I’m Too Young For This!

July 17, 2015
Ann Louise Gittleman, PhD, CNS

Ann Louise Gittleman, PhD, CNS

Award-winning nutritionist and New York Times bestselling author.

Symptoms & Solutions: When Perimenopause Strikes As Early As Your 30s…And Beyond.

“Perimenopause can catch you off guard,” writes Sara Gottfried, MD, author of The Hormone Cure and The Hormone Reset Diet, “but remember that it’s just another stage of life.  With awareness and a few simple adjustments you can navigate it with grace and joy.”

Weight gain, difficulty losing weight, bloating, brain fog, depression, dizziness, fatigue, insomnia, loss of libido, menstrual irregularities, migraines, thinning hair, swollen ankles and feet, vaginal dryness, and water retention.

Do any of these symptoms strike a chord with you?

Many women experience these symptoms as they transition into perimenopause, but when they begin to set in during the mid-30s these seemingly unrelated health concerns can be puzzling.

“It’s not unlike a bad case of premenstrual syndrome,” explains Gloria Bachmann, MD, professor and chief of obstetrics, gynecology, and reproductive sciences at Robert Wood Johnson School of Medicine. But because reproductive aging is a progressive series of changes, perimenopause is difficult to recognize.

“When they first start to appear, perimenopausal symptoms may seem unrelated,” says Nancy Lee Teaff, MD, a reproductive endocrinologist in Charlotte, NC, “and women often treat each problem individually, not seeing the connection until years later.”

“Skipped periods and hot flashes are almost automatically attributed to menopause, ” she adds, “but if your first symptom happens to be insomnia, you may spend hours in a therapist’s office before it becomes apparent that the problem is primarily hormonal.”

“I would say that 50% of women in perimenopause have been misdiagnosed,” says menopause specialist Helene B. Leonetti, MD. “Usually they’ve been given Prozac or put through a $10,000 cardiac workup.”

The Change Before the Change

When I wrote the New York Times bestseller, Before the Change, few people were even aware of perimenopause. Women like me were wondering, “What on earth is happening to my body?” After many nights without solid sleep, it’s no wonder we feel exhausted.

One of my clients, Liz, complained of “No energy…I’m tired all the time,” she told me. “My whole body is breaking down, falling to pieces. My mind, too.”

In addition, she gained 15 pounds in less than two years. “That’s fat. But if you’d seen me about 10 days ago,” she added, “I looked like I was 30 pounds overweight because of water retention. Then it went away” later in her monthly cycle.

Another client, Dianne, complained of other symptoms. “I couldn’t explain why I didn’t want sex anymore,” she said. Her doctor assured her that she didn’t have a hormone problem, nor signs of any medical disorder, and suggested an emotional or psychological cause.  Dianne was certain her lack of libido “was for a physical reason.”

“I wasn’t going to see a shrink,” Dianne told me, her eyes blazing at the thought. In fact, she seemed surprised when I dropped the subject of sex and started asking her about unrelated symptoms. While she hadn’t gained weight and didn’t have headaches, she did feel sluggish, especially in the morning.

Estrogen Dominance

While Liz and Dianne had varying symptoms, they both lacked energy and vitality—and were beginning to experience menstrual irregularities! They shared many signs of estrogen dominance—ranging from bloating and fatigue to diminished sex drive and weight gain—increasingly common concerns from the mid-30s on.

In a normal menstrual cycle, estrogen levels are high for a week or so after your period—peaking around the 12th day, beginning to drop just before you ovulate. After ovulation, the hormone progesterone increases, stimulating the buildup of the uterine lining. If the ovum (egg) has not been fertilized in this cycle, both estrogen and progesterone levels drop sharply. If the egg is fertilized, progesterone remains high during pregnancy.

During the subtle hormonal changes of perimenopause, this natural balance gets thrown out of whack. For instance, if you don’t ovulate, the ovaries don’t secrete enough progesterone to counteract the effects of estrogen—and estrogen dominance occurs.

