Why do I smell different? Navigating Perimenopause: Understanding Symptoms and Building a Supportive Action Plan

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Perimenopause is a significant transition that every woman experiences differently. It’s often shrouded in confusion, partly because it can start earlier than many expect and because its symptoms can be surprising. As a Registered Dietitian with over 17 years of experience working with women, I’ve seen firsthand how this stage can affect not just your body but also your mind and overall well-being. Let’s explore what perimenopause is, some less common symptoms you might experience, and actionable steps you can take to support your body during this transition.

When Does Perimenopause Start?

Perimenopause typically begins in a woman’s 40s, but for some, it can start as early as the mid-30s. The duration varies widely—lasting anywhere from a few months to a decade—before transitioning into menopause (defined as 12 consecutive months without a period). I have had clients as young as 35 tell me they feel symptoms of perimenopause like decreased libido and hot flushes and those aged 45 tell me they are just starting to smell differently, and have increased rage and irregular periods. The hormonal fluctuations during perimenopause can lead to a range of symptoms, some of which are widely recognized (like irregular periods and hot flashes) and others that might surprise you.

Uncommon Symptoms You Might Experience

While many women expect the classic signs, perimenopause can show up in more subtle and less talked-about ways. Here are some of the lesser-known symptoms:

Increased Anxiety and Panic Attacks: Even if you’ve never struggled with anxiety before, perimenopause can trigger unexpected mood shifts and heightened feelings of worry or panic due to fluctuating estrogen levels. If you already struggle with anxiety or panic attacks and drink caffeine check out this blog post on Anxiety and Caffeine.

Joint Pain and Stiffness: Hormonal changes can lead to inflammation, resulting in joint aches, stiffness, or even carpal tunnel syndrome.

Heart Palpitations: Surges in hormones can cause irregular heartbeats, which can be alarming if you don’t know what’s behind them.

Burning Mouth Syndrome: A lesser-known symptom where the mouth, tongue, or lips feel persistently hot or painful.

Electric Shock Sensations: Some women describe feeling brief, sharp zaps or tingling sensations, often around the head, triggered by fluctuating estrogen levels.

Building an Action Plan for Your Health During Perimenopause

Managing perimenopause symptoms involves a holistic approach that targets key areas of your health. You are not alone and for sure should speak with your physician or OBGYN about your symptoms. Some medications can be helpful with some of these symptoms to ease your transition. You are your best advocate and you get to decide what you do to ease these symptoms. Here’s an action plan focusing on four foundational aspects of well-being:

Hormonal Balance: Prioritize foods and lifestyle practices that support stable estrogen, progesterone, and cortisol levels. This includes consuming a diet rich in phytoestrogens (found in flaxseeds, soy, and legumes) and reducing processed foods and those high in sugar that can spike insulin levels.
Gut Health: A healthy gut is super important for hormone metabolism. Incorporate fiber-rich foods, probiotics, and fermented foods to support digestion, aiding the balance of hormones. Make half of your plate non-starchy vegetables with lunch and dinner to ensure you’re getting enough fiber.
Stress Management: Cortisol (your primary stress hormone) can wreak havoc on other hormones during perimenopause. Implement stress-reducing practices like mindfulness, yoga, and ensuring adequate sleep. Another area that lots of women struggle with is decreasing alcohol. We know that alcohol is a toxin (womp, womp). I know, I know, most of my clients don’t want to hear this either and lots of women use alcohol to cope with stress and anxiety. BUT if you’re truly concerned with your health and making your menopause transition as smooth as possible eliminating or significantly limiting your intake of alcohol is where it’s at.
Nutrient Replenishment: Perimenopause can increase nutrient needs, particularly for B vitamins, magnesium, omega-3s, and vitamin D. Ensuring you’re not deficient in these is crucial to managing symptoms like fatigue, mood swings, and sleep disturbances which are some of the MOST common symptoms women feel when they start perimenopause.

Why Work with a Nutrition Professional?

Perimenopause is highly individual. Could you look up information on the Internet? Yes, of course. But that would be just what it is. It doesn’t mean it’s specific to you and it certainly doesn’t mean that the person who wrote it is credentialed or qualified to give advice on it. As a Registered Dietitian with over 17 years of experience and a Certified Diabetes Care and Education Specialist (we specialize in hormonal shifts (insulin/cortisol) I provide my clients with personalized guidance tailored to their specific symptoms and lifestyle. By assessing blood work, identifying nutrient gaps, and understanding your unique stressors, I can help craft a nutrition wellness plan that supports smoother transitions through this stage.

Foods that Support Hormones

Supporting your physical and mental health through nutrition is one effective way to mitigate perimenopausal symptoms. Here are five nutrient-dense snack ideas that can help:

Flaxseed and Berry Smoothie: Flaxseeds are rich in lignans, which are phytoestrogens that can help balance estrogen levels. Paired with antioxidant-rich berries, this smoothie supports hormone metabolism and gut health.
Avocado with Pumpkin Seeds: Avocados provide healthy fats and B vitamins, which are crucial for managing stress and hormone production. Pumpkin seeds are high in zinc, supporting progesterone levels and reducing anxiety.
Greek Yogurt with Walnuts and Ground Cinnamon: This snack offers a balance of protein and healthy fats. Walnuts contain omega-3 fatty acids, supporting brain health and reducing inflammation. Cinnamon helps stabilize blood sugar, preventing insulin spikes that can disrupt hormone balance.
Hummus with Carrot and Cucumber Sticks: Chickpeas in hummus are a good source of phytoestrogens, with fiber-rich veggies supporting gut health, and aiding in the detoxification of excess hormones.
Almond Butter on Apple Slices: Almonds are high in magnesium, which can ease symptoms like irritability and sleep issues. Paired with fiber-rich apples, this snack provides sustained energy without spiking blood sugar.

Moving Forward with Confidence

Perimenopause doesn’t have to be a time of suffering or confusion. With the right strategies in place, including targeted nutrition, stress management, and professional support (and your gynecologist), you can navigate this transition with greater ease.

Sending you patience and peace,

Jackie