Is this perimenopause? Don't brush these symptoms off!
Perimenopause can start in your late 30s, and it can look like insomnia, rage, brain fog, or a body that suddenly feels unfamiliar. It is not in your head, and you don't have to white-knuckle through it. Here's what we want every woman in our community to know.
01 — Sleep disruption & night sweats
Waking at 2am drenched in sweat, or lying awake with a racing mind? This is one of the earliest and most disruptive signs of hormonal change. Declining estrogen affects your body's temperature regulation and melatonin production.
→ Indigo tip: Try keeping your room at 65–68°F. Research consistently shows this is the sweet spot for deep sleep, especially during hormonal shifts. And skip alcohol for a few weeks to see the difference it makes.
How Indigo can help:
Acupuncture & Chinese Medicine — regulates the nervous system and addresses the heat pattern associated with hormonal shifts.
Functional Medicine — lifestyle changes and hormone testing to understand your exact estrogen, progesterone & cortisol picture.
Integrative Nutrition — phytoestrogen-rich foods, magnesium support, and blood sugar stabilization before bed.
02 — Mood swings, anxiety & irritability
Feeling like a different person, snapping at people you love, waves of anxiety out of nowhere, or a low-grade sadness that's hard to explain? Estrogen plays a major role in serotonin regulation. When it fluctuates, so does your mood.
→ Indigo tip: Before reaching for your phone in the morning, give yourself 5 minutes of quiet: no news, no email. Cortisol is naturally highest in the first 30 minutes after waking, and stimulus makes it spike harder. It's a small shift with a real impact.
How Indigo can help:
Mental Health Psychotherapy — nervous system tools, emotional processing, and evidence-based support for hormonal mood changes.
Acupuncture — shown to support serotonin and GABA pathways, reducing anxiety and emotional reactivity.
Energy Healing & Craniosacral Therapy — deeply calming work that helps regulate an overstimulated system.
03 — Brain fog & memory lapses
Forgetting words mid-sentence, walking into a room and going blank, struggling to concentrate? Cognitive changes in perimenopause are real and common. Estrogen supports brain circulation and neurotransmitter function.
→ Indigo tip: Stabilizing your blood sugar is one of the fastest ways to clear brain fog. Try adding protein to every meal and avoiding caffeine on an empty stomach, two small changes that make a surprisingly big difference.
How Indigo can help:
Functional Medicine — looks at thyroid function, blood sugar dysregulation, and inflammation, all of which compound brain fog.
Integrative Nutrition — omega-3s, anti-inflammatory eating patterns, and gut health optimization (the gut-brain axis is real).
Acupuncture — supports circulation to the brain and addresses fatigue patterns rooted in kidney and liver qi.
04 — Pelvic changes & urinary leakage
Leaking when you sneeze, laugh, or jump? Vaginal dryness, discomfort during sex, or increased urgency to urinate? As estrogen drops, the tissues of the pelvic floor thin and lose elasticity. This is not something you just have to live with.
→ Indigo tip: Kegels are likely not the answer, and for some women, they can actually make things worse. If you're experiencing leakage or pelvic discomfort, the muscle may be too tight, not too weak. This is exactly why a proper assessment matters before doing any pelvic floor exercises on your own.
How Indigo can help:
Pelvic Floor Physical Therapy — our Doctors of PT specialize in restoring strength, coordination, and comfort to the pelvic floor. Now available virtually too.
Acupuncture — supports pelvic circulation and addresses the underlying kidney deficiency pattern in TCM.
05 — Unexplained weight gain & fatigue
Doing everything "right" and still gaining weight, especially around the moddle? Exhausted by midday no matter how much you sleep? Hormonal shifts affect insulin sensitivity, cortisol, and thyroid function, making this a multi-system symptom that needs a multi-system solution.
→ Indigo tip: Strength training 2–3x a week is one of the most evidence-backed interventions for perimenopausal weight changes and energy. Even 20 minutes matters. If you've been avoiding weights, this is your sign to start.
How Indigo can help:
Integrative Nutrition — our RDs use functional gut testing and a food-first approach to address metabolism and energy at the root.
Functional Medicine — comprehensive lab work including thyroid panel, adrenal function, and sex hormones.
Massage Therapy — lymphatic drainage massage supports detoxification and reduces the inflammation that drives fatigue.
A note on HRT:
There is absolutely a time and place for conversations about hormone replacement therapy, and we are so glad these conversations are becoming more normalized! HRT can be a powerful and appropriate tool for many women, and it's not something to fear or dismiss. At Indigo, we believe that it works best as part of a whole-person approach. Whether you're on HRT, considering it, or prefer to explore other options first, we're here to support you either way.
Perimenopause doesn't have to feel like falling apart. We bring together acupuncture, functional medicine, nutrition, pelvic PT, therapy and lots more, so you have a whole team in your corner.