Many women expect menopause to begin suddenly with hot flashes and the end of menstrual cycles. In reality, the transition often starts years earlier during perimenopause, and the earliest signs can be easy to miss. According to Marla Ahlgrimm, many women in their 40s attribute these changes to stress, aging, or lifestyle demands without recognizing that fluctuating hormones may also be a contributing factor.

Perimenopause is the transitional phase leading up to menopause, when estrogen and progesterone levels begin to fluctuate unpredictably. Marla Ahlgrimm explains that this stage can begin in the early to mid-40s, though some women notice changes even earlier. Because hormone levels rise and fall irregularly, symptoms may appear intermittently, which makes them easier to dismiss.

One of the most common early indicators is a change in menstrual cycles. Periods may become slightly shorter or longer, heavier or lighter, or less predictable than in previous years. Marla Ahlgrimm notes that many women assume these variations are normal aging, but they are often among the first signs of perimenopause.

Sleep disturbances are another early but often overlooked symptom. Some women begin waking during the night, have difficulty falling asleep, or feel unrefreshed even after adequate sleep. While stress and other health factors can contribute, Marla Ahlgrimm explains that hormonal fluctuations can also affect sleep regulation during this stage.

Mood changes may also emerge gradually. Increased irritability, anxiety, emotional sensitivity, or mood swings can occur even in women with no prior history of mood disorders. Marla Ahlgrimm explains that shifting estrogen levels can influence neurotransmitters involved in mood stability. Persistent or disruptive symptoms should be evaluated with a healthcare provider.

Cognitive changes are another commonly reported experience. Women may notice forgetfulness, difficulty concentrating, or “brain fog,” such as misplacing items or struggling to find words. Marla Ahlgrimm emphasizes that these changes are frequently linked to hormonal fluctuations and may also be influenced by poor sleep quality.

Weight changes can occur even without significant changes in diet or activity. Some women notice increased abdominal weight or reduced ability to maintain previous weight levels. Marla Ahlgrimm explains that hormonal shifts, combined with age-related muscle loss, can influence metabolism. Supporting metabolic health through balanced nutrition, aerobic activity, and strength training becomes especially important during this time.

Joint discomfort is another symptom that is sometimes overlooked. Mild stiffness or aching in areas such as the hands, knees, or shoulders may become more noticeable. While joint pain can have many causes, Marla Ahlgrimm notes that some women experience increased discomfort during hormonal transitions and should seek evaluation if symptoms persist.

Changes in skin, hair, and sexual health may also develop gradually. Skin may become drier, hair may feel thinner, and libido or vaginal comfort may shift. Because these changes occur slowly, they are often attributed to normal aging rather than hormonal fluctuation. Marla Ahlgrimm encourages awareness of these symptoms so women can make informed choices about care and treatment options.

According to Marla Ahlgrimm, recognizing the subtle signs of perimenopause allows women to take a more proactive approach to their health. While every experience is different, paying attention to shifts in sleep, mood, memory, menstrual cycles, weight, joints, and overall well-being can help women better understand this transition and manage it more effectively.

We all need a sweet treat every once in a while, but there are plenty of evidence-based health benefits of reducing refined sugars, such as desserts, processed snacks, and high-fructose corn syrup. Today, Marla Ahlgrimm shares the top 10 reasons that sugar should be used sparingly.

Reducing your sugar intake reduces glucose spikes.

Refined sugars can cause a rapid spike in your blood glucose levels. This is followed by an insulin surge, which can leave you feeling drained and lethargic. Marla Ahlgrimm notes that these rapid increases in glucose and insulin also increase your risk of type 2 diabetes, so quitting sugar can reduce your risk of this disease.

It’s easier to lose fat.

Once we reach the age of perimenopause, losing weight isn’t always easy. Marla Ahlgrimm explains, however, that we often thwart our own efforts by our snack choices. Reducing your sugar intake can naturally reduce your overall caloric intake. As a result, you may notice less fat in your abdomen, feelings of being more satisfied after eating, and more energy.

Lower inflammation levels.

If you suffer from systemic inflammation, lowering your sugar intake can help reduce it. Marla Ahlgrimm notes that eating less sugar can also improve joint discomfort and support immune function.

Your heart will thank you.

Excess refined sugars increase triglycerides and blood pressure. By lowering your intake, you reduce these risk factors that contribute to heart disease and other health concerns.

You’ll reduce your risk of fatty liver disease.

Fatty liver disease warrants a mention on its own, as this condition is often made worse by consuming sweetened beverages, including sugary coffee and soft drinks. Marla Ahlgrimm explains that cutting sugar reduces liver fat accumulation and can improve enzyme markers.

Energy will come naturally.

If you typically consume a sugar-laden drink or snack as a pick-me-up, you should know that reducing your sugar intake overall can lead to stable and long-term energy. In other words, Marla Ahlgrimm says you won’t experience the crash or the mid-afternoon slump that can lead to brain fog and lethargy.