Estrogen stimulates both breast cell and uterine lining growth, increasing the risk of cancer. This hormone also adds to body fat and promotes water retention. Estrogen-dominant women tend to be depressed, suffer headaches, experience slow thyroid function, lower libido, and blood sugar imbalances.

To compound the problem, high cortisol from stress or chronic pain can block progesterone receptors—exacerbating estrogen dominance and even hampering growth hormone production.  This sets off a cascade of irregular periods, PMS from hell, unrelenting weight gain, and loss of libido.  This cumulative effect is the reason that any hormone balancing regimen should include stress reduction techniques like deep breathing exercises, yoga, and a community of like-minded women for support!

By contrast, progesterone stabilizes breast cell and uterine lining growth, helps burn fat as fuel, and is a natural antidepressant and diuretic! This hormone also enhances sex drive and supports thyroid function, while stabilizing blood sugar and reducing the risk of cardiovascular disease.

As menopause begins (often around the age of 50), progesterone levels have declined 12 times as much as estrogen levels—greatly exacerbating estrogen dominance. Interestingly, men have higher levels of progesterone than some postmenopausal women!

Balance Hormones Safely

Progesterone even boosts energy levels by improving thyroid hormone efficiency. Another of my clients, Jackie, is a case in point.

At 44, she came to my office, complaining of chronic, constant fatigue and asking for an energy boosting diet. While her doctor had suspected hypothyroidism, Jackie’s test results were normal.

During our consultation, I discovered that Jackie was using estrogen patches—something she neglected to mention to her doctor since a friend (not the doctor) had given her these prescription patches. I convinced Jackie to throw out her patches and rebalance her hormones with daily applications of ProgestaKey, a natural topical progesterone body cream.

Easily applied with its pump dispenser to the abdomen, chest, face, inner arms/thighs, or neck, this bioidentical progesterone body cream helps revive vitality, spark sex drive, and enhance metabolism. One full press of the pump dispenses the recommended 20 mg of natural progesterone from wild yam.

Perimenopausal women can apply it once or twice a day, starting on the 7th day after menstrual flow begins and continuing until the 27th day. Menopausal women can apply it once or twice daily for 25 days, followed by a five-day break. You can read more about ProgestaKey including additional benefits and true stories and reviews from women at unikeyhealth.com.  Here are just a few things ProgestaKey users have to say:

Menopause Must
“This is my “Menopause Must”! I’ve been using this product for years. I love it! I used it in perimenopause as well. It helped to eliminate hot flashes, mood swings, and irregular, heavy periods. I feel that it also helps me to keep weight gain at bay.”  – Quietgirl

All the Difference in the World
“It’s like a time machine returning you to life before estrogen dominance. My fibroids have shrunk, making my periods somewhat tolerable again, and my eyes are no longer dry.”  – Mad Cute

Makes you feel like a woman again
“I started using this product a year ago, It has helped greatly with hot flashes and I actually have sexual feelings again, Plus it hurt when my husband and I had sex and I’m only 56 years old so sex was NON-Existent. Since using this cream, we are now back to having Pain-FREE sex. Thank you for this wonderful cream that REALLY HELPS.”  – Rita

Hormone Testing

How do you know if you have estrogen dominance for sure?  To accurately evaluate your body’s natural production of 6 key hormones, consider an at-home Salivary Hormone Test.

Estradiol, estriol, progesterone, testosterone, DHEA and morning cortisol are measured and completely assessed based on your age, regularity of your menstrual cycle, and undesirable symptoms that you report.

You’ll collect a single morning saliva sample in the privacy of your own home and send it to my trusted laboratory.  Within 1-2 weeks, my office will contact you with the raw laboratory data and a personal letter from me to you that details all of my recommendations to balance your unique hormone profile. You can learn more about Salivary Hormone Testing online; or for specific questions contact UNI KEY’s Test Coordinator at 800-888-4353.

