What’s Really Happening in Perimenopause? A Deep Dive with Nicole Jardim

December 1, 2025

When I sat down with Nicole Jardim on Midlife Realignment, I knew this would be one of those conversations women would replay and say, “Oh my God — that’s me.”

Nicole is the author of Fix Your Period, founder of the Institute for Menstrual Health, and one of the most hormone-literate educators I know. And yet — even with all her knowledge — her own perimenopause journey was confusing, destabilizing, and far more difficult than she expected.

That alone tells you everything you need to know about the state of women’s healthcare. 

Perimenopause Doesn’t Always Look the Way We’re Told It Will

One of the most important truths Nicole shared is that perimenopause doesn’t follow a script.

We’re often taught that early perimenopause means wildly fluctuating estrogen levels. But in Nicole’s body, estrogen steadily declined — quietly and persistently — for years.

Her periods became:

  • Lighter
  • Shorter
  • Less predictable

Then came symptoms that were easy to dismiss:

  • Anxiety (which she’d never experienced before)
  • Mood changes
  • Subtle withdrawal from life
  • Sleep disruption

When you’re in your late 30s or early 40s, it’s incredibly easy to chalk this up to stress, work, parenting, or “just life.” And that’s exactly how perimenopause hides in plain sight.

Even Experts Get Dismissed in the Doctor’s Office

One of the most infuriating parts of Nicole’s story — and one I hear daily — is what happened when she sought medical help.

Despite clear symptoms, she was told:

  • Hormone testing wasn’t necessary
  • Perimenopause couldn’t be happening yet
  • If she wasn’t trying to get pregnant, it didn’t matter

At one point, she literally had to write down which hormones she wanted tested and when, because her provider didn’t know.

This is not rare.
This is the norm.

And if someone with Nicole’s credentials was treated this way, imagine what happens to women without the language or confidence to push back.

When You’re “Cobbling Together” Your Own Hormone Care, That’s a Red Flag

Nicole described doing what so many women do out of desperation:

  • Trying DHEA
  • Trying pregnenolone
  • Throwing supplements at symptoms
  • Hoping something sticks

This DIY approach isn’t a failure — it’s a symptom of a system that doesn’t support women in midlife.

When you’re driving your own hormone care because no one else will help you, it’s time to find a new provider.

Hormone care is not something women should be forced to crowdsource.

Vaginal Dryness, Anxiety, Sleep Loss — These Are Hormonal Symptoms

As Nicole’s estrogen continued to decline, her symptoms escalated:

  • Vaginal dryness and itching
  • Worsening anxiety
  • Profound sleep disruption
  • Loss of energy and motivation

These aren’t “nuisance symptoms.”
They are quality-of-life issues — and they are hormonal.

This is why I push back so hard against the idea that women should simply “power through” perimenopause naturally.

Suffering is not a virtue.

Hormone Therapy Isn’t a Failure — It’s a Tool

Eventually, Nicole made the decision to work with a hormone-literate provider and began physiological hormone replacement therapy:

  • Estradiol
  • Progesterone
  • Later, testosterone

The results were profound:

  • Vaginal dryness resolved
  • Sleep improved
  • Energy returned
  • Blood sugar markers improved
  • Cognitive clarity came back

This matters deeply because Nicole was already:

  • Eating well
  • Exercising
  • Using supplements
  • Managing stress

Hormones weren’t replacing the basics — they were supporting a body that had lost its hormonal scaffolding.

Hormones Are a Moving Target — and That’s Normal

One of the most important points we made together is that hormone therapy is not static.

Perimenopause is dynamic. Hormone needs shift. Doses need adjusting. Monitoring matters.

Nicole tracks her hormones using:

  • Blood testing
  • Urinary hormone testing
  • At-home cycle tracking tools

But just as important as the numbers are the symptoms:

  • Sleep
  • Energy
  • Mood
  • Libido
  • Cognitive function

Labs matter — but how you feel matters just as much.

Comparing Yourself to Other Women Will Make You Miserable

We also addressed one of the most damaging narratives in midlife health right now: comparison.

Some women breeze through perimenopause.
Others struggle deeply.
Both experiences are valid.

Your need for support does not mean your body is broken.
It means your biology is unique.

There is no moral superiority in suffering quietly.

You Can Still Get Pregnant in Perimenopause — Even When the Signs Are Subtle

One critical practical takeaway from our conversation: fertility doesn’t disappear just because cycles change.

In perimenopause:

  • Ovulation can be sporadic
  • Cervical fluid patterns change
  • Traditional signs are harder to read

Women can — and do — get pregnant in their mid-to-late 40s.

Understanding your fertility, using appropriate contraception, and not relying on outdated assumptions is essential.

The Bottom Line

Nicole’s story highlights a truth I want every woman to hear:

You are not failing perimenopause.
Perimenopause is exposing gaps in care.

When women are educated, supported, and allowed individualized solutions, this transition becomes manageable — even empowering.

But that requires hormone literacy, self-advocacy, and providers who actually listen.

That’s the real work of Midlife Realignment. 

Connect with Nicole

Instagram: @nicolejardim
Website: https://nicolejardim.com
Fix Your Period Collective: https://nicolejardim.com/collective/
Institute for Menstrual Health: https://instituteformenstrualhealth.com/

Fix Your Period (Nicole’s Book) — https://nicolejardim.com/book/

Connect with Esther

  • Instagram: @gorgeousesther

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