Is it Perimenopause? 5 Signs you shouldn't wait for your period to stop

Many women are starting HRT even before they've stopped having a period.

When I was in my mid to late 30's I just thought I had grown to hate my then husband. Looking back, I'm sure that perimenopause was the cause of my rage and why no matter what he did or how hard he tried to please me, I was never happy. Those were not my best years. Needless to say, we divorced.

Perimenopause is the time period and phase leading up to menopause. It is the time when the ovaries gradually produce less estrogen and progesterone, but they don't do it smoothly—they do it in erratic "spikes and crashes."

Here are the 5 Signs to look for to confirm and know you are likely in that Perimenopause stage.

Sign 1: You can't stay asleep, and you feel a new, baseline "hum" of anxiety during the day.

Sign 2: Your cycles are getting shorter (e.g., 21 days instead of 28), significantly heavier, or you’ve started skipping a month here and there.

Sign 3: You feel "spaced out," lose your train of thought mid-sentence, or feel like you have to work twice as hard to stay productive.

Sign 4: New or worsening aches in your hips, knees, or small joints (like fingers) that don't have an obvious injury-related cause.

Sign 5: A feeling of "white-hot rage" or irritability that feels like PMS on steroids, but it lasts all month long.

HRT or Hormone Replacement Therapy is the practice of replacing the hormones that our bodies are no longer able to produce naturally.

The Estrogen Rollercoaster: What's actually happening to your Hormones in your 40's?

Trust me, you are not going crazy. It's biology and you just need understand how yours works. When you are in your 20's and 30's your brain and ovaries have polite and friendly conversations. When you hit your 40's, your ovaries begin to lose their "hearing." As a result, your body pumps out too much estrogen.

In addition, progesterone which is needed to balance estrogen, begins to decline. Without enough progesterone, you may find yourself in estrogen dominance which causes anxiety. At this time, it's not uncommon for estrogen to be 3X higher than normal and a few days later it could be at near-zero levels.

Then to add to that when your sex hormones, estrogen, progesterone and testosterone are chaotic, that causes your cortisol and insulin to join the party. The result of this is what causes "Menopause Belly" or you may be finding that you can't handle your alcohol and sugar like you used to.

My current, and favorite HRT to date, is Oestra by Inner Balance. It's one product, administered one time per day. Use PEGGY10 for 10% off.

Is This Normal? Common Questions About Perimenopause Symptoms at 40+

The Symptom	Questions	The Scientific Truth
Anxiety/Rage	"Why am I so angry/anxious in my 40s?"	The Serotonin Slide: Fluctuating estrogen directly affects serotonin and GABA levels, lowering your "patience threshold" and amping up the fight-or-flight response.
Insomnia	"Wide awake at 3 AM every night"	Progesterone Deficiency: Progesterone is your "nature's Valium." As it drops in early perimenopause, your brain loses its ability to stay in deep sleep.
Brain Fog	"Early onset dementia at 45"	Glucose Metabolism: Estrogen helps the brain use glucose for fuel. When levels dip, the brain essentially "stutters," causing memory lapses and word-finding issues.
Joint Pain	"Sudden knee/hip pain no injury"	Estrogen as Anti-Inflammatory: Estrogen is a natural joint lubricant. Dropping levels cause systemic inflammation, leading to "Menopausal Arthritis."
Heart Palpitations	"Heart skipping a beat at night"	Autonomic Flux: Erratic estrogen "zaps" the autonomic nervous system, which controls heart rate, often mimicking a panic attack or heart issue.
Frozen Shoulder	"Shoulder pain and stiffness 40s"	Adhesive Capsulitis: There is a strong correlation between estrogen decline and inflammation of the shoulder capsule, a classic "hidden" perimenopause sign.
Skin Changes	"Suddenly itchy skin and hives"	Histamine/Collagen Drop: Estrogen supports collagen and regulates histamines. Low levels lead to "formication" (feeling of bugs crawling) and thinner, itchier skin.
Heavy Bleeding	"Period like a crime scene"	Estrogen Dominance: Without enough progesterone to thin the uterine lining, estrogen keeps building it up, leading to "flooding" or heavy clots.
Burning Mouth	"Metallic taste or burning tongue"	Nerve Sensitivity: Estrogen receptors in the oral mucosa decline, affecting saliva production and making the nerves in the mouth hypersensitive.
Dry Eyes	"Why are my contacts so irritating?"	Meibomian Gland Dysfunction: Hormones control the oil glands in your eyelids. Without that oil, your tears evaporate too fast, leaving eyes gritty and red.

Why "Waiting it Out" Can Impact Your Long-Term Health

I have found that most of us think you have to wait for your period to completely stop before you are a candidate for Menopause Hormone Replacement Therapy or MHT also known as HRT (Hormone Replacement Therapy). That is not the case.

Low hormones during this time, before you officially hit menopause can cause structural damage to your heart, bones and brain. Starting HRT before you've stopped having a period can be key to aging well during this phase of your life. Estradiol which is one form of Estrogen is what most of us think of for HRT, but most of us (if you still have a uterus) also need Progesterone to balance the estrogen and to help with sleep and anxiety.

Benefit	Estradiol	Progesterone
The Brain	Sharpens memory & focus	Calms anxiety & aids sleep
The Body	Stops hot flashes & joint pain	Regulates heavy bleeding
Your Future	Protects heart and bones	Protects uterine lining
Mood	Boosts "happy" chemicals	Promotes "chill" and relaxation

How to Find an Online HRT Provider: Getting Menopause Treatment from Home

Telehealth for perimenopause is mainstream in 2026. Most GYN's are surgeons and know nothing or very little about hormones. You may find that yours dismisses your symptoms or just brushes you off and tells you that you are too young and because you are still having a period, you don't qualify. That's simply not the case.

It is because most GYN's are not educated on hormones, perimenopause and menopause that women suffer needlessly. But not any more.

I have tried seven of the most popular online, telehealth Hormone Replacement Providers and break down in my blogs and trusted providers page how each does business and what you need to know before you make a decision on who gets the honor of helping you navigate this stage of your life.

You likely want to know, how do they do business, do they take medical insurance, can you use prescription insurance for medications, will you get a one-on-one consultation and many other questions? I address all of these questions in the HormoneTherapyHub website.

I've been on HRT since I was 52, so for 6 years and don't ever plan to stop! I feel better and by combining my HRT with a GLP-1, I've gotten down to the weight that makes me happy.

Is it Perimenopause? 5 Signs you shouldn't wait for your period to stop

Is It Perimenopause? Stop Guessing and Start Healing. If you recognized yourself in these 5 signs, you don't have to wonder anymore. Speak with an online HRT provider today to see if hormone replacement therapy is the missing piece of your puzzle.

Trusted online Hormone Replacement Therapy Providers

I've tried troches that melt under your tongue, topical HRT creams, patches, pills and vaginal inserts. Currently I'm using Oestra by Inner Balance and I love it! I'm getting the best sleep of my life and all of my symptoms are gone. I feel better today than I did ten years ago.