Oct 13, 2026 · 1h 5m
Perimenopause can begin before the hot flashes
312. Perimenopause Symptoms Can Start in Your Late 30s - Dr. Remina Panjwani
Recognizing early hormonal and nervous-system changes may help distinguish perimenopause from stress, aging, or ordinary burnout.
- 1Perimenopause symptoms can emerge in the late 30s, including sleep disruption, brain fog, joint pain, libido changes, and altered body composition.
- 2Chronic stress and nervous-system dysregulation can affect cortisol, gut health, metabolism, and how hormonal symptoms appear.
- 3Testing, hormone therapy, breathwork, sleep, movement, and whole-food habits are discussed as complementary tools, with basics preceding biohacking.
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Dr. Remina Panjwani reframes familiar complaints such as poor sleep, brain fog, libido changes, and body-composition shifts as possible early perimenopause signals.
The brief
Dr. Remina Panjwani argues that perimenopause can begin in the late 30s, with symptoms often mistaken for stress or aging rather than hormonal change.
The conversation links chronic stress and a nervous system stuck in fight-or-flight to disrupted sleep, brain fog, libido changes, gut problems, and shifting body composition.
Panjwani recommends small, consistent foundations—morning light, breathing, meditation, sleep, walking, protein, fiber, and whole foods—before advanced biohacking or complex interventions.
They examine hormone testing, including the Dutch test, alongside standard panels, while discussing bioidentical hormones and the need to interpret results within a broader health picture.
The episode’s wider argument is that inherited stress patterns and generational trauma can shape physiology, making nervous-system regulation part of both hormonal and gut health.
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