.png)
Perimenopause Symptoms Explained: Queen Estrogen, Progesterone and Why You Can’t Sleep
- Dr. Ban Al-Karaghouli,
- Jan 18
- 4 min read
Updated: 4 days ago
The Royal Hormone Kingdom Guide to Menopause, Anxiety, and Brain Fog
No one tells you the exact moment perimenopause begins.
There’s no trumpet. No official announcement. No royal decree nailed to the palace door.
Instead, it usually starts like this:
You’re exhausted… but you can’t sleep
You’re calm… until suddenly you’re not
You forget why you walked into the room and then forget the room itself
And you think:
“Is something wrong with me?”
If you’re experiencing sleep problems, anxiety, brain fog, mood changes, or fatigue in your 30s or 40s, this may not be stress or aging.
Inside your body, the Royal Hormone Kingdom is awake and leadership is changing.
Queen Estrogen: The Hormone Behind Most Perimenopause Symptoms
Queen Estrogen has always been running the show.
Calling estrogen a “reproductive hormone” is like calling Beyoncé “someone who sings sometimes.”
Technically correct.Wildly incomplete.
Estrogen receptors exist throughout the body, which is why estrogen affects:
Mood and emotional stability
Brain speed, focus, and memory (brain fog)
Sleep and temperature regulation
Joint comfort and inflammation
Skin, hair, and collagen
Libido and vaginal comfort
Bone and heart health
If you feel a symptom during perimenopause, estrogen is usually involved.
But estrogen doesn’t rule alone.
Progesterone Drops First: Why Perimenopause Starts With Sleep Problems and Anxiety
For years, Queen Estrogen ruled alongside King Progesterone.
She stimulated.He soothed.
She said, “Let’s go.”He said, “Let’s rest.”
Progesterone is the hormone responsible for:
Calm
Sleep
Nervous system balance
Anxiety control
Turning your brain off at night
Here’s the scientific truth women are rarely told:
Perimenopause often begins with progesterone decline, not estrogen.
As ovulation becomes unreliable:
No ovulation = no progesterone
Less progesterone = less calm
The King leaves first.
Quietly. Early. Without warning.
Why You Can’t Sleep in Perimenopause (Even When You’re Exhausted)
Meanwhile, Queen Estrogen is still present but now she’s unpredictable.
Some days she’s strong.Some days quiet. Some nights she bursts into your brain at 2 a.m. yelling:
“ANYONE AWAKE?”
Estrogen stimulates the brain.
Progesterone calms it.
When progesterone drops but estrogen remains:
The brain stays activated
The nervous system can’t downshift
Sleep becomes fragmented or impossible
This is when women say:
“I can’t sleep.”
“I feel anxious for no reason.”
“My mind won’t shut off.”
“I’m exhausted but wired.”
And the world says:
“You’re stressed.”
No.
This is hormonal insomnia and anxiety caused by progesterone loss.
That’s not a personality problem.
That’s endocrinology.
Testosterone in Women: Why You Feel Flat, Unmotivated, or “Not Like Yourself”
Let's talk about Prince Testosterone, the most misunderstood hormone in women.
In female bodies, testosterone supports:
Energy and stamina
Confidence and motivation
Muscle strength
Libido and sexual response
The feeling of “I recognize myself”
Here’s the key detail most explanations miss:
Estrogen helps testosterone work.
Estrogen increases testosterone receptor sensitivity and availability.
So when estrogen fluctuates or declines:
Testosterone may still be present
Labs may look “normal”
But women feel less drive, spark, and confidence
The Prince is still speaking.
The Queen just unplugged the microphone.
Thyroid and Perimenopause: Why Symptoms Overlap Even With “Normal Labs”
Princess Thyroid controls the pace of the kingdom.
She regulates:
Metabolism
Energy production
Brain speed
Temperature regulation
Weight balance
Thyroid hormones rely on consistency.
Estrogen used to provide that.
During perimenopause, estrogen fluctuates up, down, unpredictable.
So thyroid hormones struggle to function optimally in the new environment.
This is why women are told:
“Your thyroid labs are normal.”
While feeling:
“Why do I feel like I’m moving through wet cement with brain fog and fatigue?”
The thyroid isn’t broken.
The hormonal context changed.
Oxytocin, Estrogen, and Emotional Disconnection in Menopause
Princess Oxytocin governs:
Emotional connection
Bonding and trust
Pleasure and intimacy
Feeling emotionally plugged in
Estrogen enhances oxytocin signaling.
As estrogen declines:
Oxytocin signals soften
Emotional connection can feel muted
Women often say:
“I love my people, but I feel distant.”
“I don’t feel lonely, just disconnected.”
“I don’t feel like myself.”
This is not emotional withdrawal.
This is receptor biology during menopause.
Other Hormones That Shift During Perimenopause and Menopause
No kingdom runs on royalty alone.
As estrogen and progesterone change:
Cortisol increases (stress sensitivity rises)
Insulin struggles (weight and blood sugar shift)
Melatonin declines (sleep quality worsens)
DHEA attempts to compensate
The body adapts.
Not because it’s failing but because it’s reorganizing.
Menopause Isn’t Chaos. It’s a Hormonal Leadership Transition.
This is the part every woman deserves to hear:
Nothing is wrong with you.
You are not broken. You are not dramatic. You are not bad at aging.
Your body is doing exactly what physiology predicts when:
Progesterone exits early
Estrogen fluctuates and declines
Hormone receptors change
The endocrine system reorganizes
Menopause is not chaos.
It’s a leadership transition with terrible PR.
Same Woman. New Era.
Queen Estrogen is still here.
She just rules differently now.
And once you understand what’s happening —once the story finally makes sense —
The fear lifts.The shame dissolves.And you stop fighting your body like it betrayed you.
Because it didn’t.
It’s just entering a new chapter.
And every new chapter deserves guidance.
Deserves wisdom.
Deserves a trusted ally who understands the kingdom from the inside out.
👑 Welcome to The Royal Hormone Kingdom.
When you’re ready, we can write the next chapter together.
Work with Dr. Ban:
Let's Flourish and Bloom together 🌸
Comments