Do you think your seemingly unrelated symptoms add up to perimenopause?  Share your story in a comment below!

Related Articles and Podcasts

Ann Louise Gittleman, PhD, CNS, is an award-winning New York Times bestselling author of more than thirty books including The Fat Flush Plan series and her latest book, Radical Metabolism. She’s been rewriting the rules of nutrition for more than 40 years and is internationally recognized as a pioneer in the field of diet, detox and women’s health issues. 

For a FREE daily dose of tips and strategies for maintaining healthy weight, conquering insomnia, and much more…check out my Radical Health Tips.

I’d like to meet and greet you on my Facebook groups, so won’t you check us out at the Radical Metabolism RevolutionFat Flush Nation, or my Inner Circle!


  1. Patty W.

    This is so important to know. My daughter-in-law is definitely experiencing much of this. It has helped her to start taking the ProgestaKey after doing the testing that showed her progesterone to be low. She is only age 35.

  2. Patti Miller

    Hi. This article is very insightful but what if I have had a hysterectomy 27 years ago and I’m experiencing tired, brain fog, vaginal dryness, no desire for sex and now heart palpitations. Thx Patti

  3. Shella

    I was 33 years old when I started to have peri symptoms… except I didn’t know it was peri! This was about 3 years after the birth of my child and my body was going WACKY! High blood pressure, fast heart beat, high cholesterol, brain fog, moody, ugly skin, sleepless nights, irregular periods/skipped periods – you name it. I landed in the ER 4 times over 2 year period with tachycardia (fast heart beat upwards of 160). The doctors wanted to give me all kinds of meds; I was referred to a cardiologist and tons of test were ordered. I simply refused to believe at 33-34 years old my body was failing me and against the encouragement of my family, I did not pursue medical intervention at that time. During a routine physical, the doctor nonchalantly asked me is I was “feeling” OK because my hormones from a blood test associated with the physical appeared a “little off. ” This was my FIRST CLUE. Then I reviewed the time of month of the ER visits and ALL were day 1 or 2 of my period… Hmmm. A Google search about any correlation between symptoms netted Ann Louise’ book “Before the Change” and I promptly bought it. I followed each step and in the course of a year I thankfully regained health and vibrancy more in line with my age. This success kicked off my still-continuing journey of more all-around healthful living including diet and exercise. That was 10 years ago now. I am 44 and at my last physical, hail and hardy except for a little overweight (working on that). Over the years, I’ve recommended the book “Before the Change” to several 30ish -early 40’s colleagues who complained of the same symptoms. No woman should suffer in silence or be at the mercy of an incomplete mainstream medical system who’s practitioners regularly appear clueless. Thank you Ann Louise!

    • Patty W.

      Thank you for sharing your story. It is so inspiring to know there is hope. “Before the Change” is a great book.

    • Team ALG

      Thank you so much, Shella, for sharing your inspiring story! It is a true testament to the power of Ann Louise’s work and research. We are so happy for you!

  4. Susan George

    I had no idea that cortisol from chronic stress could block progesterone receptors.That explains a lot. I went through menopause and was feeling good and then went through a divorce. I started getting hot flashes again and not sleeping well. I will order some ProgestaKey today.

  5. Danica

    The Progestakey sure helps me, keeps my cycle regular, maintains my mood and I now sleep like a baby…
    Thanks Ann Louise

  6. Danica

    Oh btw Shella, thanks for sharing, people won’t know till we share 🙂

  7. Lilian

    Now I understand why it is important to take progesterone even way past menopause. Since I went through menopause twenty years ago, I’m sure I am not making enough of it to balance my estrogen. I’m going to get the Salivary Hormone test to see where I am with these levels.

  8. Jackie P.

    I use ProgestaKey during days 1 – 12 at one pump daily then double up till day 25, after which I take a break. Am following your protocol posted on FaceBook and I feel terrific. Thanks so much, ALG!! You rock.

