The Perimenopause Symptoms That Blindsided Me (And the Ones Nobody Warned Me About)

I rolled over in bed and came up slowly out of a sleepy fog. Then I realized I was soaking wet.

Not a little damp. My shirt was saturated, and the hair at the back of my head was wet like I’d just rinsed it in the shower. A little panicked, I grabbed my phone off the nightstand and used the light to find my meter. Severe low, I figured. It had to be.

I pricked my finger and waited. 3…2…1…beep. 110.

Wait. What? Bad reading, maybe. So I got up, washed my hands, and tested again. 105.

What the heck was going on?

That was the first of a whole series of symptoms I had no explanation for. So I did what any of us do. I turned to Google, and Google was not reassuring: night sweats, infections, hyperthyroidism, hormones, anxiety, and of course, the worst-case one that lives at the bottom of every search: cancer.

After a few nights the sweats stopped. Then a month went by and it all started again, same pattern, still no reason I could find. It scared me and reassured me at the same time. There was no fever with it, so at least I’d talked myself down off the cancer ledge.

What I didn’t know yet was that this was the very first thread of something much bigger. And that it would be years before anyone connected it for me.

The symptoms I kept explaining away

I’m the kind of person who rolls with things, so for a long time I had a tidy reason for each one on its own.

Around the same stretch, I started getting sudden insulin sensitivity. For a few days at a time, without changing a single thing, not my food, not my activity, I’d have constant, severe lows. I was drinking juice and grabbing carbs just to stay upright. I actually started to wonder: did my pancreas kick back in? I was diagnosed as an adult. Maybe I still had a little insulin-making ability left in there, sputtering back to life.

Back to Google. And again, nothing. No solid information, nobody else describing what I was living. So I decided I must just be some kind of anomaly.

Here’s the part I don’t always say out loud. By then I’d separated from my husband and was living on my own. For years I’d had my overnight basal rates dialed in and never really worried about lows in my sleep. Now, with these random sensitivity spells I couldn’t predict, I was scared I might not wake up. That fear followed me to bed.

Then one night it happened. I’d met a wonderful new man by that point, and thank God he was there, because I woke at 3 a.m. with a blood sugar of 23. If you live with Type 1, you know exactly what that number means. I’m certain he helped me through it that night.

That was the turning point that finally got me a CGM and a pump, but that’s a story I’ve told in full over here, so I won’t retell all of it now. What matters for this story is that the 23 wasn’t random bad luck. It was one more symptom in a pile I hadn’t connected yet.

And the pile kept growing.

There were days right before my period when fatigue hit like a freight train. No amount of sleeepep touched it. My arms and legs felt achy and heavy, like I was moving through wet sand. I blamed dehydration. I wondered if my thyroid needed rechecking. But it always clustered in the couple of days before my period, and always lifted a couple of days after. For most of my adult life my periods had been light and uneventful. This was new, and it unsettled me.

Over the next few years the patterns finally started to show themselves. The fatigue and the insulin sensitivity revolved around the start of my period. And I’d get stubborn, stubborn highs the week before.

Then the rest arrived, one at a time, each easy to wave off on its own:

That last one deserves its own breath, because I know how many of us are quietly white-knuckling it. I was more active than I’d been in years. I was eating less than at any point in my adult life. And the scale went up anyway. If you’ve been doing everything that used to work and watching it not work……hear me….that is not a discipline problem. The variables simply changed.

I’ll be honest with you about where that one landed, because I don’t want to sell you a tidy ending I didn’t get. The weight did eventually stabilize; it stopped climbing. But I’m still carrying those 15 to 20 pounds today, years later, and I haven’t been able to take them back off. What changed wasn’t the number on the scale. What changed was that I stopped treating it as proof I was failing. My body is different now than it was eight years ago, and no amount of eating less was going to argue it back. That’s not defeat, it’s just the accurate starting point for figuring out what actually helps.

Every one of them got its own explanation; stress, aging, a bad week. And every explanation let me avoid the bigger question, because I didn’t yet know there was one question underneath all of them.

What my doctors said (and didn’t)

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When I finally brought the night sweats and the fatigue to my OB at an annual exam, she shrugged. “Yep, probably hormones.” No test recommended. Just a mention that vitamin B12 might help.

At my next endocrinology appointment, I asked what I could do about the sudden insulin sensitivity. Not much insight there either. “That’s unfortunately the nature of diabetes. Sometimes things just don’t make sense and insulin needs change without warning. It’s the nature of the beast. Maybe it’s time to consider a CGM.”

The nature of the beast. I sat with that one for years.

The thing that finally gave me a name was the scariest chapter, honestly. Then, my periods started stretching longer every month until, eventually, one just didn’t stop for close to a year. That led to ultrasounds, cancer screenings, and finally the discovery of a polyp. Frightening in the moment, and also, strangely, the first time the word perimenopause actually landed.

Here’s what still gets me. Even then, once perimenopause was on the table, not one of my doctors connected it back to the acne, the mood swings, or the blood sugars. I’d spent years assuming all of it was just aging. I had no idea how much of it likely traced back to one root cause; changing hormones.

