Why Am I So Tired and Gaining Weight in My 40s | Natalie Tysdal

Natalie Tysdal (00:00)

Hi everyone, it's Natalie, and for nearly 30 years I was a TV journalist and news anchor. I spent my career asking tough questions on all kinds of topics and translating complex topics into language people could actually understand. And that's exactly what I do here on the podcast for women and health topics specifically. The show is for women like you who are tired of conflicting information about their health. You want to know what the research actually says, not what sells products.

Not what's trendy, the actual science. So that's what we're gonna talk about. Hormones, menopause, weight loss, GLP ones, gut health, all of it. Inflammation, longevity, skin, hair, metabolism, fitness, sleep, because it matters to us. And all of the things that matter to us in our 40s and 50s are what we need to be paying attention to if we want to live long lives. My job is to help you separate the evidence from the hype so you can make informed decisions about your health.

without any fear, without any confusion. And here's what's I think is really important in today's world, without all of the noise. So let's start with why perimenopause is trending right now. The numbers are honestly kind of stunning. Nearly 40% of women say they were misdiagnosed during perimenopause. 40%. That's not a small number. And here's what really gets me as a journalist.

55% of women in their 30s are already having paramenopause symptoms. 30. But their doctors simply aren't catching it because everyone just assumes that peramenopause happens like in your 40s, right? So women are experiencing real changes in their bodies, and their doctors don't always mention the word paramenopause or help them understand it. So what do we do as women? We research, we Google. Research is actually calling this the biggest blind spot.

In women's health right now. There's literally a research paper about it published in 2026 calling for updated diagnostic criteria because the current guidelines, they're just not cutting it. So what are women actually searching for? Well, the questions fall into a few buckets that I'm going to outline today. First bucket, when does this start?

That's the big question so many of us have. It's been happening, we just don't identify it. Because if you're 38 and your cycle maybe is getting weird, you're still young, but you're thinking, that can't be me. I am too young. Well, spoiler, and I'm sorry if this upsets you, you're not. The second bucket that we're going to talk about is it normal? Women describe symptoms like brain fog, mood changes, sleep that is absolutely wrecked. And they're asking,

Should I be worried? Is this just life? Am I losing my mind? And then the third bucket they're searching for. Why isn't my doctor actually talking about this? And the answer is they should be, but they're not always doing that. And they're not necessarily trained to recognize it. And then the fourth bucket what can I do about it? What can I do about perimenopause once we admit that that is what's happening in our in our bodies? Not do I have to live with it forever.

But what are my real options?

Let's talk about what paramenopause actually is. And I want to be clear, I'm not just giving you the textbook definition. I'm giving you what the research shows is actually happening inside of your body. Paramenopause is the transition time leading up to menopause. On average, it lasts somewhere between four and 10 years. So that's a really wide span.

Some women experience it as just a gentle slide. Others describe it as something like a switch that just flips overnight.

Both are normal, but both kind of suck. So here's what's happening physiologically. Your ovaries are producing less estrogen and progesterone, but it's not consistent. Some months you have enough and some months you just don't. And that inconsistency, that's where a lot of the weird stuff comes from. The research from NIH published recently shows that paramenopause is basically obesogenic sensitive period.

Which is a fancy way of saying your body is more susceptible to weight changes and metabolic changes. And it's not because you're doing anything wrong.

It's just biology. So, should we talk about the symptoms now? Because this is where I think women get really confused. Because the symptoms don't feel like what we hear menopauses like. They feel like other things, mood changes. Women often think it's just depression, or they're told they have anxiety.

And honestly, their doctors are telling them that too. Researchers studying cognitive function and peramenopause found measurable changes in brain fog, in memory, and in focus. And that is not in your head. That is research. Let's talk about sleep. If you're waking up at 3 a.m. and you just can't fall back asleep, that is really common in this time period. There's literally a research study about.

Cognitive behavioral therapy for insomnia in perimenopausal women because it is such a widespread problem in this age group. Then there's cycle changes. That's obvious, right? But what's not obvious is that sometimes the cycle changes come before the hot flashes, before any classic symptoms that we often hear about. So if your cycle is getting weird, that's often just the first real sign. Weight gain, despite diet and exercise.

That can be perimenopause too.

Not because you're eating wrong and not because you're not exercising. Most of us are at some level. It is hormonal, hair loss, joint pain, skin changes, anxiety that feels new. All of this is documented in the research. And all of it is recognized as part of the paramenopause transition. But here's the problem: because these symptoms overlap with anxiety, depression, thyroid issues, and other things.

When a woman comes to her doctor with just mood changes, the doctor might order a depression screening. And when she comes in with weight gain, the doctor might suggest you need to eat differently, you need to exercise more. All of those things certainly can be helpful because more of that can be good for us. But nobody's connecting the dots to peramenopause. And when I say nobody, I don't mean all doctors, but I mean often that is the case. She's treating the symptoms.

And your doctor, he or she might be treating all of those things individually, but not the overall paramenopause, what's happening in your body. And that's why women are doing their own research. That's why they're going online and they're searching for more information because they feel something is shifting, but they don't know what that is. They're asking, is this paramenopause? Is it menopause overall? So let me give you some tips today. Here's what you can actually do.

