Perimenopause can feel like someone has turned up the volume on a body that was already too loud. For women living with fibromyalgia and chronic fatigue, the midlife hormone shift may bring more pain, poorer sleep, heavier exhaustion, brain fog, mood changes, and a shorter fuse for stress. That does not mean every new symptom is “just hormones”. It also does not mean fibromyalgia or chronic fatigue will always worsen in midlife. The reality is more nuanced. Research is still