Why it all felt connected (because it really did)

Here’s what I understand now in plain language.

During perimenopause, estrogen and progesterone don’t decline in a smooth, tidy line. They fluctuate, sometimes wildly, for years before periods stop for good. And those two hormones touch far more than your cycle. They affect sleep, mood, body temperature, skin, focus, and how sensitive your body is to insulin.

So when they swing, a whole set of seemingly unrelated things swings with them. That’s why it feels like ten separate problems showing up at once. It’s usually fewer root causes than it looks like from inside.

For those of us with Type 1, there’s an extra layer. When your insulin sensitivity shifts with your hormones, your blood sugars can climb high the week before your period, or crash for no reason you can point to, even when your food, dosing, and routine haven’t changed at all. The variables changed underneath you. You didn’t do anything wrong.

I want to be careful here, because you’re managing a serious condition. Not every new symptom is perimenopause. Some of these same signs can point to thyroid issues, other conditions, or something that genuinely needs evaluation; that year of irregular bleeding needed real investigations and a workup. Fortunately, that’s exactly what I got. I’m not here to tell you what’s happening in your body. I only want to tell you what happened in mine, and to say the pattern is real enough to be worth a real conversation with someone who knows your history.

What I wish someone had told me

I wish someone had warned me to watch for this. Not the textbook symptom list, I could’ve found that. I wish someone had told me perimenopause can start in your late thirties, that it can drag on for years, and that it would change my insulin needs in ways no one on my care team ever flagged.

I don’t say that to be bitter about doctors. Most of them simply weren’t taught how perimenopause and Type 1 collide. But the gap is real, and you and I are the ones standing in it. That gap is the whole reason this site exists.

Because I’m a bit of a nerd, I went looking on my own. I read everything, listened to podcasts, connected with other Type 1 women. And when a few friends finally said “wait, me too,” I didn’t feel so alone anymore. Relieved, and a little fired up. Why hadn’t a single one of my doctors made these same connections? Why were there no warnings?

So if you take one thing from my list, let it be this: if your body seems to have changed all at once, you’re not imagining it, and you’re not failing at something you used to be good at. Your body is changing, and your strategy gets to change with it.

You’re not the only one who didn’t connect the dots

When I started voicing out loud that perimenopause and hormone swings were wrecking my blood sugars, I half-expected I was the only one. I really thought I must be some kind of freak of nature. Instead, over time, I discovered other women with very similar stories. One had been logging higher numbers before her period for two years, but no real solutions. Another had been told hormones “shouldn’t” affect her diabetes that much, so she’d assumed she simply was just bad and managing her blood sugars.

The truth is that none of us are failures. We were simply women who’d managed a serious condition well for years, but hormone changes were making us feel like beginners again. The good thing is that more and more women like us are starting to talk opening about it and new research is starting to surface.

That’s why I started writing all of this down. So you have somewhere to bring the patterns you notice at 3 a.m., or simply to hear someone else say: yes, me too. And most of all, so you know you’re not a failure, and this phase of life is not hopeless. There is so much you can do to move through this season thriving, and feeling more like yourself.

Common questions about perimenopause symptoms with Type 1 diabetes

What are the early symptoms of perimenopause?

Perimenopause can bring irregular periods, trouble sleeping, fatigue, mood swings, anxiety, night sweats, brain fog, dry eyes, acne, and changes in weight, among others. They often appear gradually and separately, which is why many women don’t recognize them as connected at first. These were symptoms I experienced; if you’re noticing new or concerning ones, they’re worth discussing with your healthcare provider.

Can perimenopause start in your late thirties?

Yes. Perimenopause commonly begins in the forties but can start earlier. My symptoms began around age 38. Because it can start sooner than many people expect, it’s easy to attribute the early signs to stress, work, or aging rather than hormones.

Does perimenopause affect blood sugar in Type 1 diabetes?

It can. Fluctuating estrogen and progesterone change how sensitive your body is to insulin, which can make blood sugar more unpredictable even when your food and dosing stay the same. This isn’t a discipline problem; it’s a sign your strategy may need to adjust to a body that’s changing. Always work with your own care team on any changes to your management.

Why am I gaining weight in perimenopause even though I’m eating less?

Shifting hormones in midlife change how your body stores fat, uses energy, and responds to insulin, so weight can creep up even when you’re eating less and moving more than before. It’s a common and deeply frustrating perimenopause experience, and it isn’t evidence that you’ve stopped trying hard enough. In my own case the weight climbed 15 to 20 pounds and then held there; I haven’t taken it back off, and I’ve made peace with the fact that my body is simply different now than it was a decade ago. If weight changes are worrying you, they’re worth raising with a provider who understands midlife hormones.

Nothing here is medical advice. I’m sharing what I’ve learned living with Type 1 diabetes through midlife, not practicing medicine. New or concerning symptoms deserve a real evaluation; always work with your own care team on changes to your management, devices, or medications.