You used to bounce back from late nights. Handle stress better. Eat out without worrying about bloating or sudden weight gain. Now? You’re tired by 3pm, irritable for no clear reason, and stuck in a body that doesn’t respond the way it used to. These might be early symptoms of perimenopause – a phase that can feel confusing, invisible, and easy to dismiss.

You might be in perimenopause – the hormonal transition that can begin years before your periods actually stop. And it shows up in ways most women aren’t told about: not just hot flashes or irregular periods, but deep fatigue, mood swings, gut issues, cravings, and stubborn belly fat.

Let’s explore the real, everyday symptoms of it and how small shifts in your food, movement, sleep, and stress rhythms can change everything.

What Is Perimenopause, Really?

Perimenopause is the 5–10 year phase before menopause when your hormone levels – especially estrogen and progesterone – start to fluctuate wildly. You’re not menopausal yet (your periods haven’t stopped for 12 months), but your body is already in transition.

In India, perimenopause commonly starts between 40 and 45 – sometimes earlier, especially in urban women with high stress or erratic lifestyles.

Yet most women don’t realise what’s happening because we’re taught to watch for hot flashes or missed periods – not exhaustion, bloating, and mood changes.

The Hidden Symptoms of Perimenopause

Every woman experiences this differently. But here are some of the most common and misunderstood signs of perimenopause:

• Fatigue that doesn’t improve with sleep
• Digestive issues (bloating, constipation, new food sensitivities)
• Weight gain, especially around the belly
• Mood swings or feeling low for no clear reason
• Anxiety or irritability, often worse before your period
• Poor sleep or waking at 2–4am
• Brain fog or trouble concentrating
• Cravings, especially for sugar or salty foods

If 2–3 of these resonate with you – and your cycle has started to shift (shorter, longer, heavier, or unpredictable) – it’s worth considering that perimenopause might be at play.

A 2025 review found that fatigue, sleep disturbance, and mood changes were among the most common and distressing early perimenopausal symptoms – often going unrecognised by healthcare providers.

What’s Actually Going On?

Perimenopause doesn’t mean your hormones are “dropping” – it means they’re fluctuating unpredictably.

One month, estrogen may spike too high. Next, progesterone might dip too low. Your stress hormone (cortisol) rises more easily. Insulin becomes harder to regulate.

The result? Metabolic chaos. You feel like your body is working against you – because in some ways, it is. But this isn’t a broken body. It’s a body asking for rhythm and recalibration.

Let’s look at how each of your lifestyle pillars can help bring that rhythm back.

1. FOOD: Stabilise Blood Sugar to Steady Your Hormones

During perimenopause, fluctuating estrogen and progesterone make your body more sensitive to blood sugar spikes. That means sugary tea-time snacks, skipped meals, or carb-heavy dinners now hit harder.

Try this:

• Build each meal with 20–30g of protein (eggs, dal, tofu, paneer, chicken, fish)
• Add healthy fats like ghee, seeds, or nuts
• Prioritise fibre from vegetables and whole pulses
• Eat within a 10–12 hour window (e.g. 8am–6pm) to support insulin sensitivity

The North American Menopause Society recommends protein-rich, low-glycaemic meals to support hormone balance and reduce fatigue during perimenopause.

2. MOVEMENT: Don’t Just Burn Calories – Build Resilience

Many women try to “outrun” weight gain in their 40s with intense cardio. But overtraining – especially without enough recovery – spikes cortisol and worsens the very symptoms you’re trying to fix.

Instead, aim to:

• Walk daily (especially after meals)
• Strength train 2–3x/week to build lean muscle and support metabolism
• Try restorative movement like yoga, mobility work, or Pilates once a week

A 2022 paper in Frontiers in Endocrinology confirmed that strength training improves insulin sensitivity, reduces visceral fat, and supports hormonal balance in perimenopausal women.

3. SLEEP: Anchor Your Cortisol to Restore Energy

In perimenopause, your ability to fall – and stay – asleep often takes a hit. Cortisol starts rising at the wrong times. Melatonin production may dip. And even when you get 8 hours in bed, you wake up groggy.

Restore rhythm by:

• Getting 10–15 minutes of morning sunlight within an hour of waking
• Avoiding caffeine after 2pm
• Eating dinner by 7:30pm to avoid sleep-disrupting blood sugar swings
• Dimming lights and screens after 8pm
• Using 4-7-8 breathing or gentle breathwork before bed

4. STRESS: Learn to Downshift – Even When Life Doesn’t

Emotional load increases in your 40s – family, work, aging parents, growing kids – and your nervous system can’t buffer it the same way anymore. Chronic stress lowers progesterone, worsens estrogen dominance, and fuels the tired–wired cycle.

Daily stress resets to try:

• 5 minutes of breathwork before lunch
• One 10-minute break without screens or stimulation
• A walk with music or silence (not a podcast!)
• Saying no – and meaning it

Even short, consistent rest rituals reduce cortisol and inflammation. Dr. Sara Gottfried writes extensively about how nervous system regulation is key to hormonal balance in perimenopause.

You’re Not Lazy. Your Body’s Just Shifting.

Perimenopause can sneak up in strange, subtle ways – tiredness, brain fog, mood swings – and too often, it gets brushed off or blamed on you. But these changes are real. And they’re not permanent.

You don’t need a dramatic overhaul. You need a little more patience. A little more awareness. Just start noticing what your body is trying to say – and meet it with steady, realistic steps.

This isn’t a breakdown. It’s a turning point.
Your body’s evolving – and all she wants is for you to start paying attention.