Cravings may go away.

There’s no easy way to say this: sugar is a drug. Marla Ahlgrimm says that sugar activates your brain’s dopamine reward pathways and makes you look at food, specifically sugar, as a quick way to get a dopamine hit. By eliminating refined sugars, you’ll reduce your craving for sweets and improve your appetite regulation.

Glowing skin.

In our 40s and 50s, our skin can begin to really show the signs of aging. Reducing your sugar intake slows damage to collagen and elastin, two of the main compounds in our face that keep our skin smooth and supple. By cutting out sugar, you’ll decrease the rate at which your face ages.

Improved oral health.

Marla Ahlgrimm says that one of the damaging ways sugar can affect a woman’s health is by causing enamel erosion and cavities. Further, eating too much sugar can make it harder to maintain healthier gums, as it feeds oral bacteria. By cutting out sticky, refined sugars, you can improve your oral health and keep your teeth pearly white.

Better hormone function.

For women in their menopause era, improved hormone balance may be the number one reason to quit sugar. Marla Ahlgrimm says that by reducing your sugar intake, your body may regulate its cortisol levels, and this can result in improved PMS symptoms and a reduced risk of conditions such as PCOS, which are insulin-driven.

You don’t have to deprive yourself completely. Marla Ahlgrimm says that reducing your sugar intake does not mean cutting out everything you love. She does recommend, however, finding healthier ways to satisfy your sweet tooth. Doing so can help you experience all of the benefits above and more.

As women, we’re used to how our hormones can play a role in our everyday health and well-being. But, according to Marla Ahlgrimm, even minor hormone fluctuations can affect everything from mood and sleep to energy and even how our bodies react to outside influences.

Marla Ahlgrimm explains that hormones influence nearly every major system in the body. However, most women are taught from an early age to only pay attention to the “big” hormonal shifts, which typically happen around puberty, pregnancy, and menopause. In reality, even small hormone variations between these periods of life can have a noticeable effect on how we feel each day. Even changes that fall within “normal” lab ranges can still affect energy levels, stress tolerance, sleep quality, mood, and other aspects of our lives.

Hormones Work In Balance

One of the most important things women should know is that their hormones work in balance. Marla Ahlgrimm likens this to a symphony rather than a solo performance. Estrogen, progesterone, thyroid hormones, cortisol, and more interact constantly. Even a slight drop in one of these can influence how the others behave. Because of this, Marla Ahlgrimm says that symptoms of health conditions can appear before any of the levels of these hormones are considered abnormal.

Small fluctuations are triggered by the menstrual cycle, stress levels, sleep changes, caloric intake, illness, inflammation, aging, and medical changes. Marla Ahlgrimm also notes that hormone changes can be affected by a woman’s physical activity. And while small fluctuations are considered normal, they are not always without symptoms.

Mood Changes Begin With Small Shifts

Even mild hormone variations can influence neurotransmitters in the brain. Estrogen and progesterone especially affect serotonin, dopamine, and other chemicals that regulate mood and emotional stability, says Marla Ahlgrimm. A subtle swing up or down in any of these can show up as irritability, anxiety, and an overall roller coaster of emotions.

Sleep Matters

Marla Ahlgrimm explains that our hormones are highly sensitive to our sleep patterns, and sleep quality is also affected by hormones. Progesterone has a calming and sleep-supporting effect. Cortisol controls the sleep and wake rhythm. Estrogen regulates body temperature and the sleep cycle. Marla Ahlgrimm notes that small disruptions can lead to night waking, lighter sleep, and feeling unrefreshed despite having spent the recommended seven to nine hours technically asleep.

Energy Levels And Hormone Rhythm

According to Marla Ahlgrimm, a woman’s energy level is one of the earliest indicators of a subtle hormone shift. Hormones regulate how each cell uses the fuel it’s provided, how the thyroid controls metabolism, and even how the body processes blood sugar. An insignificant “on paper” shift in hormone levels can leave a woman feeling wiped out in the afternoon, mentally fatigued, and physically energetic but out of it.

Supporting hormone stability

Marla Ahlgrimm says that it doesn’t matter what age or stage you are in; fluctuating hormones can take a toll on your daily routine. She explains, however, that there are a few self-help steps that you can take to support hormone stability each day. This includes maintaining a consistent sleep schedule, eating meals that are high in protein and fiber, working out, eating enough calories, reducing alcohol and caffeine consumption, and getting enough daylight. The retired pharmacist and women’s health expert explains that these small steps can help smooth out the hormone rhythm so that dips may not be quite as noticeable.

Ultimately, Marla Ahlgrimm reports that hormone health is not just about major life stages. Small routine fluctuations that are considered clinically insignificant can have a huge effect on our daily lives. Recognizing the patterns can give women more insight into our bodies and more control over our well-being each day.