We all hear about how women’s hormones change — but the way that we talk about it in our culture? It’s vague at best. And often it’s quietly dismissed with a shrug and a “That’s just how it is.”

Here’s the truth: Yes, your hormones do shift as you age. That part is normal. But what’s not normal is how little we’re told about what’s actually happening beneath the surface, or how we’ve come to accept feeling off as just part of the deal.

“Here’s the truth: Yes, your hormones do shift as you age. That part is normal.”

As a functional medicine doctor, I see this all the time. Women in their 30s, 40s, and 50s telling me they feel exhausted, anxious, foggy, disconnected from their bodies — like something’s changing but no one’s given them a roadmap. And most of the time? They’re right. Their hormones are shifting. Their needs are changing. And they deserve more than vague reassurance or to be brushed off.

Let’s get into what’s actually happening at each stage and what you can do about it.

Hormones in your 30s: Laying the foundation

Your 30s are often a continuation of the hormone rhythm you’ve had in your 20s, but this is the decade where subtle shifts begin.

“This is the decade where subtle shifts begin.”

Progesterone (the hormone that supports the second half of your menstrual cycle each month and helps keep you calm and sleeping well) may slowly start to decline. This can lead to symptoms like anxiety, irritability before your period, or changes in your flow. If you’ve been on hormonal birth control for years, this is often the stage where we start to see underlying imbalances that were previously masked.

It’s also a key decade for fertility — and that doesn’t mean just whether or not you want to get pregnant. Fertility isn’t a switch that flips on or off. It can be a mirror of how well your body is functioning overall. When I say this decade is about hormonal resilience, I mean your body’s capacity to handle stress, stay regulated, and maintain hormone balance even as demands increase — physically, emotionally, and metabolically.

“When I say this decade is about hormonal resilience, I mean your body’s capacity to handle stress, stay regulated, and maintain hormone balance even as demands increase.”

Your menstrual cycle is one of the clearest monthly check-ins your body gives you. Irregularities in your cycle — like changes in flow, PMS symptoms, ongoing sleep issues, or mood shifts — can all be early indicators of deeper imbalances. So even if you’re not actively trying to conceive, tuning into your cycle can give you critical insights into your thyroid health, stress levels, metabolic function, and more.

Fertility isn’t just about pregnancy. It’s about the vitality of your entire system. And your 30s are the time to pay attention to the signals your body is sending.

What to pay attention to in your 30s:

  • Stress and cortisol levels (your adrenal glands are working hard!)
  • Sleep quality and cycle regularity
  • Blood sugar stability and energy changes
  • Signs of estrogen or progesterone imbalance (e.g. PMS, mood swings, breast tenderness)
  • Fertility curiosity or concerns (whether you’re trying now or simply thinking ahead)

Supportive practices:

  • Build sustainable stress-management habits now: breathwork, sleep routines, boundaries with tech
  • Support liver detox pathways to metabolize hormones effectively (think leafy greens, cruciferous vegetables, hydration)
  • Track your cycle — not just for fertility, but for insight into your body’s overall balance
  • Consider functional lab testing to better understand your baseline before you’re actively trying to conceive (if applicable)

Hormones in your 40s: The perimenopausal decade

Perimenopause is the transition leading up to menopause — and it can last up to 10+ years. Most people associate menopause with their 50s, but perimenopause typically begins in your early-to-mid 40s (sometimes even late 30s). It’s a time of hormonal fluctuation that can feel a bit like a rollercoaster (mostly because we don’t talk enough about it).

“Most people associate menopause with their 50s, but perimenopause typically begins in your early-to-mid 40s (sometimes even late 30s).”

Your estrogen and progesterone levels don’t just drop in a straight line — they rise and fall unpredictably. This can lead to symptoms like heavier or irregular periods, hot flashes, sleep disruptions, mood swings, increased anxiety, and changes in metabolism.

And here’s something I tell my patients often: You’re not losing your mind. You’re in hormonal transition. It doesn’t mean you’re in full-blown menopause, or that something is severely off. It’s normal, but that doesn’t mean it has to feel awful.

What to pay attention to in your 40s:

  • Cycle length, flow, and symptom changes
  • Sleep disruption and night waking
  • Mood shifts or anxiety that feels “new”
  • Changes in body composition or metabolism

Supportive practices:

  • Rebuild your foundation: Prioritize sleep, gut health, blood sugar stability, and stress reduction.
  • Strength training is your friend — it helps support bone health and metabolism.
  • Consider working with a functional medicine provider to test hormone levels and explore additional support options like adaptogens, targeted supplementation, or bioidentical hormone therapy if appropriate.

