“I Don’t Feel Like Myself Anymore”: The Perimenopause Symptom Nobody Names

By Tina Chagoury, Clinical Dietitian · 6 min read · 2026-08-21

It is the sentence I hear most often, and for years it was dismissed as vague. It is now one of the most recognised descriptions of perimenopause there is.

"I am not feeling like myself."

I hear that sentence every single day. For a long time it was treated as something vague, as though the woman saying it were exaggerating, or simply tired, or stressed, or just getting older.

That has changed. In perimenopause and menopause research it now has a name: NFLM, not feeling like myself. Because it is not a superficial complaint. It is often the single most accurate description of this stage of life.

What women are actually describing

When a woman says this to me, she usually means some combination of the following.

Her body changed suddenly. Weight begins collecting around the abdomen even though nothing about her eating changed.

She wakes up exhausted. Even after a full night of sleep.

Her patience is gone. She snaps at small things, then feels awful about it and concludes that something is wrong with her personally.

She cannot tolerate input. Not noise, not the children, not work, not appointments, not cooking.

Her memory slips. She genuinely loses words. She walks into a room and cannot recall why. Her thinking does not feel clear.

Everything else shifted too. Her cycle changed, her sleep turned upside down, her appetite changed, and even her sense of herself feels different.

And the hardest part is what she hears back: that is your age, eat less, you will be fine.

Why this is not weakness

This is not fragility and it is not a loss of control. Very often, "I am not feeling like myself" is the first way the body communicates that something internal has genuinely changed and needs investigating.

Several systems can be involved, usually at once:

• Hormones. In perimenopause, oestrogen does not simply decline. It fluctuates unpredictably, up and down, while progesterone falls earlier and more steadily.
• Blood sugar. Unstable glucose produces mood swings, afternoon crashes, cravings and brain fog directly.
• Nutrient deficiencies. Low iron, low vitamin D and low B vitamins all affect energy and mood.
• Cortisol. Stress physiology changes how you sleep, how you store fat and how you cope.
• Digestion. Gut problems raise inflammation throughout the body, including the brain.

None of these are visible from the outside. All of them are testable.

Why the brain fog is real

The cognitive symptoms deserve particular attention, because they frighten women more than anything else. Losing words, losing your train of thought, no longer being able to hold several tasks at once.

Oestrogen has direct effects on the brain. When it fluctuates sharply, cognition fluctuates with it. Add disrupted sleep and unstable blood sugar and the effect compounds. This is a physiological process, not the beginning of decline.

What to do about it

Start with the pattern, not the symptom list. Chasing each complaint separately is how women end up with five specialists and no answers.

Get properly tested. A full thyroid panel, not TSH alone. Fasting glucose and fasting insulin. Vitamin D. Iron and ferritin. Inflammatory markers. A clear picture of your cycle.

Stabilise blood sugar first. Protein within an hour of waking, protein at every meal, and no all day grazing. This alone resolves a surprising share of the mood and energy complaints.

Protect sleep. Hormonal repair happens during sleep. Consistent wake times, morning light and a dark bedroom do more than any supplement.

Build muscle. Resistance training is the most effective intervention available to a woman in this stage, for metabolism, blood sugar and long term health.

Ask, dig, investigate. Do not accept an answer you know is incomplete.

The goal

The aim is not to endure this stage. The aim is to feel like you live in your body again: present, calm, strong, and able to say that you feel like yourself.

You should never have to accept a version of yourself that does not feel like you.

This article is nutrition education, not medical advice. Hormone therapy decisions belong with your own doctor or gynaecologist.

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About the author. Tina Chagoury is a licensed clinical dietitian specialising in women's hormonal health. After her own experience with breast cancer and treatment induced early menopause, she built the Hormone Reset Method™, a structured six month programme for women in perimenopause and beyond. Learn more about the Hormone Reset Method.