I’m a Natural Health Practitioner. I Still Almost Missed My Own Perimenopause

Samantha Stupak is a natural health practitioner and the CEO of CBH Energetics.

The year my body started rewriting the rules

I'm 45, and if you had asked me a few years ago what perimenopause looked like, I would have described hot flashes, maybe some night sweats, and a missed period here and there.

That was about all anyone ever told women my age. If your mom's generation was anything like mine, they mostly white-knuckled through it without saying much.

What showed up for me looked nothing like that. I started waking around 3 a.m. with my mind already racing, my knees ached on morning walks for no obvious reason, and I'd lose a word mid-sentence in conversations I could normally have in my sleep. Each change felt small and separate enough to explain away, so I did, for longer than I'd like to admit.

I've spent more than a decade as a natural health practitioner looking at the patterns behind people's symptoms, and I still didn't connect my own dots right away. That says a lot about how little of this we were ever taught to recognize.

That's a big part of why I'm grateful to be in it now. For the first time, women in perimenopause are starting to have better research, language, and … each other.

Why this is a good time to be in it

For most women, perimenopause gets underway somewhere in their 40s, and the first small hormonal shifts can show up as early as the mid-to-late 30s. It can last anywhere from a few years to more than a decade before menopause hits.

For generations, women moved through those years with hardly any explanation for what was happening and even less support. Over the past couple of years, that has started to shift significantly.

Research on women's midlife health is growing, long-held assumptions about this stage are being revisited, and even federal health agencies have updated how they talk about menopause care. All of it is opening up conversations in practitioners' offices that many of us were never invited into.

And social media has blown the doors wide open too. Women are openly sharing what they’re going through, and each social media post, podcast, or 3 A.M. group chat makes it easier for the next woman to recognize herself sooner than I did.

The signs that are easy to miss

Hot flashes get most of the airtime. But these are the shifts I am seeing from clients in their late 30s and 40s and in myself.

Anxiety that comes out of nowhere

Many women describe a new edge of worry, irritability, or dread that doesn't match anything going on in their lives. Research shows the risk of depressive symptoms climbs noticeably during perimenopause and settles back down after menopause. That timing points to the hormonal ups and downs of this stage as a real driver, which means these feelings deserve genuine attention and support.

Sleep that unravels at 3 a.m.

Many women tell me they drift off easily and then wake in the early hours with their minds already racing. I spent months blaming that 3 a.m. wake-up on my schedule before I saw the pattern. Sleep problems become far more common during the menopause transition. Progesterone has a naturally calming effect, and as it starts to dip, that deep, steady sleep gets harder to hold onto. Add high cortisol from everyday stress, and you get the exhausted-all-day, wired-at-night feeling so many of us know well.

Brain fog and the missing word

You walk into a room and forget why, or reach for a word you use every day and come up empty. For me, it was names and everyday nouns, usually mid-sentence, usually in front of people.

My clients describe it in remarkably similar ways. Some say it feels like wading through a swimming pool to get to what they want to say. Others describe a cloud sitting over their thoughts, or a word hovering right on the tip of their tongue that won't quite land. What they're noticing is slower thinking, as if their brain is running a half-step behind where it used to be. They read the same paragraph three times, lose the thread of a conversation halfway through, or blank on the name of a coworker they've known for years.

This is the sign I find most fascinating, because so much of it comes down to what estrogen does in the brain. It helps keep your brain fueled, and it’s especially busy in the areas that handle memory, focus, and pulling up the right word when you need it. It also supports the brain chemicals that keep your memory sharp and your mood steady. So when estrogen starts swinging, those areas feel it, and CBH Brain Scans of women in perimenopause actually show those shifts happening.

What I love telling women is that the brain adapts. For most of us, things settle down after menopause, and memory tends to bounce back.

Achy joints and stiff mornings

For me, it was my knees. I'd head out for my usual morning walk and spend the first ten minutes feeling about twenty years older than I am, with no injury and nothing about my routine that had changed.