Hormones in your 50s: Menopause and beyond

By now, most of us have heard the list of symptoms associated with menopause. But let’s be clear: Menopause is not a disease. It’s a natural transition — defined as going 12 consecutive months without a period, with the average age landing around age 51. After that point, estrogen and progesterone levels remain low — but that doesn’t mean you’re destined to feel off forever.

Some women experience relief in this stage. For others, it brings new changes to navigate — like shifts in skin elasticity, libido, bone density, or stress tolerance. That’s partly because your adrenal glands now take on more of the job of producing small amounts of estrogen and testosterone, rather than your ovaries, which were the primary source of these hormones before menopause. Supporting your stress response isn’t just helpful, it’s essential.

“Some women experience relief in this stage. For others, it brings new changes to navigate — like shifts in skin elasticity, libido, bone density, or stress tolerance.”

This is also the stage where maintaining muscle becomes more than just a fitness goal — it becomes a health imperative. Estrogen plays a protective role for both muscle and bone, and as levels decline, you need more intentional strategies to stay strong. That means resistance training, lifting heavy weights, and prioritizing movement that builds, not just burns.

It’s also the time to rethink the old “just walk more” advice. Walking is wonderful, but by itself, it’s not enough to preserve bone density or muscle mass. If you want to thrive into your 70s, 80s, and beyond, you need to actively build strength and protect your skeletal system.

The empowering part? There’s so much you can do to feel vibrant, strong, and grounded in this phase of life. I tell my patients all the time: This is your next chapter, and how you care for yourself now lays the foundation for the next 10–20 years and beyond.

What to pay attention to in your 50s:

  • Bone density and muscle strength
  • Cardiovascular health and metabolic markers
  • Vaginal dryness or urogenital symptoms
  • Mental clarity, memory, and mood shifts

Supportive practices:

  • Incorporate strength training at least 2–3x per week — prioritize heavier weights over more reps to stimulate muscle growth and support bone density.
  • Emphasize protein with every meal — aim for 1g per pound of ideal body weight daily to support muscle maintenance, metabolism, and recovery.
  • Keep moving — add walking, joyful movement, and mobility work to stay flexible and energized.
  • Explore pelvic floor therapy or vaginal estrogen to support genitourinary health and intimacy.
  • Consider hormone therapy — this isn’t one-size-fits-all, and functional medicine allows you to personalize your approach.
  • Dial in stress regulation and create consistent daily rhythms — your adrenal glands will thank you.

Understanding the hormone symphony

One of the most important things to understand is that hormones don’t operate in isolation. Your brain, thyroid, adrenals, ovaries, pancreas — they’re all in communication. It’s what’s often called the hormone symphony. If one is out of tune, it throws off the whole harmony of the body.

“Your brain, thyroid, adrenals, ovaries, pancreas — they’re all in communication.”

This is why addressing one issue — say, sleep trouble or cycle irregularity — often leads us to explore many parts of your physiology. Your hormones are talking to your brain, your gut, your immune system, even your bones. So, age isn’t the only factor when it comes to feeling in rhythm.

My final thoughts

Hormonal health isn’t just about fertility, menopause, or tracking your age: It’s about how you feel in your body, how you recover from stress, and how you show up in your life.

Your hormones are messengers, constantly working behind the scenes to help you adapt, regulate, and thrive. So whether you’re 31 or 59, your experience matters and there’s always room for an improved experience.

“Your hormones are messengers, constantly working behind the scenes to help you adapt, regulate, and thrive.”

Your symptoms are information. And there’s so much you can do to support yourself — starting with awareness, care, and the reminder that you’re not meant to navigate this in the dark.

Let’s normalize the conversations. Let’s look at the data. Let’s listen to women.

Dr. Jaclyn Tolentino is a Board-Certified Family Physician and the Lead Functional Medicine Physician at Love.Life. Specializing in women’s health and hormone optimization, she has been featured in Vogue, The Wall Street Journal, and Women’s Health. As a functional practitioner and a breast cancer survivor, Dr. Tolentino is dedicated to uncovering the root causes of health challenges, employing a holistic, whole-person approach to empower lasting wellbeing. Follow her on Instagram here for more insights.