Perimenopause: All the Symptoms of Pregnancy without the Cute Baby

I know there are some of you out there that felt better when pregnant. If so, I’m sure hoping perimenopause takes your physical and mental health soaring as well. 

I personally did not feel great as a pregnant woman.


On my third pregnancy, I even wrote a letter instructing myself to NEVER do this again, listing out all the terrible symptoms as a reminder.

But with pregnancy comes the knowing that there will be an end to the suffering. That the end result will be an adorable baby.

And so despite my letter, I still had a fourth child. 

Overall, I found some similarities with the symptoms of pregnancy and perimenopause (my current phase of life). Here is what I experienced.


When I initially started to feel “off,” in my mid-forties, I tried counseling. And eventually I decided to try an SSRI (see “Why I Tried Anxiety Medication at 45″).

This certainly helped the anxiety. And I didn’t have other physical symptoms of perimenopause at that time for about a year.


For me, the physical symptoms of perimenopause mimicked pregnancy. 

A missed period was a tell-tale sign that something was hormonally different. Then I would be very nauseated if I didn’t eat, and I was often very hungry.

And the fatigue.

Bone-deep tiredness. I found myself sleeping 11-13 hours on the weekends, and barely being able to function with 9-10 hours during the week.

My kids grew very accustomed to me needing a nap anytime we drove somewhere further than two hours away.

I didn’t have any time to do “life.” My life was sleeping, and I knew this issue wouldn’t be resolved in nine months.

Did it make sense that stressors in my life might be making me more tired?


My daughter had cancer. I have four teenagers. But I could just feel that this fatigue was more than mental strain. 

And then the night sweats.

Initially, they only occurred a couple times, before my cycle. But as my cycle became more irregular, so did the night sweats. I’d wake up one or two times a night, completely drenched, about 30% of nights. 

Please note: Night sweats can also be a symptom of other health conditions, so be sure to discuss any night sweats with your primary care provider.

Looking for a Cause & Treatment

Initially, when my isolated symptom was fatigue, my primary care provider (PCP) had me schedule a sleep study.

But when the other symptoms occurred, she scheduled some labs on very specific days of my cycle. I found out that hormone levels fluctuate throughout a woman’s cycle. So you cannot just “have your hormones tested” at any time.

These labs showed that I was certainly in perimenopause, with only slightly diminishing estrogen levels.

My provider and I discussed the pros and cons of hormone replacement, and I started a birth control pill with a low dose of estrogen.

The pill caused acne, spotting in between my cycle, and some abdominal discomfort. My PCP expects that these side effects will diminish as my body adjusts.

But all of those side effects are worth it for me, because I’m no longer sleeping my life away.

How I’m Feeling Now

I still like a good 9-10 hours of sleep on the weekend when I can get it, because it’s a little treat I like to give myself! But on the weekdays, I don’t wake up thinking about when I’ll be able to go back to sleep. I’ve driven to Minot and the Twin Cities without napping! And I haven’t had a night sweat since starting the pill. 

Other women describe perimenopause symptoms of being unable to sleep, weight gain, mood changes, along with the fun of an irregular, unpredictable cycle. And perimenopause typically begins for women in their 40s and lasts an average of four years.

I’m sorry, but I wasn’t going to feel like a pregnant lady for FOUR YEARS.  

Perimenopause: There’s More to Learn

As a health care provider myself (I’m a physical therapist), let me assure you that we cannot read all the latest research and attend trainings on every specialty and condition.

Many providers have very little training and knowledge in the area of perimenopause. It’s not a life-threatening condition, and it happens to all women, therefore it’s just not high on the priority list for continuing education for providers. 

For this reason, I highly recommend that you transition to a provider certified by the North American Menopause Society; their website contains a provider locator

I’m happy to report I have gained about 9-10 hours a week back to myself. Self-care beyond sleep? Yes please!

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Erika has worked in the educational setting as a physical therapist for 17 years, after attending UND and NDSU. After recognizing difficult behaviors in her third child, she became an advanced trainer of the Nurtured Heart Approach®. Professionally, Erika is also a mentor, course-captain, and clinical instructor, and has served students in the Autism magnet program for 10 years. She recently served on the Pediatric Advisory Board for Curriculum Development at UND, and on a task force with the Department of Instruction to create the first school-based PT/OT guidelines in the state. She also is a mentor with BioGirls, leads a group of teenage boys at confirmation, leads a Girl Scout troop, and has coached baseball. For the past two Mother’s Days, Erika has hosted a Neighborhood Chalk Party, an event designed to further build relationships in neighborhoods on the principle of “it takes a village to raise a child.” She was born and raised in Hankinson, ND, and has lived in the Fargo area for over 25 years with her husband (who you may know as the radio DJ on Bob 95 FM: "Chris, John and Cori in the Morning"). Together they have four children: girl-boy-boy-girl, ages 10-16. Erika is passionate about empowering kids, preventative health, hiking, and national parks.


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