  9. Sandy M

    I did one course of topical progesterone in April. It is now the end of July and I haven’t had another period to take a second course. What do I do? I had normal periods until then–do I just go with the menopausal scenario? I am 47.

    • Lisa L.

      I had similar situation when I was going into menopause. The first month I counted the days like I was perimenopausal. When my period still didn’t start, I switched to the menopausal instructions. I’ve been taking it on for 25 days and off for 5 days ever since.

  10. Debbie

    I can totally relate to the story you told about Liz. I’m ordering ProgestaKey in hopes that I can turn around some of those symptoms.

  11. Betsy

    I did take the Salivary Hormone Test and found out I was estrogen dominant. Using ProgestaKey has really balanced my hormones and I feel so much better. No more hot flashes!

  12. Carolyn K.

    I’m just starting to have some symptoms. I’m in my late 30’s and under a lot of stress. Sounds like I should take the Salivary Hormone Test to see where my hormone levels are and go from there. Thanks for the information.

  13. Dorothy

    I went through menopause over 20 years ago and am in my mid 70’s. I’m wondering if taking progesterone is a good idea at my age. I have heard that it is important to have progesterone for bone health.

    • Alyce

      Dorothy, I’m older too and the ProgestaKey has helped me. I know I sleep better and my bone scans continue to show no loss. I do exercise regularly too.

  14. Julie

    I’m taking birth control which I understand can make my estrogen high. I’m thinking I should take ProgestaKey to help balance this.

  15. Tanya

    Great information. This may be what I am missing.

  16. Christina

    These symptoms sound like me. I’m in my mid 30’s so I thought I was too young for menopause, but I guess not. Good to know about this.

  17. Sylvia

    I’m so glad to know about the hormone test. I know I need to get my levels checked. I’m sure I need progesterone but I want to have some confirmation. Thanks!

  18. Anna Z.

    Interesting blog. I have been getting several of these symptoms and treating them individually. I’m glad to know that low progesterone may be the cause. I’m ordering the ProgestaKey to see if that will get rid of my hot flashes and insomnia.

  19. Olga

    ProgestaKey helped me lose my spare tire. I must have been low on progesterone. I started taking it for hot flashes but an unexpected benefit was that my stomach just kept shrinking!

  20. Clarita

    Thank you for discussing this issue. Changing my estrogen dominance by taking ProgestaKey helped me get rid of uterine fibroids.

  21. Dawn T.

    Interesting article. I didn’t know I could get symptoms as early as this. I’m in my early 30’s now, so it is good to know about this.

  22. Pamela

    That Salivary Hormone test sounds interesting. I’m not seeing a doctor right now so I’m glad I can get this test and find out my hormone levels on my own. Thank you Ann Louise!

  23. Maria F.

    Thanks for the blog Ann Louise! I sure need progesterone based on what you said.

  24. Joanna

    ProgestaKey helped me a lot. I have no more hot flashes and I sleep through the night.

  25. Bev

    Glad to know what I am in for. Sounds like a nightmare if your hormones aren’t balanced. I will for sure take that test to find out when the time comes. Good to know it is available.

  26. Jennifer

    I thought I was too young, I’m 35, but I have had a couple of hot flashes. I’m glad to know that other women can have them too and I’m not totally abnormal. Good information, thanks!

  27. Madelaine

    What a god send this progesterone creme is. I had really bad PMS and irregular periods. The ProgestaKey got it all normalized within a couple of cycles.

  28. Sheryl

    I’m using ProgestaKey for bone health. I’m having a hip replacement so and want to be sure my hip bone is strong. I’m also taking Oste-oKey for that really effective calcium.

  29. Mary

    It’s so interesting to learn about these symptoms. I hope I don’t have a hard time going through menopause. I remember that my Mother did. I’m glad I discovered your blog so I can keep informed and maybe I won’t have it so bad.

  30. Rosemary

    It is so interesting to learn that stress can block progesterone. Wow, that is a big one for me. Maybe that’s why my period is irregular and I’m only 32. Thanks for the infor!

