The Change is Normal (But Hard Nonetheless)

“My body is a mess,” I told my nurse practitioner. “I’m bloated, my cycle is crazy off, I’m getting some of the worst headaches I’ve ever had, and I’m so irritable. One minute I’m fine and the next I’m crying. I’m so moody and I notice that I’m super forgetful too.”

When I finished listing off my complaints and concerns, she said quite matter of factly, “Perimenopause. That’s what’s going on.”

We reviewed my symptoms again, including my irregular bleeding, and determined I needed some further testing, but it was pretty clear. I was entering a new stage in life. 

Although women begin experiencing perimenopause at different ages, the signs leading toward it—such as menstrual irregularity—typically begin in your 40s. Some women notice changes in their mid-30s, others experience it later. And what might those signs of perimenopause be?

The biggest change a woman will notice is that her menstrual cycles may lengthen or shorten. The level of estrogen in her body rises and falls unevenly during menopause, thus the irregular and sometimes brutally heavy (or barely there) periods. If you have a persistent change of seven days or more in the length of your menstrual cycle, you may be in early perimenopause. If you have a space of 60 days or more between periods, you’re likely in late perimenopause. 

Perimenopausal women also experience menopause-like symptoms, such as hot flashes, sleep problems, urinary urgency, joint pain, weight gain, hair loss or thinning, and vaginal dryness. Oh joy! Don’t forget mood swings, irritability, decrease in sex drive, difficulty concentrating and remembering things, and possibly mild depression. But hold on, most women don’t experience all the possible symptoms of perimenopause (I had to leave several off the list)! So before you totally panic, just know that perimenopause in your body will look different than someone else’s. 

I’m smack-dab in the thick of perimenopause and it stinks (to be honest). The good news is, I did find a doctor who is helping me through this new phase of life. I also sought out a friend who is an expert on nutrition and exercise in women going through perimenopause. Her resources have been invaluable to me as I seek to stay physically and emotional fit during this season in life. 

Honestly, I’ve found the best resource of perimenopause to be the wisdom of women who’ve been “through it.” These are women who are ten, fifteen, thirty years older than myself, who are open about their “own change” and how it impacted them. 

On the field, I often found women of all ages eager to talk about their life experiences, including their health issues. Perhaps this is because I’m a nurse, so it seems a little more natural, I’m not sure. I do know, talking about our bodies is one way women connect and can find support. Hearing other women’s experiences with perimenopause makes me feel not so alone; it reminds me that I’m normal. THIS is normal. The changes in estrogen, the hot flashes and headaches, the long days between periods, are normal. This is how I was made. 

My perimenopause journey is unique to me, but I take comfort in the fact that I am not alone. Talking openly with my husband about it, and even our older kids has helped all of us navigate this new phase with grace and patience. Asking advice from my older female friends and doing some research online has also been extremely helpful for getting the support I need. Most importantly, God is certainly not surprised by the changes happening in my body, and like a loving mother, is holding me graciously through this period in my life (couldn’t resist the pun). Even though the symptoms of perimenopause are not the best, it is a time to reflect and embrace the changes my body is going through. I can praise God that my body is doing what it is designed to do. I am fearfully and wonderfully made! 

Depending where you are in the world, there may or may not be resources at your fingertips for support during perimenopause. But I would encourage you to talk about it with others—perhaps in a Connection Group, with a female mentor, or a friend back home who is a doctor or nurse. And again, there are lots of resources online—including what is normal and NOT normal during perimenopause (like when the bleeding is TOO much, go to the doctor!). Seeking out a good OB/GYN in-country might be a helpful step you want to take as well. No matter what, just know you are not alone during “the change.” 

We women are in this together!

Have you experienced perimenopause? If so, please consider sharing how it impacted you and what advice you might offer women how are going through it.

Photo by Annie Spratt on Unsplash


  1. Michele September 12, 2021

    I’ll go first! I started perimenopause mid-thirties, and finally went into menopause at age 48. There isn’t a ton of research or information on perimenopause, so it’s good to know that any symptom of menopause can actually start ten years plus BEFORE your periods do, so you don’t wonder what’s wrong with you!

    I would add a couple of symptoms to the list you gave because I didn’t know these were symptoms and was a little nervous about what was going on until I found them in lists of menopause symptoms: Restless legs, intense itching under the skin (I thought I had a parasite or something!) and weird nerve pain/achiness that’s hard to describe (I am not a hypochondriac- hardly go to the doctor, but I started wondering if I had fibromyalgia)! I hope others will add to the list of symptoms because it’s so varied and it just helps to know that something you’re experiencing is likely just hormones and will pass.

    One tip I would give is to adjust your diet, exercise and sleep routines according to your body’s changing needs- and accept that your body’s needs are changing! I think it’s a good idea to change your supplements too if you can. I use Menopause One by Rainbow Light and discovered when I ran out for a while during lockdown last year, that it does make a difference. I started it in late perimenopause and it helped balance my moods and reduce hot flashes, etc.

    1. Ellie September 13, 2021

      Wow, Michele that was really helpful actually because I have been having more restless legs and weird shooting nerve type pain and I was worrying because an uncle died of motor neurone disease and I’m fairly sure the Drs thought that I was just neurotic when I asked about it but it’s quite intense and it’s good to hear that it can be a symptom of perimenopause because I definitely have some other symptoms (am in my early 40s) so that would tie up. 🙂

      1. Michele September 14, 2021

        So glad that clicked for you! It’s such a relief to realize, Ohhhh- it’s just THAT!

