'It's Not in Your Head.' Here's What I Wish I'd Said

I was 41 when the chronic shoulder pain started.

My orthopedic surgeon — a man — explored everything. He ran imaging. He found structural issues and fixed what he could, performing surgeries on both shoulders. We spent four years pursuing surgical fixes. But even after the repairs, the pain persisted.

So he ordered bloodwork. We tested for MS. We ruled out autoimmune conditions. Everything came back normal.

And then, gently, he asked: "Could this be psychological?"

Not dismissively. Thoughtfully. But the question landed the same way: if your tests are normal and your surgery was successful, then the problem must be in your head.

I carried that question with me.

Then came the back pain

At 45, new chronic pain developed in my back. Different from the shoulder pain, but just as persistent. I went back to see my orthopedic surgeon. He ran imaging again. Nothing structurally wrong. Everything normal.

He said: we've ruled out the big structural and autoimmune issues. You need to talk to your general physician about what's causing this.

So I did. My general physician — also a man — looked at those same test results and said: "Everything looks normal. You should try meditating and journaling. The pain is probably stress-related."

He didn't order new tests. He didn't investigate further. He just looked at the results my orthopedic surgeon had already pulled and used them to dismiss me.

I left that appointment feeling erased. The pain was real. I knew it was real. But if all my tests said I was fine, then I was fine. Which meant the problem was me — my stress, my psychology, my inability to handle my own life.

Eight years of not knowing

I lived with pain in one shoulder, then the other—which still hurt even after 2 surgeries—then back pain. I meditated. I journaled. I tried to manage the stress. I went to my therapist weekly. Nothing changed because the problem wasn't stress.

Then, at 49, new symptoms arrived. I started waking at 3am every single night. I was exhausted. I was gaining weight despite not changing anything about my diet or exercise.

Suddenly, the pattern became clear. The shoulder pain at 41. The back pain at 45. The 3am waking at 49. The weight gain. The exhaustion. They weren't separate stress symptoms. They were connected.

It wasn't until I spoke to my OB/GYN at 49 that someone finally said the words: "This is perimenopause."

Eight years. Eight years of suffering without a name for it. Eight years of two male doctors asking if it was psychological while my body was actually going through a physiological transition that nobody mentioned.

What I wish I'd understood at 41

Here's what I wish someone had told me in that follow-up appointment when I was 45:

"Your labs are normal and we've fixed the structural damage we could find. And I also hear you — you're still experiencing pain, and that pain is real.

You're in your mid-40s. Perimenopause is a ten-year transition. It causes inflammation. It changes pain perception. It destabilizes your nervous system. It doesn't show up on standard bloodwork, but it's real.

What you're experiencing isn't psychological. It's physiological. And we need to approach it that way."

But nobody said that. So I spent eight years not understanding.

The real problem

Here's what I know now: perimenopause doesn't announce itself clearly. It unfolds in layers. And most women don't get the education they need to recognize it — especially not from doctors—male or female—who may dismiss unexplained symptoms as stress or psychological rather than physiological.

I didn't know at 41 that shoulder pain could be a perimenopause symptom. I didn't know at 41 that my body was beginning a ten-year transition. I didn't know at 41 that I needed to start building infrastructure — strength, sleep stability, nutritional support — to handle what was coming.

By the time I understood what was happening, I'd lost eight years.

And the worst part? Multiple male doctors had already ruled out the "big" issues. They could have said: "Okay, MS is ruled out. Autoimmune issues are ruled out. But you're in your 40s, and these symptoms could be perimenopause. Let's talk about that." Instead, they asked if it was in my head.

What a better response looks like

A doctor who understands perimenopause would say:

"Your bloodwork and imaging look good — we've ruled out autoimmune disease and structural damage. But your symptoms are real, and we haven't yet looked at perimenopause.

You're in your 40s. Perimenopause typically lasts about ten years, and it can start now. It affects inflammation, pain perception, sleep, metabolism, and everything else. It doesn't show up on the tests we just ran.

The pain you're experiencing could be part of this transition. What helps isn't meditation or assuming it's psychological — it's understanding what's happening in your body and building the infrastructure to support it: anti-inflammatory nutrition, strength training, sleep support, stress management that addresses the physiological layer.

This could be the beginning of a transition. Let's talk about how to actually prepare for it."

That's medicine that actually helps. That's seeing the whole picture.

Why this matters

Eight years is a long time to suffer without understanding. Eight years I spent thinking something was broken about me, about my ability to handle stress, about my psychology. Eight years I could have been building strength differently. Eight years I could have been learning what my body needed. Eight years I could have been preparing for the transition instead of being blindsided by it.

I don't want that for anyone else. I don't want women thinking something is broken about their minds when actually their bodies are going through a transition that deserves support, not dismissal.

What to do if this happens to you

If you're experiencing symptoms — shoulder pain, back pain, sleep disruption, weight gain, anything that doesn't have an obvious explanation — and your doctor tells you everything looks normal:

Trust your body first. Your lived experience is data. If something feels wrong, something is wrong.

Ask about perimenopause. Even if you think you're "too young." Even if it's just one symptom. Ask.

If your doctor dismisses you as stressed or psychological, see your OB/GYN. They understand this transition in ways general practitioners often don't — and many of them have actually studied it.

Don't wait eight years like I did. The sooner you understand what's happening, the sooner you can actually support your body through it.

Look for patterns. One symptom is confusing. Multiple symptoms across different systems — pain, sleep, metabolism, mood — that's a pattern worth investigating.

Educate yourself. Read about perimenopause. Understand what it is and what it does. You don't need permission from a doctor to take your own health seriously.

Find support. A health coach trained in perimenopause can help you understand what's changing and what actually helps.

The bottom line

You're not too young. Your symptoms aren't just stress. Your symptoms aren't in your head. Your body isn't broken — it's in transition. And you deserve to understand that transition before you've spent eight years suffering without a name for it.

Your body is the authority. Listen to it. And if your doctors won't, find ones who will.

— Jeannie