#perimenpause

At some point in your 40s, you’ll probably ask yourself one of the following questions:

Why am I suddenly wide awake at 3 a.m. for no reason?

Where did this weight come from and why won’t it go away?

Is it just me, or am I more anxious, more irritable, and less focused than I used to be?

Do I just need to “get it together,” or is something actually happening in my body?

If any of that sounds familiar, I’m going to say something no one said to me when I needed to hear it:

You’re probably in perimenopause.

It doesn’t matter if you’re still getting a period.

It doesn’t matter if you’re in “good shape” or eating clean.

It doesn’t matter if your bloodwork came back normal.

Hormonal shifts in your late 30s and 40s can disrupt everything: sleep, mood, energy, memory, metabolism…

And yet most women are never told what’s happening, let alone what to do about it.

This week on The Tamsen Show, I spoke with Dr. Heather Hirsch, one of the top menopause specialists in the country.

We talked about why women are so often blindsided by perimenopause and what real support should actually look like.

Here are a few things I learned from our conversation that every woman in her 30s and 40s should hear:

1. Perimenopause is not menopause. It’s the years leading up to it, and they can be the hardest.

You don’t have to have hot flashes to be in it. You don’t have to stop getting your period. You don’t even have to “feel old.” These years are marked by fluctuating hormones, not the total drop-off that happens later. That’s why symptoms feel so inconsistent.

2. If you’re dismissed, it doesn’t mean you’re wrong. It might just mean your doctor wasn’t trained.

Dr. Hirsch shared that most doctors receive little to no education on perimenopause. And if you look okay “on paper,” it’s easy to be sent home without a plan. But feeling awful with “normal” labs doesn’t make you dramatic, it makes you human.

3. Hormone therapy is part of the conversation, but it’s not the only one.

Some women benefit from HRT. Others don’t need it. What matters is having an informed discussion with someone who understands the full picture. This shouldn’t be a taboo topic or a last resort.

4. You don’t need to wait until you’re in crisis to get help.

Most of us were taught to tough it out. But preparing for perimenopause the way we prepare for pregnancy, or even a career transition, can change the game. It gives you time to track patterns, explore options, and make choices before things feel unmanageable.

Here’s the real takeaway: if you’re in your 40s and feeling off, don’t gaslight yourself.

You’re not imagining it, you’re not overreacting and you’re definitely not alone.