    2. Monica F September 14, 2021

      Michele! Thank you for sharing your experience and your tips– I totally agree with adjusting your diet, exercising and getting into a good sleep routine. I also take supplements for perimenopause, and will look into the one you have recommended. Thank you so much for sharing your symptoms as well– I have definitely had some of those achy pains as well. Your comment is so helpful to all of us!

  2. Karen Huber September 13, 2021

    Perimenopause has been my unhappy companion on the field the last 3 years. Absolutely debilitating physically and emotionally, and even moreso during a move, family crisis, AND a global pandemic which shut down all public health in our country for months. I’ve had to come to terms with saying no to things because of “lady troubles”, but also being open about the reality of ageing on the field with trusted friends and colleagues. I had NO idea pm was even a thing until I experienced it, most likely because no one spoke about it. Like ever! I’m so glad we’re talking about it here, and hoping that some find encouragement and camaraderie along the way.

    I will say, a few bits of advice I would give to women and their families going through this while serving full time overseas:

    1) Prioritise your own healthcare. If you’re not feeling great and you don’t know why, seek out help in any way you can. Go to the GP, chat with your member care, schedule a trip home if you need to. But don’t put yourself last. And if things don’t improve, follow up.
    2) Don’t change insurance companies if you’re about to turn 40. WAIIIIIIIITTTTTT. Or else, every period problem you have will be preexisting. Ask me how I know. :/
    3) Say no or take your time, unashamedly. Perimenopause is absolutely a chronic health issue. It will not go away for a good while. Pace yourself, rest yourself, lean into the fallow season if at all possible. If you’re haemorrhaging 3 out of every 4 weeks, there’s no reason to be out in harvesting fields. Let the young ones do it. 😉

    1. Monica F September 14, 2021

      Karen, my heart goes out to you, and I totally resonate with what you have shared. I was pretty vague in my post about my personal symptoms, but after weeks of passing clots and almost needing to go to the ER, my primary care doc finally took what was happening to me seriously. Ironically, during the last two years of my perimenopause we’ve moved twice, changed insurance twice, and I’ve been working as a nurse during the pandemic. It’s been really, really hard. And the insurance thing has been a nightmare (as you say in your comment). I feel like you’ve “seen me”! And yes, to taking care of yourself, saying “no” and pacing oneself. Thank you, thank you, thank you for your comments here. So good.

  3. Grace L September 13, 2021

    I experienced perimenopause for most of my 40’s. And between 49 and 51 I went through a very emotional menopause. I would often be seen up at the altar rail after church weeping uncontrollably, seeking prayer and comfort. And add to that, I hit menopause just as my son turned 13 and went through puberty. My years of perimenopause were challenging but I was mostly functional other than the intense migraines. No, that’s not totally true. It was okay for about 1 week out of 4 each month.

    And just to note, this was all happening before I went on the field. Yes, I was 53 when God called me to serve in Asia long term. By this time I was more emotionally stable because I had been taking HRT for 2 years. Having my hormones come into better balance was like night and day for me. I was no longer having my periods and no longer dealing with menopause symptoms. I felt great, and I still do.

    When I was going through PM and M I read a book by Gail Sheehy called “The Silent Passage”. It helped me a lot to see that what I was experiencing was normal. But what I liked the most was the last chapter which was all about being a post menopausal woman. The author shared many testimonies from post menopausal women who talked about what a wonderful season of life it was to be past all the hormones and the periods. That gave me hope to be able to persevere through it. And it has been true in my situation. My post menopausal life has been wonderful. Serving overseas for 20 years including getting married in my mid-fifties and serving together with my husband. I encourage all who are struggling with this to take it easy on yourselves and to look forward to a much better season in life coming up.

    1. Michele September 14, 2021

      Grace, that is so encouraging- thanks! I was actually SO relieved when I hit menopause because perimenopause went on forever (probably 12-15 years for me). I’m coming out the other side now with just a few random symptoms here and there- and, I’m realizing- a change in heat tolerance(?) I haven’t heard anyone speak so positively about the post-menopausal years, but have been optimistic, nonetheless. This just confirms and makes me so excited for what’s ahead.

      1. Grace L September 14, 2021

        Yes, be excited about what lies ahead. It will get better. Post-menopausal life is a season in which women can bloom. It’s a wonderful season in which to be used by God. I am 76 now and am still active in advancing God’s kingdom, just not overseas anymore. Be hopeful!

    2. Monica F September 14, 2021

      Thank you for this encouraging note Grace…I appreciate how raw you were in your sharing with us. Thank you for the resource and advice as well. It’s so wonderful to hear from others so we don’t feel so alone!

      1. Grace L September 14, 2021

        Praying for God’s grace for you and all the others dealing with perimenopause. It was during this season of my life that I really grabbed onto 2 Cor. 12:9-10 – “My grace is sufficient for you, for My power is made perfect in your weakness. Therefore I will boast all the more gladly about my weaknesses, so that Christ’s power may rest on me. That is why, for Christ’s sake, I delight in weaknesses, in insults, in hardships, in persecutions, in difficulties. For when I am weak, then I am strong.

        Thank you, Monica, for sharing this challenging topic with us.

  4. Phyllis September 17, 2021

    I recently turned 41, and I almost feel like we need a private Facebook group or something for discussing all this!

  5. Monica F September 19, 2021

    I’m so glad this post has sparked so much discussion and advice! This would make for a good support group:)

  6. Grace L September 19, 2021

    Yes, Monica. That is a good suggestion. And there are at least several of us who are on the other side who could cheer you on. I am not committing to get involved with much these days but I would be willing to be one to be one to stand on the sidelines to encourage. I have no medical background, but the experience of walking with God through a challenging time that so many women go through. Thank you, Monica, for sharing so openly about your experiences and helping to spark this conversation.

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