Perimenopause & menopause: where to start.
Sleep that falls apart, 3am waking, hot flashes, mood swings, weight around the middle, cycles that change. The transition is normal; the symptoms don't have to be. The path: progesterone, sleep, strength and the labs by phase.
Three steps, in order.
What perimenopause actually is, what changes first, and why sleep is the lever.
Sleep, mood, cycle, temperature — see which system leads.
Read these first.
From The Dr. Axe Show.
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Women's Health: Hormones, Nutrition and Training Through Every Life Stage
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Sleep, mood, temperature and cycle symptoms — see which system leads and the first step.
Open the toolStraight answers.
Why do I wake at 3am in perimenopause?
Progesterone falls first and it's calming; add a blood-sugar dip overnight and cortisol spikes. A protein-and-fat snack before bed, magnesium, and testing progesterone in the luteal phase are the first moves.
What labs should I ask for in perimenopause?
FSH, estradiol and progesterone timed to your cycle, a full thyroid panel, ferritin, vitamin D, fasting insulin — and a bone density scan if you're over 45 or have risk factors.
Is HRT right for me?
A decision for you and your clinician, informed by symptoms, timing and risk. The lifestyle foundation — sleep, strength, protein, magnesium — helps whichever way you decide.