Many women in their late 30s, 40s — and for some, even into their 50s — start noticing perimenopause symptoms they can’t quite explain.
Sleep shifts.
Mood feels off.
Periods become unpredictable.
Libido goes up, down… or disappears for a bit.
And your body just doesn’t feel the same.
For a lot of women, no one has actually explained why.
If you've ever found yourself googling "perimenopause symptoms" or "early signs of menopause", you're not alone.
And that can feel confusing.
So let’s talk about what’s really going on.
Because when you understand your body, things start to make a lot more sense — and that alone can take some of the fear out of it.
Perimenopause Symptoms: The Fluctuation Phase
Perimenopause is the transition leading up to menopause — and it can last for years.
During this time, estrogen and progesterone don’t just slowly decline.
They fluctuate.
Up, down, all over the place.
Which is why you might feel completely fine one month…
and totally off the next.
Common symptoms can include:
- Irregular or heavier periods
- Hot flashes or night sweats
- Anxiety or mood shifts
- Brain fog
- Sleep issues
- Breast tenderness
- Joint aches
- Vaginal dryness
-
Changes in libido
Some months you feel like yourself. Other months, not so much.
That inconsistency? That’s your hormones recalibrating. Not you falling apart.
Menopause: The 12-Month Mark
Menopause is officially diagnosed after 12 months without a period.
At that point, estrogen levels settle into a lower, more consistent place.
You may notice:
- Vaginal dryness
- Less natural lubrication
- Slower arousal
- Sleep disruption
- Skin and hair changes
- Metabolic shifts
-
Lower libido
And let’s just say this clearly—
Low libido does not mean your sexuality is gone.
It usually means your body needs something different now.
Desire can start to feel different during this phase - sometimes, lower, sometimes
inconsistent and sometimes just... not there at all.
And sometimes, simple support - like using the right kind of lubricant or adding more direct
stimulation - can make a significant difference.
If you're not sure where to start, I go deeper into this in
Let's Talk Lube
What About Testosterone?
Women have testosterone too — not just men.
It’s made in the ovaries and adrenal glands, and it plays a role in:
- Desire
- Energy
- Motivation
- Orgasm intensity
Testosterone levels gradually decline starting in your 30s, so by the time you reach menopause,
they’re often lower than they used to be.
So yes — hormones matter.
But they’re not the whole story.
Sleep, stress, medications, relationship dynamics, body image, and overall health all play a role in desire too.
This isn’t just one thing.
Supporting Your Body Through These Changes
If something feels off, you don’t have to just “deal with it.”
A lot of women choose to talk with their gynecologist or a functional medicine provider to better understand
what’s happening in their body.
That might include checking hormone levels and talking through options like:
- Estrogen (patches, creams, or vaginal support)
- Progesterone
-
Testosterone therapy (creams or pellets, in some cases)
For some women, this can make a big difference — especially with things like sleep, vaginal dryness, energy, and libido.
For others, focusing on stress, lifestyle, and nervous system support is just as impactful.
There’s no one right path here.
This isn’t about “fixing” your body.
It's about working with it instead of against it.
So let’s just simplify this for a second:
Perimenopause is the transition.
Menopause is the milestone.
Postmenopause is everything after that twelve month mark - your new baseline.
Your body isn’t failing you.
It’s changing.
And when you understand what’s going on, it starts to feel a lot less confusing — and a lot less overwhelming.
This isn’t the end of your sexuality.
It just means your body responds differently now… and may need something different too.
In Part 2, we’re going to talk about something that doesn’t get discussed enough—
How sexual activity (including masturbation) actually supports vaginal health, blood flow, and libido during this stage.
And we're going to talk about it - because it matters.
Because pleasure isn’t something you age out of.
It’s something you learn to experience differently.
With care and intention,
Risa Katz, LCSW, FMCHC
Founder, Pleasure Treasurz
Where pleasure is normal, natural, and yours.
