Are You in the Gap Between Postpartum and Perimenopause?

Nov 6

If you got pregnant in your late 30s or 40s, you might be in the transition.

More women are having children later in life, often in their late 30s or 40s. During this stage, the focus is usually all about fertility: getting pregnant, staying pregnant, and welcoming a healthy baby.

What often gets overlooked are the hormonal shifts already happening in the background. Rising FSH levels, declining estrogen, and other subtle changes in the body may be present but are rarely discussed. They are often seen as background noise rather than clear signals.

The reality is that hormone levels can begin to shift in your 30s. By your 40s, most women are in some stage of perimenopause, even while they may still be trying to conceive or are caring for a newborn.

This means you can be postpartum and entering perimenopause at the same time, which can feel like an emotional and physical whirlwind. For many women, it feels like going down a fast-twirling slide without warning.

What Is Perimenopause or the Menopausal Transition?

Perimenopause, also called the menopausal transition, is the stage when your body begins shifting toward menopause. It happens as your ovaries start to slow down and produce fewer eggs, leading to lower levels of hormones like estrogen and progesterone.

This change does not happen overnight. Just as it takes a coordinated group of hormones to support pregnancy, it takes another hormonal shift to move the body into menopause.

Menopause is defined as going 12 consecutive months without a menstrual period. The time leading up to that is called perimenopause, and it can last anywhere from 4 to 7 years on average. For some women, it lasts more than a decade.

What are the symptoms of perimenopause?

Perimenopause symptoms vary from person to person, but common changes include:

Hot flashes and night sweats
Changes in body fat, especially more fat around the stomach
Dry skin or thinning hair
Vaginal dryness or painful intercourse
Irregular periods
Mood swings or sleep disruptions

Perimenopause is not a straight decline in hormones. It’s a time of fluctuation, which can make symptoms feel unpredictable. One month you may feel fine, and the next you might experience multiple symptoms at once. This hormonal instability is what makes the transition especially challenging for many women.

Why You Need Extra Support After Having a Baby in Your Late 30s or 40s

If you had a baby in your late 30s or early 40s, your body may be navigating two major hormonal shifts at once: postpartum and perimenopause.

In earlier generations, women often had 10 to 15 years between their last pregnancy and the onset of perimenopause. That gap gave the body time to recover and adjust. Today, more women are going from pregnancy and breastfeeding directly into the hormonal shifts of midlife.

Many symptoms that feel like typical postpartum changes—night waking, mood swings, vaginal dryness—could also be signs of perimenopause. The overlap can be confusing, but understanding the cause helps you take action.

Can Postpartum Feel Like Perimenopause?

Yes, and often it does. That’s because estrogen and progesterone drop significantly after childbirth, especially if you’re breastfeeding. This drop can mirror what happens during perimenopause, which also involves fluctuating and declining hormone levels.

Here are some symptoms that appear in both postpartum and perimenopause:

Interrupted sleep or waking at night
Vaginal dryness or discomfort during sex
Brain fog or forgetfulness
Constant hunger or unstable blood sugar
Belly fat or weight gain around the midsection
Mood changes or irritability
Feeling hot or cold for no reason
More frequent urinary tract infections

If you had a child later in life, you could be transitioning through these stages back-to-back—or even at the same time.

Don’t Wait to Get Support

Your symptoms are your clues. If you’re in your 40s or starting to notice changes, talk to your OB/GYN. Most perimenopause care is based on the symptoms you describe, not just lab work or test results. Early attention leads to better support and treatment options, including topical hormone therapy or lifestyle adjustments.

Your Nutrition Needs Are Changing Too

What your body needs during perimenopause is not the same as what it needed for pregnancy or postpartum recovery. In midlife, your body needs:

Lower glycemic foods to support blood sugar
More anti-inflammatory foods
Fewer refined carbs and sugars
Higher amounts of nutrients like calcium and magnesium
Different quantities of key foods like whole soybeans, tofu, and leafy greens

You also need a nutrition plan that fits your body type, ancestry, lifestyle, and individual needs. If you’re in both postpartum and perimenopause, it’s especially important to support your body with the right combination of food, sleep, and stress recovery.

Perimenopause Food Plan Blueprint

So what should you eat during perimenopause?

Your nutrition needs change during this phase. Supporting your hormones through food can make a big difference in how you feel and how your body responds to the transition.

Here’s a simple food blueprint to help you start:

Focus on nutrient-dense foods at every meal
Choose low glycemic index (low GI) carbohydrates
Include protein with every meal or snack
Add phytoestrogens like tofu and whole soybeans
Eat fewer total calories to match shifting metabolism
Limit inflammatory foods (like processed sugar and seed oils)
Increase antioxidants by eating a wide range of colorful fruits and vegetables
Consider targeted supplements for bone, brain, and hormone health

How You Experience Perimenopause Is Not One-Size-Fits-All

Perimenopause does not have to feel like a constant struggle. There is a wide range in how women experience this transition. For example, studies show that Asian women report half as many hot flashes and night sweats compared to white or Black women. While genetics may play a role, research points to diet, physical activity, and lifestyle habits as major influences.

In addition to nutrition, menopausal hormone therapy can be a safe and effective option. Modern approaches use transdermal patches or vaginal hormone treatments, and the Menopause Society has recommended their use since 2019 for symptom relief and long-term health support.

The key is building a plan tailored to your unique biology, health history, and lifestyle. A personalized approach can reduce symptoms, improve energy, and protect your long-term health.

It’s time to take care of you.

If you’re navigating the shift from postpartum to perimenopause, the right plan makes all the difference.

Dr. Burns