Most women deal with some joint or muscle symptoms during this transition. Estrogen helps keep joints, muscles, and connective tissue resilient, so the stiffness many women chalk up to “getting older” often has a hormonal component.

A cycle that changes the rules

Cycles may shorten or lengthen, periods may become heavier or lighter, and the whole rhythm may become less predictable. A cycle that shifts by a week or more and stays that way is an early marker. Tracking your cycle alongside your symptoms can reveal patterns that are invisible month to month.

New reactions to food, wine, or allergy season

This is one I see constantly with clients, and most women have never connected it to perimenopause until now.

Someone who has enjoyed a glass of red wine with dinner for twenty years suddenly gets flushed cheeks and a pounding head after half a glass. Aged cheese, cured meats, or last night's leftovers start leaving her congested, itchy, or bloated. Spring allergies hit harder than ever, and some women notice hives, a racing heart, or a wired feeling at night with no obvious trigger.

In my experience, histamine is often part of the story. Histamine is best known for its role in allergies, and it also plays a part in digestion, inflammation, and keeping your brain alert. That last piece is one reason high histamine can make it harder to stay asleep, which ties right back to those 3 a.m. wake-ups.

Estrogen and progesterone both influence mast cells, the immune cells that store and release histamine. Estrogen can rev them up while progesterone helps calm them down. When estrogen swings high as progesterone falls, there's more histamine in circulation and less of a brake on it.

I like to explain it as a bucket. Hormones, stress, seasonal allergies, and histamine-rich foods all pour into the same one. For years, yours may have had plenty of room. In perimenopause, the hormone side fills it faster, so the glass of wine that used to be fine is suddenly what makes it spill over. Many women notice it most around ovulation or in the days before their period, when the balance tips toward estrogen. Once you see the pattern, it becomes much easier to work with.

Looking at the whole picture

From a holistic standpoint, perimenopause symptoms rarely trace back to one hormone acting alone. Hormones work as a network, and estrogen and progesterone are in constant conversation with cortisol, thyroid hormones, insulin, and the nervous system. When one shifts, the others feel it.

In my practice at CBH Energetics, we look at several layers together when someone is in this stage:

• Hormones as a set. Progesterone often starts declining before estrogen does, which can leave estrogen relatively dominant even while overall levels fluctuate. Many of the signs above live in that gap.

• Stress load. Cortisol and the sex hormones share building blocks and pathways, so years of running on stress can make the transition feel much louder.

• Nutrients. Magnesium, vitamin B6, zinc, boron, and vitamin D all support mood, sleep, bones, and hormone pathways. When they run low, poor sleep, cramps, low mood, and rougher PMS tend to stack on top of the hormonal changes.

• Environmental load. Everyday exposures from plastics, fragrances, and household products can interact with hormone signaling and add to what the body is already managing.

A few places to start right now

• Write it down. Keep a simple log of sleep, mood, aches, cravings, and where you are in your cycle. Two or three months of notes can reveal a pattern faster than any single appointment.

• Protect your sleep window. A consistent bedtime, a cooler room, and less alcohol and screen time in the evening go a long way as progesterone shifts.

• Feed your muscles and joints. Protein at every meal and some form of strength training help support the muscles and bones estrogen used to protect.

• Notice your histamine load. If wine, aged cheese, or leftovers suddenly bother you, cut back for a few weeks and notice what changes.

• Find people who take you seriously. Look for a practitioner with menopause training or a holistic provider who looks at the full picture, and bring your notes.

Perimenopause can feel like your body is rewriting the rules without telling you. These days, if I’m up at 3 a.m., or a word slips away mid-sentence, I know what’s happening, and that alone takes so much of the worry out of it. The upside is that we’re going through it at a time when we finally have each other.

If any of this sounds familiar, write it down, take it seriously, and find someone who will look at the whole picture with you. This stage deserves curiosity and a lot of kindness, and now is a great time to give it both.

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