The Word That Scares Me a Little

Perimenopause. Even typing it feels strange, like a word that belongs to someone older, someone else, not me. But lately it’s everywhere. My friends say it over coffee, half joking, half not. The women around me who are a little older bring it up like something they wish someone had warned them about sooner. And if I’m honest, it scares me a little.

A few weeks ago I watched Mel Robbins interview Dr. Mary Claire Haver, an OB/GYN who specializes in menopause, and something she said stuck with me.

Perimenopause can start as early as your 30s, years before anyone is thinking about it, and most doctors were never actually trained on it in depth. That’s not a small gap. That’s most of the medical system quietly under-preparing for something that affects roughly half the population.

I’m noticing small things in my own body now that I didn’t used to. The belly fat that used to respond to training and eating well doesn’t move the same way it used to, even when nothing else about my routine has changed. Some nights I wake up at midnight for no obvious reason, wide awake, and lie there for an hour before falling back asleep.

Individually, these feel like nothing. Together, they’ve made me curious enough to actually look into what’s happening.

What’s Actually Behind It

As estrogen and progesterone start to fluctuate, sometimes years before periods become irregular, the effects show up in ways that don’t always get connected back to hormones. Estrogen influences insulin sensitivity and where the body stores fat, which is part of why fat distribution can shift toward the midsection even without changes in diet or exercise (Davis et al., 2012, Journal of Clinical Endocrinology & Metabolism). Sleep disruption is common too, hormonal shifts affect the body’s temperature regulation and can fragment sleep, including waking in the middle of the night without an obvious trigger (Baker et al., 2018, Sleep Medicine Clinics).

None of this means something is wrong with you. It means your body is in an actual, measurable transition, one that’s been under-researched and under-discussed for a long time.

Why the Research Gap Is Real

Historically, most exercise and metabolic research was conducted on men, or on women without accounting for hormonal life stages at all. Dr. Stacy Sims, a researcher who has spent years focused specifically on women’s physiology, has pointed out that training and nutrition advice built for a 25-year-old body doesn’t automatically apply once hormones start shifting. That gap is finally starting to close, but slowly, and mostly because more women are asking the questions their doctors weren’t trained to answer.

What I’m Actually Doing About It

I’m not waiting for symptoms to get worse to take this seriously. I’m reading more, asking my own doctor more specific questions instead of accepting “that’s just aging,” and paying attention to my training and nutrition through this specific lens instead of a generic one. Strength training in particular is one of the most well-supported interventions for the metabolic shifts of perimenopause, it directly supports insulin sensitivity and muscle mass at exactly the stage where both start to matter more.

The Takeaway

Perimenopause isn’t a distant, later-in-life event. For a lot of us, it’s already quietly starting, and the fact that it feels scary or unfamiliar is mostly because we were never given the information early enough to expect it. I’d rather know now and prepare than be caught off guard later.

As within, so without.

References

• Davis, S.R., et al. (2012). Understanding weight gain at menopause. Journal of Clinical Endocrinology & Metabolism, 97(4), 1218-1225.

• Baker, F.C., et al. (2018). Sleep and menopause. Sleep Medicine Clinics, 13(3), 443-456.