When Pernicious Perimenopause Makes You Feel Like a Stranger. 

About a month ago, one of my best friends – who also happens to be an OB/GYN – said something that stopped me in my tracks:

“People always talk about hot flashes and dry vaginas, but it’s so much more than that.”

I laughed, but the truth of her words settled deep.  Because this season I’m in – it’s not just about physical symptoms.  It’s about a shift that I can’t quite put my finger on.

I’ve read all the inspiring takes on perimenopause – how this is a time of awakening, of stepping into power, of shedding old expectations and embracing a new version of ourselves. And I want to believe that.

But right now?  I’m still in the messy middle and calling bullshit on the whole “awakening” thing.

It didn’t happen all at once.

There was no dramatic turning point, no clear sign that something was shifting.  It was subtle at first – so subtle that I barely noticed.  A little more fatigue than usual.  A little more irritation over things that never used to bother me.  Sleep that wasn’t quite as restful.

I told myself it was stress.  That I just needed to take better care of myself.  But, wait…I’m an expert in health and well-being, I’m a physician, I’m a superwoman…aren’t I?  

But then it got worse.  Despite quitting alcohol, meditating daily, taking care of my body with nutritious habits, exercise, time outside…something was very “off”.  

My body didn’t seem to be responding the way it used to.  My mind felt foggy at times, my emotions were unpredictable and I’ve been so, so tired.  

Then, an uninvited guest suddenly showed up to my party.  Her name is Anxiety and she’s a real bitch.  Turns out my hormones invited her when I wasn’t looking.  

Luckily, I have some great women in my life, a doctor who listens and understands (and a super supportive husband) who have helped me navigate all of this.

So, if you find yourself thinking “I just don’t feel like myself right now” – read on. 

What’s Actually Happening in Our Bodies?

Perimenopause – the transition leading up to menopause – can start years before we expect it. It can begin as early as our late 30s or early 40s, sometimes even a full decade before menopause officially arrives.

Menopause itself is just one day – it’s the point when we’ve gone 12 consecutive months without a period.  But perimenopause?  That’s the long, unpredictable road leading up to it.

During this time, estrogen and progesterone levels start fluctuating wildly – sometimes dropping, sometimes surging – causing a ripple effect throughout the body.  These hormonal shifts impact:

    The brain → leading to brain fog, forgetfulness, anxiety, and mood swings.

   The nervous system → making us more sensitive to stress, overwhelmed more easily, or unable to tolerate things that never used to bother us.

    The metabolism → slowing down, leading to weight changes and energy fluctuations.

    Sleep cycles → making restful sleep harder to come by, with middle-of-the-night wake-ups that feel impossible to fix.

    The cardiovascular system → leading to heart palpitations, temperature fluctuations, and blood pressure shifts.

And yes, hot flashes, night sweats, low libido and vaginal dryness can be part of it – but they don’t define the experience.  The real struggle?  It’s the feeling that we’re losing control over a body and mind we used to understand.

The Part No One Talks About

We hear about the symptoms, but we don’t talk enough about what it feels like to be in this transition.

We don’t talk about the quiet grief of feeling like a stranger in your own body.

We don’t talk about the exhaustion that doesn’t go away with sleep.

We don’t talk about the way anxiety sneaks in, even when nothing is wrong.

We don’t talk about how hard it is to articulate what’s happening when you don’t fully understand it yourself.

And maybe the hardest part?  No one prepares you for how alone it can feel.

If you’re struggling, you’re not alone.

I used to push through exhaustion – that’s a lot harder to do right now. 

I used to feel really in-tune and self-aware – now, I feel like I’m waiting for a familiar version of myself to reappear.

But here’s what I’m starting to realize: maybe I’m not supposed to go back to who I was before.  Maybe there were some red flags popping up that I shouldn’t have been ignoring.  Maybe this isn’t about getting back to anything – it’s about becoming something new.

I don’t have all the answers yet, but I do know this:

•     You are not crazy, and you are not alone. Your experience is real. Your emotions are valid.
•     This transition is not just physical – it’s personal. It’s an identity shift as much as it is a hormonal one.
•   There are things that can help – nutrition, movement, stress management, sleep support.
•     There are treatment options available – Hormone Replacement Therapy (HRT) may be a great option for certain women.  There are also natural supplements and alternative therapies like acupuncture which may help. This doesn’t have to be a battle we fight alone.
•    You don’t have to rush through it.  You don’t have to have it figured out yet.
•     There is something on the other side of this.  I may not be there yet, but I believe that. And maybe, just maybe, the struggle is part of the transformation.

The Rebirth of You?

Perimenopause isn’t the end of you.  It’s a transition.  A messy, frustrating, confusing one – but still, just a transition. 

Maybe we won’t wake up one day and suddenly feel like our old selves again. But perhaps we’re not meant to. 

Maybe we’re evolving into something new – something stronger, wiser, and more resilient. 

Maybe we just need to give ourselves grace, find the people who truly get it, and remind each other that we are still us – even if we don’t fully recognize ourselves yet.

For now, I’m still trying to make peace with it all.  And if you are too, you’re not alone…you ARE a superwoman.