Have you ever wondered if you’re in perimenopause?
You are not alone!
Many women struggle to get a clear answer because there isn’t a single test that can confirm it. Our hormones fluctuate so much during this transition that a one-time blood, urine, or saliva test often isn’t helpful. Even the popular DUTCH test, which measures hormone metabolites, can’t definitively diagnose perimenopause.
So how do you know?
A menopause-informed clinician (like me!) should be able to recognize perimenopause based on your symptoms, history, and age—and most importantly, by listening to you. Unfortunately, too many women are dismissed or told their symptoms are “just aging” or “all in their head.”
The Perimenopause Diagnosis Puzzle
Perimenopause is the extended transitional stage leading up to menopause, triggered by fluctuating estrogen and progesterone levels. It typically starts in your 40s, but for some, it can begin as early as the mid-30s. The length varies, lasting anywhere from 2 to 10 years (with an average of 4 years).
Since there’s no definitive test, ruling out other conditions that mimic perimenopause—such as thyroid disorders, anemia, insulin resistance, musculoskeletal conditions, and autoimmune diseases—IS KEY! From there, a diagnosis is made by recognizing the cluster of symptoms you’re experiencing.
Some of the most common perimenopausal symptoms include:
✔️ Irregular periods (shorter, longer, heavier, or skipped cycles)
✔️ Hot flashes & night sweats
✔️ Sleep disturbances & fatigue
✔️ Mood changes, anxiety, or irritability
✔️ Brain fog & memory issues
✔️ Weight gain, especially around the midsection
✔️ Changes in hair, skin, and nails
✔️ Low libido & vaginal dryness
✔️ Muscle & joint pain
The challenge? Symptoms can fluctuate day to day, making it hard to see patterns—unless you track them.
How to Track Perimenopause Symptoms Effectively
Many women don’t realize they were in perimenopause until they’re looking back at the changes in hindsight. That’s why tracking your symptoms in real time can be incredibly helpful for understanding what’s happening in your body and getting the support you need.
Here are some key tracking tips:
📝 Track consistently – Log your symptoms regularly, not just on bad days. Key things to track: the total number of days in the cycle, including bleeding and non-bleeding days, PMS symptoms, hot flashes, sleep quality.
📊 Include frequency, intensity, and duration – A simple “yes/no” checkmark won’t show patterns.
⏳ Notice patterns over time – Symptoms like hot flashes or brain fog may ebb and flow rather than be constant.
⚖️ Avoid obsessing – Your cycle and symptoms will vary, and that’s normal.
📱 Use a symptom journal or tracking app – This makes it easier to share details with your doctor.
If you’re on birth control or don’t have a cycle due to an IUD or hysterectomy, tracking is still valuable (but sometimes can be tricky!) Pay attention to shifts in your energy, sleep, mood, and body instead.
What’s Next? Creating Your Perimenopause Health Strategy
Once you start seeing patterns, you can take action. Every woman’s path through perimenopause is unique, so your hormone health strategy should be personalized. Depending on your symptoms and goals, you might explore:
🌿 Lifestyle shifts – Nutrition, stress management, and movement to support hormone balance
💊 Targeted supplements – Adaptogens, magnesium, or omega-3s can help with specific concerns
🧬 Support your body’s foundation – Calm your nervous system, nurture your gut microbiome, support liver health, and address micronutrient deficiencies. (This is where Functional Medicine lab testing comes in because it helps you identify your “hot spots.”)
🩺 Prescription options – If needed, bioidentical hormone therapy (BHRT) may be indicated – even if you are still having periods! This is something I offer in my practice.
Most importantly, you deserve to be heard and supported. If you’ve been dismissed or told “everything looks fine” when you don’t feel fine, keep advocating for yourself.
Would you like personalized guidance? I’ve been developing a comprehensive hormone therapy program to help women navigate perimenopause with clarity and confidence. If you’re looking for tailored support, reply to this email or schedule a time to chat—I’d love to help you “stop guessing.”
To your very best health,
Dr. Jennifer Horton, DO, ABFM, IMFCP
Peace and Calm Health Functional Medicine
P.S. I cannot wait!!
Exciting news! My Hormone Lifestyle Reset Program is coming to Flow Yoga Studio starting March 27! This program goes beyond metabolism and weight loss—it’s designed to help you improve sleep, digestion, and energy while supporting your hormones.
NEW – It also includes three exclusive yoga workshops (led by me!):
🧘♀️ Restoring Calm: Hormones, Sleep & Stress Relief
🌿 Gut Check: Optimizing Digestion for Hormonal Harmony
🔥 Release & Rejuvenate: Lower Inflammation, Boost Your Metabolism
Curious? Join me for a FREE Q&A at Flow Yoga Community (in person or online) on March 9, 3:45-4:45 PM. [Link to register HERE.]
