9 Symptoms of Perimenopause

Perimenopause doesn’t usually show up all at once — and it rarely looks the way most of us expect.

For many women over 40, the first signs are subtle. Easy to overlook. Easy to explain away as stress, work, or “just getting older.”

In this video, I walk through 9 perimenopause symptoms women over 40 shouldn’t ignore — and how they often begin quietly, long before you realize what’s really happening in your body.

I’m Kimberly Hoyt, a physician assistant with over 20 years in medicine, and I’m walking through this season right alongside you. If you’ve been thinking something feels different, this video will help you connect the dots.

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Medical Disclaimer:
The information shared on this channel is for educational and informational purposes only and is not intended as medical advice. Kimberly Hoyt, PA-C, and associated content are not a substitute for professional medical care, diagnosis, or treatment. Viewing this content does not establish a patient-provider relationship. Always consult your own healthcare provider before making changes to your health plan, starting supplements, or addressing medical concerns.

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Medical Disclaimer: The information shared on this channel is for educational and informational purposes only and is not intended as medical advice. Kimberly Hoyt, PA-C, and associated content are not a substitute for professional medical care, diagnosis, or treatment. Viewing/Listening to this content does not establish a patient-provider relationship. Always consult your own healthcare provider before making changes to your health plan, starting supplements, or addressing medical concerns.

General Disclaimer: I am not a CPA, attorney, insurance/real estate agent, contractor, lender, or financial advisor. The content in these episodes shall not be construed as tax, legal, financial advice, or other and may be outdated or inaccurate; it is your responsibility to verify all information yourself. This is a podcast for entertainment purposes ONLY.

Episode Transcript

Kimberly Hoyt (00:00):
Perimenopause doesn't always announce itself

(00:03):
with dramatic hot flashes ormissed periods.
For most of us, it sneaks inquietly.
Your cycle shifts a little bit,sleep feels different, your
energy dips, and you startthinking what is going on with
my body?
I'm Kimberly Hoyt, a physicianassistant who's been practicing
for over 20 years and.

(00:23):
A woman in her forties walkingthrough these changes right
alongside you.
And honestly, I've beensurprised at how subtle some of
these first signs for me were.
It's easy to blame stress orwork or just getting older, but
these little changes are yourbody's way of saying.
Hey, something's shifting.

(00:43):
In this video, we are breakingdown nine perimenopause symptoms
every woman over 40 shouldn'tignore, and how often they start
long before you realize what'sreally happening.
And stick around because numbernine is one most women would
never connect to perimenopause,but it might explain a few

(01:05):
things you've been noticing.
All right.
Number one, hot flashes andnight sweats.
Hot flashes don't always startas full body firestorms.
Early on, they can feel likerandom, warm waves.
Maybe your cheeks or your chestheat up for a few seconds, or
maybe you wake up slightlysweaty and just wonder if the

(01:26):
thermostat was off.
Later, they turn into thoseclassic whole body surges,
sometimes followed by a chill.
Why is this happening?
Estrogen helps regulate yourinternal thermostat.
When it starts swinging, yourbrain can overreact to tiny
temperature changes.
You're not broken.
Your body is just testing somenew settings.

(01:47):
Number two, period changes yourcycle is one of the first things
to shift.
Maybe it shows up a few daysearly or a few days late.
Maybe it's heavier one month andlighter the next.
At first, it's easy to shrugthis off as maybe I'm just a
little stressed, but thosesubtle shifts mean your hormones

(02:08):
are losing their perfect rhythm.
Your ovaries don't release anegg every month now, which
lowers progesterone, the hormonethat keeps your lining stable.
So when estrogen runs the show,your period can do all sorts of
things, come early, last longer,hit heavier.
This is your body's rhythmchanging.

