If you’ve been Googling your symptoms at midnight wondering if you’re losing your mind — welcome. You’re probably not. You might just be in perimenopause.
And before you say “but I’m only 38” — yes, it can start that early. Most women expect perimenopause to arrive somewhere around 50 with a dramatic entrance and a hot flash. In reality, it tends to sneak in the side door years earlier, wearing the disguise of anxiety, bad sleep, and jeans that no longer fit the way they used to.
So what does it actually look like in the beginning?
Your Sleep Goes Sideways
Not necessarily full-blown insomnia — more like waking up at 3am for absolutely no reason and staring at the ceiling until your alarm goes off. Progesterone, one of the first hormones to dip in perimenopause, is your calming, sleep-supporting hormone. When it starts to decline, your nervous system notices. You might feel wired but tired, restless at night and exhausted by 2pm.
Your Mood Has Opinions
If you’ve been feeling irritable, anxious, or emotionally flat in a way that doesn’t quite match your circumstances — that’s a clue. Estrogen plays a significant role in serotonin production, so as levels start to fluctuate (not just drop — fluctuate wildly, which is the hallmark of perimenopause), your mood goes along for the ride. Women often describe this as feeling like PMS that never fully goes away. Or just… not feeling like themselves.
Your Cycle Gets Weird
Perimenopause doesn’t usually start with skipped periods. It often starts with cycles that are slightly shorter, heavier, or just off in a way you can’t quite put your finger on. You might ovulate less consistently, which means progesterone dips even further. Some months feel fine. Others feel like your body is running a completely different program.
Your Brain Feels Like a Browser With 47 Tabs Open
Brain fog is one of the most common — and most dismissed — early symptoms of perimenopause. Forgetting words mid-sentence. Walking into a room and having absolutely no idea why. Struggling to concentrate in a way that feels new and unsettling. Estrogen supports cognitive function, blood flow to the brain, and memory. When it starts to shift, so does your mental sharpness.
You’re Gaining Weight Without Doing Anything Differently
This one gets women the most. You haven’t changed what you eat or how much you move — but your body composition is quietly shifting, particularly around your midsection. This happens because fluctuating estrogen affects insulin sensitivity, cortisol, and how your body stores fat. Eating less and exercising more often makes it worse, not better. (I know. It’s deeply unfair.)
So What Do You Do With This?
First — trust yourself. If something feels different in your body, it probably is. The fact that your labs came back “normal” doesn’t mean you’re imagining it. Standard bloodwork often misses the fluctuations that define early perimenopause entirely.
Second — find someone who will actually look. Functional medicine testing goes deeper than a basic hormone panel. It looks at the full picture: cortisol patterns, thyroid function, nutrient levels, inflammation markers — all the things that contribute to how you feel day to day.
You don’t have to white-knuckle your way through the next decade. This transition can be navigated — with the right support.
Think you might be in perimenopause? Let’s talk. Book a free discovery call with Dr. Jena and get an honest answer about what’s going on.
About the Author: Dr. Jena Hullman, DC is a functional medicine practitioner and chiropractor with over 20 years of clinical experience. She specializes in perimenopause care for women 35–55, using advanced functional lab testing to identify root causes and build personalized hormone support plans. She sees patients in person in Traverse City, Michigan and virtually nationwide.
