Is This Perimenopause? Symptoms and Relief for Women Over 40

If Your Group Chat Looks Like This, You’re Not Alone

“Is anyone else waking up at 3 a.m. every night?”

“Why am I gaining weight when I haven’t changed anything?”

“I walked into a room and completely forgot why I was there.”

“Does anyone else feel exhausted ALL the time?”

“Why can I suddenly not handle wine anymore?”

“Also… is anyone actually interested in sex these days?”

If your group chat has started sounding a little like this, you’re definitely not the only one.

I spend a lot of time talking to women in their late 30s, 40s and early 50s, and some version of these questions comes up again and again.

Usually, it’s not one dramatic symptom that makes a woman think maybe this is perimenopause.

It’s more like…

• You’re waking up at 3 a.m. for no apparent reason.
• Your clothes are fitting differently, even though you haven’t really changed how you eat or exercise.
• You can’t find a word you’ve used approximately 47,000 times in your life.
• You’re tired. But also somehow not sleeping.
• Your patience is… not what it used to be.
• And the things you’ve always relied on to feel good don’t seem to be working quite the same way anymore.

Eventually, you start wondering:

Is this just what happens in your 40s?

Not exactly.

But there are some very real changes happening during this stage of life.

Yes, perimenopause can affect more than your period. 

Here are some other perimenopause symptoms:

Perimenopause is the transition leading up to menopause, when hormones including estrogen and progesterone begin fluctuating. It typically begins in the mid-40s, although some women notice changes as early as their late 30s or early 40s. 

And while changes to your menstrual cycle may be one of the more obvious signs, they’re certainly not the only ones. Sleep is a big one.

Sleep in Perimenopause: Why are you waking in the night?

Research from the long-running Study of Women’s Health Across the Nation (SWAN) found that insomnia symptoms affected roughly 31-42% of perimenopausal women at annual assessments, with symptoms becoming more common in later perimenopause.¹

And those middle-of-the-night wake-ups that seem to be happening in every group chat? Waking several times during the night was the most commonly reported sleep problem in SWAN research, and difficulty staying asleep increased as women progressed through the menopause transition.²

Brain fog in Perimenopause

You may already be noticing it. Losing words. Walking into a room and forgetting why you’re there. Feeling like your brain has 17 tabs open and you can’t quite find the one that’s playing music.

A large 2026 study of more than 14,000 women aged 45–55 found that perimenopausal women were more likely to report cognitive symptoms than premenopausal women. Interestingly, there was very little difference in objective cognitive performance.³

So yes, the experience of brain fog is real. Send this blog post to anyone who doubts it.

But no, it doesn’t necessarily mean your brain is suddenly failing you.

I’m doing everything the same, so why is my body changing?

This might be one of the most frustrating parts of this stage of life.

Because most of the women I work with aren’t doing nothing.

Quite the opposite.

They’re exercising.

They’re trying to eat well.

They’ve added more protein.

They’re walking.

They’ve listened to the podcasts and followed the health accounts.

They may have had bloodwork done, bought some supplements and tried changing their workouts.

They’re trying.

Which is why it can feel particularly frustrating when their body still doesn’t seem to be responding the way it used to.

There’s some interesting research behind this.

A study following women through the menopause transition found that around the beginning of the transition, the rate of fat gain doubled while lean mass began to decline. These changes continued through approximately two years after the final menstrual period. Interestingly, overall body weight didn’t suddenly accelerate in the same way.⁴

That’s an important distinction.

Because the scale isn’t always telling us what’s actually changing.

You can weigh roughly the same and have less muscle and more body fat than you did several years ago.

And that’s one of the reasons I talk so much about strength training and protein. I know your Instagram feed is probably telling you the same thing. But I’m not trying to sell you a protein powder. Maintaining muscle really does matter as we age — for strength and function, metabolic health, bone health and our ability to stay independent later in life. 

I’m much less interested in helping a woman chase a smaller number on the scale than I am in helping her build a body that is strong, metabolically healthy and capable of supporting the life she wants to live for decades to come. 

The problem isn’t that you haven’t found the right perimenopause checklist

This is where I think things get unnecessarily complicated.

Because once you start searching for answers, you quickly discover approximately 4,732 things you’re apparently supposed to be doing.

• Eat more protein.
• Eat fewer carbs.
• Fast.
• Definitely don’t fast.
• Lift heavy.
• Walk 10,000 steps.
• Do less cardio.
• Take creatine.
• Take magnesium.
• Track your glucose.
• Fix your cortisol.
• Try hormone therapy.
• Stop drinking wine.
• Get eight hours of sleep.
• Meditate.
• And don’t forget to reduce your stress.

Easy, right?

Except you also have a career.

Maybe kids.

Possibly aging parents.

A household.

Relationships.

A social life you’d actually like to enjoy.

And an already very full calendar.

Your health cannot become another full-time job.

And I think this is where a lot of women get stuck. They don’t necessarily need more health information, they need help figuring out which information actually matters for them.

Hormones matter. But they’re not happening in a vacuum.

