Menopause is a well-known life stage, but perimenopause—the transition leading up to menopause—often catches women off guard. Many don’t expect symptoms to appear in their late 30s or early 40s, sometimes even earlier. Because these changes can be subtle and unpredictable, it’s easy to mistake them for stress, lifestyle changes, or other health conditions.
So, what exactly is perimenopause, and how do you recognize it if you’re not expecting it?
What Is Perimenopause?
Perimenopause is the phase before menopause when your hormone levels begin to fluctuate, but you haven’t yet reached full menopause (which is confirmed after 12 consecutive months without a period). This stage can last several years—typically 4 to 8 years—before periods stop completely.
During perimenopause, the ovaries don’t follow their regular pattern of oestrogen and progesterone production, leading to erratic cycles and a range of symptoms. These fluctuations can cause noticeable physical, emotional, and cognitive changes—some of which are surprising and easily overlooked.
Who Might Not Expect Perimenopause?
Many women don’t associate their symptoms with perimenopause because they believe they’re "too young" or assume menopause only happens after 50. However, hormonal shifts can begin much earlier than expected.
You might not be looking for signs of perimenopause if:
You’re in your late 30s or early 40s and still have regular periods.
You’re on hormonal contraception, which can mask symptoms.
You have children still at home and assume menopause is something for “later.”
You’re not experiencing hot flushes, so you think it’s not menopause related.
You assume stress, lack of sleep, or lifestyle factors are causing your symptoms.
Signs of Perimenopause You Might Not Recognise
Because perimenopause symptoms don’t always appear the way we expect, it helps to understand the early and less obvious signs.
1. Irregular Periods (But Not Gone Yet)
Your menstrual cycle may become: ✅ Shorter or longer than usual ✅ Heavier or lighter than normal ✅ More unpredictable (skipping a month, then returning)
Many women don’t notice this at first because life is busy, and tracking cycles isn’t always a priority. If your periods start to change, take note—it could be an early sign of perimenopause.
2. Mood Swings, Anxiety, and Irritability
Suddenly feeling on edge, emotional, or overwhelmed? Many women attribute this to stress or burnout, but fluctuating oestrogen levels can directly affect serotonin and dopamine, the brain’s mood-regulating chemicals.
This can lead to: ❌ Increased anxiety or panic attacks (even if you’ve never had them before) ❌ Unexplained irritability or rage ❌ Feeling low, unmotivated, or tearful for no clear reason
If your emotional state feels unpredictable or different from your usual personality, hormonal shifts could be playing a role.
3. “Menopause Brain” – Brain Fog and Forgetfulness
Do you find yourself:
Losing words mid-sentence?
Forgetting why you walked into a room?
Struggling to focus at work?
Brain fog is a common but under-discussed symptom of perimenopause. Oestrogen plays a role in cognitive function and memory, so its fluctuations can lead to difficulty concentrating, forgetfulness, and mental fatigue.
4. Poor Sleep (Even If You Were Always a Good Sleeper)
Perimenopause can disrupt your sleep in unexpected ways, even if you’ve never struggled before. You might experience:
Waking up frequently during the night
Restlessness or night sweats (even if mild)
Early waking (e.g., 3 AM, then struggling to fall back asleep and mind racing, worrying and heart palpitations)
Many women think their poor sleep is due to stress or a busy mind, but hormonal shifts (including lower progesterone levels, which help promote sleep) can be the underlying cause.
5. Sudden Weight Gain or Changes in Body Shape
If you’re gaining weight unexpectedly, particularly around your waist and laying down fat on your tummy,perimenopause may be a factor. Declining oestrogen and progesterone affect metabolism and how the body stores fat, making weight gain more common even if your diet and exercise haven’t changed.
Women often blame lifestyle choices, but this shift in body composition is often due to hormonal changes rather than simply eating habits or activity levels.
6. Changes in Skin and Hair
Oestrogen helps keep skin firm and hydrated and supports hair growth. During perimenopause, declining levels can cause: ✅ Drier skin (even if you’ve always had oily skin) ✅ Increased sensitivity or redness ✅ Thinning hair or increased shedding
If you’re noticing more hair in your brush or changes in skin texture, it could be an early sign of perimenopause.
7. Increased PMS or Breast Tenderness
Some women experience worse PMS symptoms in perimenopause due to fluctuating progesterone levels. This can include:
More painful periods
Sore, swollen breasts
Increased bloating and fluid retention
If your usual PMS symptoms feel more intense than they used to, it could be a sign that hormonal shifts are beginning.
8. Aches, Joint Pain, and Increased Stiffness
Oestrogen has an anti-inflammatory effect, so as levels drop, joint pain, muscle stiffness, and overall body aches can become more noticeable. Women often mistake this for aging, over-exercising, or poor posture, but it could be a direct result of perimenopause.
What to Do If You Think you’re in Perimenopause
If you recognise several of these symptoms, it’s a good idea to:
✅ Track your cycle and symptoms. Use a menopause tracker to monitor patterns over time. ✅ Get your hormone levels checked. Blood tests aren’t always definitive, but they can offer clues. ✅ Talk to a menopause specialist. Many doctors are still undertrained in perimenopause, so seeking an expert’s advice can help. ✅ Prioritise nutrition, exercise, and stress management. Small lifestyle adjustments can make a big difference. ✅ Consider HRT or supplements. Some women benefit from HRT, while others use supplements like Menopause by Hazel to support symptoms naturally.
Final Thoughts: You’re Not Too Young for Perimenopause
Many women dismiss their symptoms or don’t seek help because they assume they’re too young for menopause-related changes. However, perimenopause can start earlier than expected, and recognising it allows you to take control of your health and well-being sooner.
If you suspect you’re in perimenopause but aren’t sure, don’t ignore the signs. Understanding your body’s changes empowers you to make informed choices—whether through lifestyle changes, supplements, or medical support.
Menopause isn’t something to endure—it’s a transition to navigate with confidence. If you’d like more guidance, check out our Menopause by Hazel supplements or contact us at bristolmenopause.com to support your journey through every stage.
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