“Why Do I Feel Like Crap?”: The Overlap Between Long COVID and Perimenopause

Dr. Gary Kaplan and I recently hosted a webinar on the immune system—what happens when it becomes dysregulated and how that affects healing. One of the best questions came from a woman in her 40s: “How do I know if what I’m experiencing is Long COVID… or perimenopause?”

Honestly? It’s a great question—and a hard one. Because here’s the truth: the symptoms can look nearly identical.

Both can make you feel like your body has betrayed you—exhausted, foggy-headed, moody, anxious, and just off. A 46-year-old patient recently said it best:

“I feel like I’m dragging from the second I wake up. I forget names, lose my keys, and I’m hot all the time—then I wake up drenched in sweat. My sleep’s a mess. Sometimes I get a strange burst of energy, but then feel like I could pass out. My hair’s falling out, my nails are brittle, and no matter what I do, my midsection keeps growing.”

She looked at me and asked, “Am I sick? Or is this just getting older?”

That question sits at the center of what so many women are grappling with.

What Is Perimenopause?

Menopause is defined as 12 months without a period. Perimenopause is the hormonal lead-up—and it can last up to a decade. But it’s not a graceful winding down. It’s hormonal whiplash—a surge, then a drop, then another surge.

That rollercoaster can cause:

• Mood swings
• Brain fog and memory issues
• Hot flashes and night sweats
• Insomnia
• Fatigue
• Anxiety and palpitations
• Midsection weight gain

And too often, it’s brushed off as “just stress” or “just aging.”

Meanwhile… Long COVID Can Look Strikingly Similar

At the Kaplan Clinic, we see this daily. Long COVID can cause:

• Persistent fatigue
• Autonomic dysregulation (palpitations, dizziness, energy crashes)
• Brain fog
• Insomnia
• Hair thinning
• Anxiety and mood shifts
• Hormonal imbalance
• Temperature swings

Here’s the kicker: Women ages 35 to 55—prime perimenopause years—are also among the most affected by Long COVID.

So yes, you can be navigating both. Even with normal labs.

So What’s Next?

There’s no single test that gives you a neat answer. But there is a way forward.

At the Kaplan Center, we begin with a comprehensive evaluation:

• A deep dive into your symptom timeline
• Targeted hormone, thyroid, immune, and inflammatory testing
• Evaluation for mold toxins and heavy metals
• Attention to trauma and chronic stress patterns
• Support for both the nervous and immune systems

We develop a unique plan based on you, but above all else: we listen. You deserve more than vague reassurance or being handed a reflexive antidepressant.

Because so many women today are living in bodies caught between transitions: hormonal, immunological, and emotional. If this story feels familiar, you’re not alone.

Schedule an appointment. Let’s sort through the gray and help you find your way back to yourself.