Is This Perimenopause?

Perimenopause doesn’t start the day your period stops. For many women, it’s a long, messy transition that can stretch seven to ten years and still look “normal” on the calendar, which is exactly why so many women spend their late 30s and 40s feeling off without a name for what’s happening.

In this episode, we’ll clarify the difference between perimenopause and menopause, and get specific about what hormones actually do in this phase: progesterone often drops first, estrogen can swing high and low, ovulation becomes less predictable, and stress load can amplify strain on cortisol and thyroid. That volatility shows up as real symptoms, not you “being dramatic” or “not handling life well.”

We’ll walk through the most common perimenopause patterns I see in clinic, cycle and bleeding changes, waking at 2–4 a.m., anxiety and irritability, brain fog and word‑finding issues, abdominal weight gain without big habit changes, joint stiffness, libido shifts, headaches, and heart palpitations, and why women so often get brushed off or offered symptom‑only tools with no real explanation.

Then we’ll talk about why early recognition matters for your healthspan: how supporting sleep, blood sugar, your nervous system, and your muscles and bones now can change how your next decades feel. I’ll also share practical scripts for your next appointment, which labs to ask about, and how to respond when you’re told everything is “normal” but you’re clearly not fine.

Free Workshop: Her Next Decades – Clear Energy Edition
Feeling “too young to feel this tired”? Here’s what your body is trying to tell you.
If you’re dragging through the day, wired and tired at night, or being told “everything looks normal” while you clearly don’t feel normal, this is for you.

In this 60‑minute live Zoom workshop, we’ll cover:
• Why your energy is more than a willpower issue, it’s a healthspan signal
• 3 myths that keep women stuck in low energy and burnout
• The 3‑step Next Decades Healthspan Method I use with clients
• A simple Clear Energy Self‑Check you can do with a pen and paper

When: Wednesday, June 24, 6:30–7:30 pm Mountain (MT)
👉 Save your spot here: Her Next Decades: Clear Energy Edition

Start Here: Take the Next Decades Quiz to understand what your body may be  signaling right now: 👉 https://rootremedyic.involve.me/next-decades-healthspan-quiz

This is a quick, three-minute check-in on your energy, brain fog, mood, sleep, joints, weight, habits, and long-term health. At the end, you’ll see where to focus now and receive a one-page guide with the five key levers we discuss on this podcast.

Work With Me: If you are looking for more personalized support, I work with women in Arizona, Colorado, Florida, Idaho, Oregon, Montana, Washington,  and Wyoming through my telehealth clinical practice: Root & Remedy Integrative Care. 👉 https://www.rootremedyic.com/work-with-me

Ready to talk? Book a free Clarity Call:
👉 https://rootremedyintegrativecare.as.me/clarity-call

Digital Guides: Not in a state I serve? Browse the Wellness Library for clinically
written guides on hormones, gut health, cortisol, sleep, and stress:
👉 https://www.rootremedyic.com/products

Explore More: Find all links, resources, and ways to connect:
👉 https://linktr.ee/rootremedyic

Transcript

Perimenopause Is A Long Transition

SPEAKER_00 0:01

Let's get something clear. Perimenopause is not menopause. And that misunderstanding is why so many women feel off for years. It is not a single moment in time. It is a transition. And most women are in it long before anyone ever names it. Today we're going to break down that perimenopause actually is and why it feels the way it does, and what you can start to pay attention to now. Welcome back to Her Health Span on Her Terms. I'm Dr. Sherry Irwin. I'm an integrative clinician and founder of Root and Remedy Integrative Care. This podcast is for women in their 30s, 40s, 50s, and beyond who feel too young to feel this old and want to understand what is really happening in their bodies and what they can do about it. Today we're going to zoom in on perimenopause and the transition of it, which is one of the most misunderstood and underexplained phases in women's health.