  31. Jackie

    I’ve been trying to get pregnant to no avail. I’ve heard that being low in progesterone may be part of the problem. I’m going to take the Salivary Hormone test and then probably take the ProgestaKey.

  32. Lollie

    It sounds like just what I need. I’m starting to get some symptoms. Thanks for the info.

  33. Donna

    Such interesting information. I’m sure my daughter will benefit from it. I am way past menopause. Thanks

  34. Mary Anne

    I’m so glad to know that what I am feeling is somewhat “normal” because my doctor is not being very helpful. Great information. I will try the ProgestaKey.

  35. Angie

    ProgestaKey has helped me sleep better and also helped me lose weight. I’m so glad you have such a quality product I can trust that gives me such great results.

  36. Barbara

    What an informative blog. I went through menopause much later. It’s amazing that women today are faced with this big life change starting in the 30’s many times.

  37. Trisha

    I’m way past menopause but I decided to try ProgestaKey for my brain fog and slow memory. It has helped a lot. My tummy area is getting flatter too.

  38. Geneva

    The ProgestaKey really helped me lose the weight around my tummy and got rid of my hot flashes. I was a little older ( mid 40’s) but it worked great for me.

  39. Merle

    This is very interesting. I’m telling my daughter about this blog. Thanks Ann Louise. I’ve followed your work for years!

  40. Ingrid

    Sure is good to know that what I am experiencing is somewhat normal. I thought I was crazy. I’ve had terrible mood swings. I’m going to try the ProgestaKey.

  41. Teresa

    Amazing that women are going through this so young. I started taking ProgestaKey in my late 40’s when I started having symptoms and it has continued to help me. I don’t have mood swings and no more hot flashes.

  42. Belinda

    Very interesting. I had no idea that these symptoms could happen in your 30’s. I guess this is another good reason to take care of ourselves.

  43. Dottie

    This is interesting Ann Louise. I will send your blog to my grand daughter to let her know about this situation. Thanks!

  44. Amy Williams

    I am 47 years young! I just turned 47 on Aug 20th. For most of my reproductive years, I only had a period every other month and thought nothing of it. I have 6 kids and never had trouble getting pregnant, which stumped the dr’s! My kids are ages 24, 22, 20, 18, 16, 12.
    When I was approaching 40, I heard about Progesterone cream and how most women are estrogen dominant by that time. So I started to use Progestacare around age 43 and my periods then came every month! But now, Im not sure if it is helping or not. I dont know if it is the right brand?
    I wake up a lot at night and my hair is thinning. Ive read Dr John R Lee’s books in addition to following this health post on FB.
    I also have Hypo thyroid but I was able to lose weight doing a wheat/gluten free diet
    Any advice would be GREATLY appreciated! is it normal to have thinning hair when perimenopausal and how to stop it!?

    • Ann Louise Gittleman

      Hi Amy, You could take a Salivary Hormone Test to see your level of progesterone. ProgestaKey is very pure and made from wild yam so you can get really good results using it, if you need it. Being hypothyroid can cause hair loss and many times makes weight loss slower. I suggest taking the Tissue Mineral Analysis test to find out how to support your adrenals and thyroid with the proper vitamins and minerals and speed up your metabolism.

  45. Debbie

    Hi Ann. I am 47 and have been living with these symptoms since my early 30’s. Every doctor has tried a new “therapy” and nothing has worked. I chose to stop all therapy about 10 years ago and just live with the misery because the side effects were worse. I’ve made huge strides to maintain an excellent whole food, plant based diet which has helped tremendously but there is still one area “missing”. The biggest issue is libido and not for lack of trying very hard. I really miss it! I live in Europe and have questions about some of this at my distance. I would like to take the saliva test but wonder about the length of time for mailing (2+ weeks each direction depending on customs) and if it would impact the results negatively? Also, “medication” cannot be shipped in and out of my country. Is there someone I can talk to about shipping and what options I might have? Thank you kindly for your help! Love the article!!


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