Hormonal changes may absolutely be part of what you’re experiencing.

And for some women, discussing hormone therapy and other treatment options with their healthcare provider is an important part of the conversation.

But I also don’t think we do women any favours by blaming every change after 40 on hormones.

Because your sleep, nutrition, movement, stress, recovery and hormones are all interacting.

Maybe hormonal changes are disrupting your sleep and now you’re exhausted.

Being exhausted makes it harder to exercise.

It also makes you crave quick energy in the afternoon, or drink another coffee to get through your workday.

And when you get home depleted you order dinner because you can’t even contemplate cooking.

Then you’re annoyed with yourself because you were supposed to work out and meal prep.

And now someone on Instagram is telling you that your problem is cortisol.

This is why I like to zoom out.

What’s actually going on in your life and your body right now?

Not what should you be doing.

Not what your friend is doing.

Not what worked for you at 32.

What do you need now?

So where do you actually start to relieve perimenopause symptoms?

Before trying to change everything, I’d look at a few fundamentals.

How are you sleeping?

Not just how many hours you are in bed. Are you waking frequently? Are you waking rested? Has your sleep changed over the past few years?

Are you eating enough of what your body needs?

Particularly protein, fibre and nutrient-dense foods. Sometimes the answer isn’t eating less. It’s eating differently.

Are you building and protecting muscle?

Strength training becomes increasingly important in midlife. More cardio isn’t automatically better.

What does your stress and recovery actually look like?

Not “Do you meditate?”

Does your body ever actually get a chance to recover from the pace of your life?

And is there anything else we need to investigate?

Not everything that happens in your 40s is perimenopause.

Fatigue, sleep disruption, mood changes and changes in weight or body composition can have other contributors too. Sometimes a medical assessment is an important part of figuring out what’s going on.

You don’t need to be perfect in every one of these areas.

You need to figure out where your biggest opportunities are.

And then start there.

Next Steps: You need an action plan you can stick to that fits your life

And I know that knowing where to start is often the hardest part.

Maybe you’ve brought some of these concerns to your healthcare provider but haven’t really gotten the answers or support you were hoping for. Or you’ve found plenty of advice online, tried adding more protein, changing your workouts, taking a new supplement or improving your sleep — but you’re still not sure whether any of it is actually right for you.

And even when you do know what you want to change, there’s still the challenge of actually following through when work gets busy, your kids need you, you haven’t slept well, or life just… happens.

That’s the gap I see so many women getting stuck in. It’s not that they don’t care about their health or aren’t trying hard enough. They need help making sense of all the information, deciding what matters most for them, and turning it into something they can realistically do and sustain.

This is a big part of why I created Total Health Reset.

The women I work with are very capable women.

They’re used to figuring things out.

They’re smart. They’re motivated. They care about their health.

And in many cases, they already know a lot about what they “should” be doing.

The problem isn’t a lack of information.

It’s figuring out how all of the pieces fit together for them.

Total Health Reset is my personalized 8-week coaching program where we do exactly that.

We look at your nutrition, movement and strength, sleep, stress, symptoms, routines and the reality of your schedule.

This isn’t another plan you’re handed and then left to figure out on your own. We build it together, around your health, your goals and your actual life. Then we adjust as we learn what works for you.

We figure out what’s working, what’s getting in the way, and what deserves your attention right now.

Because I’m not interested in creating the perfect plan for a hypothetical woman who has unlimited time to exercise, cook and sleep eight uninterrupted hours every night.

I’m interested in creating one that works for you.

Because ultimately, I don’t want you spending your 40s constantly wondering whether you’re doing enough for your health.

I want you to know what matters, feel confident in what you’re doing and have a way of taking care of yourself that you can actually sustain.

And ideally, feel a whole lot more like yourself again.

If you read those group-chat messages at the beginning and thought, Wait… are you in my group chat? then it might be time to stop trying to piece all of this together on your own.

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References

1. Ciano, C., King, T. S., Wright, R. R., Perlis, M., & Sawyer, A. M. (2017). Longitudinal study of insomnia symptoms among women during perimenopause. Journal of Obstetric, Gynecologic & Neonatal Nursing, 46(6), 804–813. 
2. Kravitz, H. M., Zhao, X., Bromberger, J. T., Gold, E. B., Hall, M. H., Matthews, K. A., & Sowers, M. R. (2008). Sleep disturbance during the menopausal transition in a multi-ethnic community sample of women. Sleep, 31(7), 979–990.
3. Naysmith, L. F., Ward, H., Elliott, P., Atchison, C., Hellyer, P., Denno, P., Williams, S. C. R., & Hampshire, A. (2026). Cognition and the menopause transition: Cross-sectional evidence from a large community cohort. npj Women’s Health, 4, Article 14.
4. Greendale, G. A., Sternfeld, B., Huang, M., Han, W., Karvonen-Gutierrez, C., Ruppert, K., Cauley, J. A., Finkelstein, J. S., Jiang, S.-F., & Karlamangla, A. S. (2019). Changes in body composition and weight during the menopause transition. JCI Insight, 4(5), e124865.