Menopause Vs Perimenopause Defined

SPEAKER_00 1:09

Let us start by defining terms because this is where a lot of confusion begins. Menopause is defined as 12 consecutive months without a menstrual cycle, without a period. Perimenopause is everything before that point when your hormones are changing, but your cycles have not completely stopped yet. Perimenopause is not a single day, a single moment, or just a winding down phase. It is a transition that can last anywhere from several years to seven to ten years. Hormones during perimenopause do not decline smoothly. That would be nice. They fluctuate. What happens hormonally? Progesterone usually declines first and more steadily. Estrogen becomes erratic, sometimes very high, sometimes low. Ovulation can become less consistent. Other hormones like cortisol and thyroid are often under more strain due to life's load and stress. This hormonal volatility is what drives a lot of the symptoms women experience in their later 30s and 40s. You might still be getting regular menstrual cycles, and in your mind, that means, hmm, I'm not in menopause yet, so this can't be that. Meanwhile, your sleep is changing, your PMS is getting worse, you're waking maybe between 2 and 3 a.m. Your body feels different, you're more sensitive to stress, your weight is shifting. Maybe all of these sound familiar to you, maybe one of them sounds familiar to you, maybe none of these yet. Maybe this is a picture of what the future looks like for you. This is perimenopause physiology. And if the word has never come up in a clinical visit, I'm not surprised. Let's

Symptom Patterns To Watch

SPEAKER_00 3:09

walk through some symptoms that often show up in perimenopause, but are usually blamed on things like stress, being too busy, getting older, or my favorite, just life. You do not have to have all of these to apply for you, but listen to the pattern. Cycles and bleeding changes, shorter cycles, for example, 26 days instead of 28 or 30. Heavier flow than normal, spotting maybe between periods, more painful periods. Next category: sleep, trouble falling asleep when you never used to, waking between 2 and 4 a.m. and having trouble going back to sleep. Feeling wired and tired at the same time. That one's always fun. Mood, more anxiety than you used to. Irritability that feels out of proportion. Low mood that seems tied to a certain part of your cycle. Next category, brain and focus, word finding problems. Forgetting what you walked into a room for more often than you used to. Now we've all done that, but this is a pattern that's increasing. Feeling like your brain is off on some days. Next category, body changes, weight shifting to your abdominal, even if habits have not changed much. Many patients I see will say, I'm still exercising the same way, I'm eating the same way, but this midsection weight is out of control. And this is starting to happen in the 30s and the 40s, and more prevalent in the 50s. Breast tenderness at odd times, joint pain or joint stiffness, the big one, change in libido. Started seeing this in patients even in their 30s. So this is not a problem just for the 50s and 60s. And the other category, heart palpitations, headaches around your periods. Most

Why You Are Told It Is Stress

SPEAKER_00 5:17

women who experience these are told it's stress, you're getting older, it's normal. All women go through this. And many are often offered. My favorite is SSRIs and other antidepressants, sleep aids, and maybe even oral contraceptives without a deeper explanation. And while those tools sometimes have a role, they are not all be all. They don't give a full explanation of what is actually happening. They're maybe just masking or treating a symptom. These symptoms are your body's way of saying, hey, your hormones are shifting. Your nervous system and metabolism are reacting. This is a transition worth paying attention to. It changes what you prioritize in your habits and support. If you think about it, this is just me not handling life well. You may automatically blame your personality, motivation, or your willpower. If instead you understood my hormones are changing, my nervous system and metabolism are undergoing more strain than before, you are more likely to soften the self-blame, seek appropriate hormonal or health band support, put more value on things like muscle, sleep, nervous system downshifts, and blood sugar stability. Early recognition also matters because options like lifestyle shifts, nutritional support, and when appropriate, hormonal support work better earlier in the transition. You can prevent years of poor sleep, cumulative metabolic stress, unaddressed mood changes, and accelerate a bone and muscle loss. It is the difference between spending seven years telling yourself you're falling and failing and coping versus spending those years building strength, stabilizing the blood sugar, getting better sleep, and a nervous system that gets some recovery time. Perimenopause is not something to tough it out without understanding. It is information about how your body is moving into the next decades. So