(02:29):
It's not just misbehaving.
Number three, sleep problems.
You fall asleep, fine, butsuddenly it's 3:00 AM and you're
wide awake.
You scroll, you toss.
Maybe fall asleep for a fewhours before the alarm clock
hits.
That's often how it begins.
Not full insomnia.
Just those middle of the nightwake up that make mornings

(02:51):
harder.
Here's why.
Progesterone, the calminghormone that helps you stay
asleep, starts dipping.
Add in some of those smalltemperature changes or a little
bit of stress, and your brainthinks it's time to problem
solve instead of rest.
So next time you're awake at3:00 AM remember, it's not just

(03:12):
stress, it's hormones doing somenight duty.
Number four, mood shifts.
This one's kind of sneaky.
Maybe you're more irritable, abit more anxious, or tears come
easier than they used to.
Later, the swings can get alittle bit stronger.
Big waves of frustration orsadness that catch you totally

(03:33):
off guard.
Estrogen and progesterone bothtalk to your brain's mood,
chemicals, your serotonin, yourdopamine, your gaba.
When those hormones fluctuate,your emotions can too.
So if you feel off, it's notweakness, it's just the
chemicals.
Number five, vaginal dryness anddiscomfort.

(03:55):
You might notice intimacy feelsdifferent.
Maybe a little drier, maybe morefriction.
At first, it's mild.
Later it can turn intoirritation or even pain.
That happens because estrogenkeeps those tissues hydrated,
elastic, and supple.
As levels dip, there's lessmoisture and less cushion.

(04:17):
It's extremely common andabsolutely treatable.
Moisturizers, lubricants andlocal estrogen can restore
comfort fast.
You don't have to push throughthe pain.
Number six, which goes alongwith this lower sex drive.
You still love your partner, butthat spark just takes a little
bit longer to light.
You need more rest, moreconnection or calm before that

(04:40):
desire shows up.
That's normal.
As sleep, stress and hormoneschange.
So does the libido.
It's not gone.
It just needs a little extrafuel.
Addressing sleep, stress, andcomfort brings it back.
if any of this sounds familiar,take a second to like this video
and subscribe.
It helps more women realize thatthey're not alone.

(05:03):
Okay, moving on.
Number seven, brain fog.
Ever forget what you walked intothe room for.
Lose a word, mid-sentence.
That's perimenopausal brain fog.
It starts small, little lapses,tiny hesitations.
Later it can feel like.
Focus and memory just aren't assharp.

(05:24):
Estrogen supports your brain'smemory circuits, so when it
dips, and especially when sleepsuffers, those circuits just lag
a little bit.
Your brain's not broken.
It's just kind of buffering, andonce those hormones settle in,
clarity returns.
Number eight, fatigue.
That deep bone tired feelingthat doesn't match what you

(05:46):
actually did today.
That's that perimenopausalfatigue early on.
It's mild, slower mornings,harder afternoons.
Later it can feel like no amountof coffee helps.
Hormone shifts throw offcortisol.
The stress energy hormone, sleeploss, and mood strain pile on.

(06:08):
Your body isn't lazy.
It's just asking for recovery.
And number nine.
This one is crazy to me.
Aches and joint stiffness.
Your hands, your shoulders, yourknees, they can just feel
stiffer than they used to.
Estrogen helps keep inflammationin check, so when those levels

(06:28):
fall off, joints can feelcreakier or sore.
You didn't suddenly age 10 yearsovernight.
It's just another hormonalripple.
Movement, hydration and strengthtraining helps a lot here.
There are some common thingsthat we see in perimenopausal
women that you may not relate toperimenopause.

(06:49):
Frozen shoulder is one thatshows up around this time, and
plantar fasciitis type symptomscan be a ripple effect from
these hormone changes.
All right.
We made it through those ninesymptoms.
Now, perimenopause doesn'thappen overnight, and it's
different for everyone.
These symptoms aren't a signthat your body's falling apart.

(07:12):
They're your body communicating.
If you're over 40 and arestarting to notice even a few of
these, like your cycle changing,sleep acting up, mood shifting,
it's time to listen and supportyour body in new ways.
And we're just getting started.
In my next video, we're divinginto the unusual symptoms of

(07:32):
perimenopause that no one istalking about, but every woman
should know.
So make sure you subscribe andturn on your notifications, and
if this video helped you connectthe dots, please share it with a
friend.
You might help her do the same.