Perimenopause Isn’t Just Hot Flashes — 7 Signs Your Hormones Are Changing

By Dr. Anne Morgan | Thrive Once More, Lee’s Summit & Liberty, Missouri

When most people hear the word perimenopause, they immediately think of hot flashes — but that’s just one piece of the puzzle. For many women, the signs that your hormones are shifting begin years before your cycle stops — and they show up in ways that don’t always scream “hormonal.”

If you’ve been feeling off, but your labs keep coming back “normal,” it’s time to look deeper.

Here are seven subtle (and not-so-subtle) signs your hormones may be changing — and what you can do about it.

1. You’re Tired All the Time — Even After a Full Night’s Sleep

Fatigue is one of the most common early signs of hormonal imbalance. As estrogen and progesterone fluctuate, they impact your adrenal function, sleep quality, and energy regulation. If you feel like you’re dragging through the day even with good sleep hygiene, your hormones may be at play.

2. Your Mood Feels Off — Irritable, Anxious, or Just... Meh

Do you feel more anxious, emotional, or disconnected lately? Hormonal shifts can directly affect neurotransmitters like serotonin and dopamine, leaving you feeling unlike yourself. You’re not crazy — and you’re not alone.

3. Your Periods Are Changing — Heavier, Lighter, Irregular

Perimenopause often brings changes in cycle length, flow, and intensity. You may go months without a period, then suddenly have two in one month. These changes are a clear sign your reproductive hormones are starting to fluctuate.

4. You’re Gaining Weight — Especially Around the Middle

Even if you haven’t changed your diet or lifestyle, hormone imbalances can cause your body to store more fat — especially around your belly. This is often tied to declining estrogen and rising cortisol, and it’s a frustrating but common part of perimenopause.

5. You’re Not Sleeping Well (or at All)

Falling asleep, staying asleep, or waking up wired at 3 am? Hormones like progesterone and estrogen play a huge role in regulating sleep. When they shift, your sleep can take a serious hit — which only worsens fatigue, mood, and weight gain.

6. Your Libido Has Quietly Disappeared

Many women don’t realize that a declining sex drive is often hormonal. As estrogen and testosterone drop, so does libido — and vaginal dryness or discomfort may show up too. This isn’t about age — it’s about imbalance.

7. Your Hair, Skin, and Confidence Are Changing

Hair thinning, skin dryness, brittle nails — they’re all physical signs that your hormone levels are shifting. These changes can feel subtle at first, but they often snowball over time if not addressed.

So What Can You Do About It?

The first step is knowing that you don’t have to just “tough it out.”

At Thrive Once More, we help women across the Kansas City area navigate perimenopause with clarity, confidence, and real solutions. Through bioidentical hormone therapy, personalized lab testing, and whole-body support, we help you feel like you again — not just “normal,” but optimal.

Ready to Find Out What’s Really Going On?

👉 Book a Thrive Wellness Assessment
A one-time, in-depth consultation with Dr. Anne Morgan that includes labs, symptom review, and personalized next steps — so you can stop guessing and start healing.

📍Serving women in Liberty, MO and Downtown Lee’s Summit

💻 Virtual options available

Because perimenopause isn’t just about hot flashes — and you deserve care that sees the whole picture.