How To Talk With Your Clinician

SPEAKER_00 8:12

let's talk about how to bring this into a clinical visit and into your own awareness. So, questions to ask your medical provider. You might say something like, I'm in my 40s and I'm noticing changes in my cycles, my sleep, my mood, and my weight. Could this be perimenopause? Can we look at my hormones in a bit more detail, including estrogen and progesterone, and possibly testosterone or DHEA if appropriate? These symptoms are affecting my quality of life. That is a big one. State, these symptoms are affecting my quality of life. What options do we have beyond watch and wait or just antidepressants? Or this is just what women go through. You can also ask about things like thyroid testing beyond just the TSH, the thyroid stimulating hormone. Or maybe test vitamin D. I've seen more providers starting to test vitamin D with the annual exam. But maybe you need to look at your ferritin or your B12. They might have to do with some type of energy issue, blood pressure, lipids, so your cholesterol, your triglycerides, blood sugar, and hemoglobin A1C. If your concerns are brushed off, that is unfortunately a very common situation. It is okay to say, I understand that nothing looks dangerous right now, but I'm not fine. I would like to understand what is driving these symptoms. So some women will get those labs done and they come back normal. And the provider will say, there's nothing we can do. Or often they won't draw labs at all. They'll say there's no labs that are related at all to perimenopause. There's nothing for us to draw. But there are labs that can be drawn, as I've stated above. Or you can seek a second opinion with someone who takes hormones and health span seriously.

A Self-Check For Recent Changes

SPEAKER_00 10:24

Questions to ask yourself: What has actually changed in the last one to three years? Where am I most feeling like not myself? Is it my mood that's not like myself? Isn't my energy level? I used to want to go for hikes and biking, and now my energy is, gosh, I barely get off the couch. Sleeping, oh my gosh, that 2 to 4 a.m. sleep pattern of waking up and not being going back to sleep. I never was like that before. Brain, I used to be a sharp thinker, but now I'm forgetting things or I have to constantly write things down. What have I been telling myself is just stress that might be more than that? Those are questions I want you to think about. Analyze yourself. Doesn't matter if you're in your 30s, 40s, 50s, or 60s. Analyze yourself. This is really important for your health and it's important for your health span. It's important for you to acknowledge where you're at and where you've been. Perimenopause doesn't mean you have lost control. It means your body is shifting the rules of the game and inviting you to shift with it.

Tools Quiz Workshop And Closing

SPEAKER_00 11:36

If you're listening to this and thinking, this might be me, but you're not sure where to begin. You do not have to figure out it all alone. There's a couple options for you that I can help with related to understanding. In the show notes for this episode, you're going to find a link to the next decades quiz. You may have heard this in prior episodes if you've listened to them before. I bring it up because it is great for women wanting to understand and have a guide to check in on how your current symptoms are and habits that you have currently are actually shaping your future health. That is something as women, we often don't take into consideration. We live in the moment, we live in the day, we're fighting through the day. We're just lucky if we get the kids in the car and the lunch is made and we get to work and we get home and we make dinner and we sit down and we watch TV for five or 10 minutes and then we go to bed. But a lot of our habits and our symptoms are shaping that future health. We don't always think about the future, but we need to as women. When you're done with the quiz, it instantly gives you a result green, yellow, or orange result in your health span, giving you an idea of where you're at. You also get a free handout, five levers that quietly shape your next decades. That is also a helpful tool to kind of understand where you're at as well and things that you can do to help improve your current health and your future health. You don't have to remember all this. If you look in the show notes, that information is available. Before we wrap up, a quick invitation. If you're listening and thinking I'm too young to feel this tired or I just don't understand my symptoms, I'm hosting a free live workshop called Her Next Decades Clear Energy Edition. It's happening on Wednesday, June 24th from 6.30 to 7.30 p.m. Mountain Standard Time. So take into consideration what time zone you're in, and it'll be hosted on Zoom. I'll be talking about why your energy is so important in your health span and why it is a signal, three myths that keep women stuck in the low energy and burnout phases, and the three steps, the next decade health span method I use to turn vague fatigue into a clearer, realistic plan. You can save your free spot using the link for that free workshop in the show notes. Thank you for being here. Perimenopause is not talked about enough. And when it is, it is often reduced to jokes about hot flashes or moodiness. You deserve much fuller, more respectful conversation about what is happening in your body and what is possible in your neck decades. If the episode, if this episode helped you feel seen, I would love for you to continue to follow. There will be weekly episodes with additional inspiring topics, breaking mythbuster scenarios. And I would love a review. I would love you to share this with another woman you think could benefit from this information. I'm Dr. Sherry. Take care of your present self this week, and your next decades will thank you very much. Next week, we're going to be talking about menopause maxing, early signs, real solutions.