And I hope to separate this into two things tracking and communication. First of all, tracking. The first thing, this is really simple but really important, that is not being asked by many healthcare providers. Track your cycle. And I don't just mean mark when your period starts and when it stops. I mean tracking what's actually happening. Start a journal, do it in the notes app on your phone, whatever it is, find one place where you're doing this and track.

when your period starts and ends to begin with, any spotting or unusual bleeding, how you're sleeping, good night, bad night, horrible night, just write it all down. Your mood, and I mean really specific, not just I was in a bad mood, but irritable, anxious, weepy, whatever it is, be as specific as you can be. Then track your energy. Did you want to move or did you want to just stay in bed all day?

One or two other symptoms that stand out for you, write those down or put them in your phone, however you're tracking. Maybe it's joint pain. Maybe it's brain fog. Have you started to identify that you have brain fog? You know, when someone asks you someone else's name and for the life of you, you can't come up with that name. I know that. Many of you do too. Write that down, whatever it is for you. And do this for two or three months. You will probably start to see a pattern, and that pattern is your evidence.

That pattern is what you take into your doctor. Why? Because when a doctor sees any type of pattern, when he or she can see that your mood, your sleep, your cycle are all connected and cyclical, that's when the light bulbs go off and that's when a diagnosis can change from maybe you have anxiety to, okay, this could be perimenopause. Okay, so the next thing I talked about tracking. Now let's talk communication. When you go to your doctor, don't lead with

I think I'm in perimenopause. Lead with the data. I've been tracking my symptoms and I'm noticing some patterns. Can we talk about whether this could be paramenopause? According to the American College of Obstetricians and Gynecologists, the way to diagnose paramenopause is actually pretty straightforward. It's based on your symptoms and your cycle changes. Not blood tests, surprisingly, this time, not blood tests. And if your doctor says,

Well, let's go ahead and check your hormone levels. You can ask, what will that tell us that my symptoms and my cycle aren't already telling us? Because here's the thing: hormone levels can fluctuate widely during perimenopause. And I'm a big proponent of getting blood draws and tracking things like your vitamins and your thyroid and hormones too, but it doesn't tell the whole picture. A blood test on day five of your cycle tells you something completely different.

Than a blood test on day 21. So most of the time the blood test isn't all that helpful. Now, combined with other things, it can be important, but it's not everything. Your lived experience is the evidence that you will need. Okay, so some other practical stuff now. Sleep, huge. I've done so many episodes on women's health and the importance of sleep, good sleep hygiene, and all of that. If you are not sleeping, almost everything in your life will be worse.

So if sleep is the biggest problem, well, it's worth addressing that first. It might be your sleep hygiene, how late you're staying up, what screens you're watching, when you're eating, your caffeine levels, all of those things are important. And you can look back through old episodes here of my podcast where I talk to sleep experts. That's really important that you get that right. But it might also be that you need more magnesium. It might be that your progesterone is tanking, which can affect your sleep.

But sleep first, very important that you're getting a good night's sleep. Also, movement, it matters. And I don't mean just get out and run yourself ragged and do a whole lot more cardio. Some cardio is good, but research shows strength training and consistency matter more during perimenopause. Sometimes hard to say when you say it so many times. It matters more during perimenopause than the intensity of your workout. So think three or four times a week.

Of doing something that you actually love to do that gets your body moving. No heroic workouts. You'll burn out if that's what you're trying to do. Just make it part of your life. Okay, let's talk nutrition now. The usual stuff applies, but during paramenopause, consistency there matters more than perfection. Not about restricting the things that you love, about showing up for your body consistently. That's really what I want to emphasize with both exercise exercise and with nutrition.

And please know if your doctor says, this is all normal, there's really nothing we can do, that's not the answer you need to accept. There are practitioners, OBGYNs, functional medicine doctors, nurse practitioners who specialize in all of this and who have all of the research, are trained and then trained some more, and who take it seriously. Find one of those practitioners, because I promise you it will make a difference.

Also, the reason everyone's searching for paramenopa paramenopause information right now isn't because it's just a trendy topic. It's because we're more informed and we're experiencing real changes, real symptoms. And for many women, they're not getting real answers from the places that they want and they need and they expect those real answers. You're not crazy, and your symptoms, they are very real and they're so normal.

This is how God created us and it's okay. So don't feel like there's something wrong with you. The transition deserves actual attention and actual care. If you're searching for all of this information, you probably already know something's shifting in my body. So trust that. Learn to trust your body. Track it and do a good job of tracking it. And then bring all of that to someone who will take it seriously alongside you. Because that's what this phase of our lives deserves.

If this resonated with you today, I would love to know and get your feedback. Send me a message, leave me a review, forward this to someone who you think might need it. Or maybe you just know someone who is confused about their health and why they're feeling this way, and this might be the answer for them. You can also head over to natalytisdle.com where you will find everything we talk about here on the podcast.

And if you're looking for other resources, guides, articles, recommendations, be sure to check out natalytistal.com forward slash favorites. I've got a lot of really great information there that is free and it will help you with the phase of life and your health that you're going with. And I'm going with alongside you. Next week, we're talking about GLP medications, one, two, and three, because we're hearing about all of them. And we are going to get into the real questions.

that all of you are asking and I'm getting a lot of messages about it. Where can I get them? Should I be taking them? Are they safe? All of it. Until then, take care of yourself and I'll talk to you next week.