yourself last long enough. Well, your body has paid the bills, and the receipts are due. Perimenopause will amplify that stress load, and this is often when women feel like they're falling apart. You're not, but your body just needs a different strategy right now. So let's dive into what you can do to support yourself, okay? 'Cause this is the empowering part. Perimenopause is not just something to survive, right? Like, I always like to think with my clients, you know, like, some symptoms, you know, they're, they're kinda non-negotiable, but suffering is optional. Nobody has to suffer through this phase of life. I definitely like to say perimenopause does not have to suck. If perimenopause is sucking for you, you know you need better support. You need a better roadmap. So th-this phase of life is something that you can navigate strategically, right? So here's where to start. Number one, stabilize your blood sugar. I can't even tell you how far wide-reaching stabilizing your blood sugar is, but as that estrogen begins to fluctuate, your blood sugar becomes more and more sensitive. You become more insulin resistant as estrogen decreases. Okay? So if you're skipping meals, you're drinking coffee on an empty stomach, or you're under-eating protein, and I promise that you are, unless you're tracking it and you've been with... working with somebody who tells you to eat more protein. I promise you, everybody e- under-eats protein. Um, these symptoms are gonna intensify. So here's some quick wins, quick fixes. We need at least 30 grams of protein every single meal. This is a non-negotiable. Non-negotiable. If you're 35 plus and you're not eating 30, at least 30 grams of protein at every single meal, well, you're making life harder on yourself, and you don't have to choose this path. You have to have a little bit of a learning curve to figure out what 30 grams of protein looks like and is, right? How, how much Greek yogurt is that? How much ground beef is that? How much chicken breast is that? W- if I eat a salad and salmon for lunch, will that cover it? Like, you gotta do a little bit of learning here. You gotta invest in yourself in this learning. But once you have this knowledge, you use it for the rest of your life, and it's not as hard as it sounds. I want you to eat within an hour of waking, okay? None of this, "But I'm not hungry" business. None of this running through Starbucks and getting one egg white bite and a protein latte, whatever that is, okay? I want you to eat a real breakfast within an hour of waking. Pairing carbs with protein and fat. Stop eating carbs on their own. I'm not gonna say never eat chips, never eat crackers, never eat a banana, but just pair those with a protein and fat and your blood sugar will thank you. This alone dramatically improves sleep and your mood stability. The second thing is you're gonna prioritize nervous system regulation. Doesn't that sound so much fancier than just stress less? Okay. 'Cause who can just stress less? So progesterone is calming. If your progesterone's dropping, you need to build that calm intentionally. So this might look like going on a nice walk instead of waking up for Orange Theory. Strength training three days a week instead of going to the gym five days a week or seven days a week. It might look like putting your phone down and doing breathwork before bed instead of scrolling. It might look like going to bed earlier and protecting your sleep like it's non-negotiable. The thing is, is that I can give you a ton of supplements, I can run every test on you, but you really cannot out-supplement chronic stress in perimenopause. This is where the lifestyle piece comes in, and it's really not as overwhelming as it might sound Number three, rethink your workouts. Right? I kind of touched on this, but what worked for you at 30 may not work at 42. So if you have, like, excessive high-intensity training, that's gonna spike your cortisol. It's gonna wor- worsen your symptoms overall. So things like strength training and recovery become essential. No more of these, you know, 60-minute cardio classes. This is one of the first things that we adjust inside my program because when women shift their exercise strategy, inflammation drops and symptoms improve way faster than you would expect. It's really fun to see. And number four is you have every ability to assess where you're at. Don't guess. And this is critical. Many women assume that they have estrogen dominance, so they start random supplements, something they saw on Instagram, right? And maybe it wasn't the estrogen at all. Maybe it was their gut. Maybe it was their liver. Maybe their methylation isn't optimized. Okay? It's... It actually is a little bit more complicated and deeper than whatever your friend is doing or whatever Instagram is telling you. So if you're not evaluating things like your thyroid function, your iron status, where's your ferritin at? Blood sugar markers. Do you know your fasting insulin number? If it's not under six, you need to come talk to me. Ovulation quality. Do you even know that you ovulate? Women come and work with me and they're like, "Yeah, yeah, I get my period every 28 days." Great. What day is your ovulation? They have no clue. They have no clue. This is, like, an essential part of being a female. We gotta learn these things about our bodies, and I teach you how to do this. So without all these things, you're just guessing Perimenopause actually is kind of nuanced, right? It, it's not generic, uh, recommendations for everybody. So this is exactly why I created The Balanced Hormone Solution, because in my program, I don't just ever tell anybody, "Yeah, it's just perimenopause." I'm assessing your physiology, I'm identifying what's driving your particular symptoms, and I'm building a phased plan so you're never throwing random solutions at a moving target. Ugh, my pet peeve. So what I want you to know is that perimenopause is not the beginning of a decline. It's... I want you to think of it like a recalibration phase. But if you try to push through with the same habits that worked in your 20s and 30s, you're gonna feel like you're losing control, and that's when women start thinking, "Well, maybe this is just how it is now. Maybe this is just aging." But it's not. With the right strategy, many women actually feel more stable, stronger, and more grounded in perimenopause than they did in their 30s. Is that... Can you even imagine that? Can you imagine the- your 40s being the best decade of your life? That's what I'm here for, okay? But it requires support. It requires accountability. It requires a roadmap that works for you. So if you find yourself in your late 30s or 40s, your symptoms are increasing, you're feeling dismissed, confused, you're tired of guessing, you do not have to figure out this alone. So if you wanna work with me inside The Balanced Hormone Solution, we walk step-by-step, hand-in-hand. You get unlimited support. We stabilize your stress physiology, your nervous system. Your noise in your brain, in your body starts to quiet for the first time in you don't even know how long. We support ovulation and progesterone, optimize thyroid, metabolism. That hourglass shape begins to come back. Women are fitting back in their wedding dresses from 30-plus years ago. It's the most amazing thing. I love watching these women get healthier than they ever could imagine was even possible. So perimenopause is a whole lot more than hot flashes, skipped periods, and you deserve more than just, "Wait it out, you'll get on the other side, and everything will normalize." If you're ready for clarity, a personalized roadmap, details are in the show notes. All right? Let's hop on a call. Let me sh- tell you how it works. If it's a good fit for you, we'll jump in. If it's not, I'll definitely give you some free resources and point you in another direction. Okay. So thank you for being here. Remember, this is not the beginning of a decline. It's an invitation to rebalance. I will see you next time on The Balanced Hormone Solution.

Speaker 2 20:15

That's it for today's episode of The Balanced Hormone Solution podcast. If this resonated, don't just listen, do something about it. Make sure to subscribe so you don't miss what's coming next, and if you know another woman who's tired of feeling like a stranger in her own body, send her this way. For more support, check out the show notes. I've got resources to help you get started. Just remember, your body isn't broken. You just need the right tools. See you next time