5 Signs You Might Be In Perimenopause
Over 40 symptoms have been linked to perimenopause—the start of the menopause transition. This makes sense: a woman's body runs on estrogen, so when estrogen levels fluctuate, the body responds. Let's explore what perimenopause actually is, why changing estrogen has such profound impact, and the top five signs most commonly experienced.
Understanding Perimenopause
Perimenopause is part of the larger menopause transition—the move from having periods to no longer having them. Many people think "menopause" means an older woman without periods, but that's only part of the story. The menopause transition is mostly perimenopause, which can start in a woman's late 30s and last up to ten years. Menopause is actually one day—the anniversary of 365 days without a period. Everything after is post-menopause.
Much of what happens during those 5-10 years of perimenopause has been dismissed for decades as aging, stress, or isolated medical issues. Fortunately, we're in an era where women are being heard and the scientific understanding of menopause's body-wide impact is finally addressing women's needs properly.
Why Estrogen Matters
Reproductive hormones like estrogen aren't limited to the reproductive system—they're powerful chemical messengers regulating systems throughout the body. Cells in the brain, bones, muscles, gut, heart, and immune system all have hormone receptors designed to respond to these signals.
Estrogen helps regulate brain function by supporting neurotransmitters like serotonin, maintains bone density, supports vascular health, and influences how the body uses insulin. When hormone levels fluctuate during perimenopause, these systems become dysregulated, causing symptoms ranging from tinnitus and UTIs to joint pain and digestive changes.
The Top 5 Signs
Irregular periods – changes in cycle length, flow, or skipped periods
Personal Note: My periods were incredibly regular until my 365 days without one began. In my mid-40s, during perimenopause (though I didn't know it yet), my period was late enough that I took a pregnancy test despite my husband's vasectomy—and it came up positive! False positives can happen during perimenopause due to hormone fluctuations. That's actually how I first learned the word "perimenopause."
Hot flashes and night sweats – sudden heat sensations, often disrupting sleep
Personal Note: I had consistent night sweats after giving birth, but experienced very few hot flashes once I realized I was perimenopausal. I credit small diet changes for avoiding them.
Sleep disturbances – trouble falling or staying asleep, even without night sweats
Personal Note: I only struggled with sleep due to night sweats during perimenopause, but sleep issues worsened during my 365 days towards menopause. I brushed it off as stress, but it can be helped medically and naturally—no need to suffer once you recognize hormones might be involved.
Mood changes – increased anxiety, irritability, or depressive symptoms
Personal Note: These are especially hard to notice because life is stressful, and we point to external factors. The key is noticing when your response falls outside your "usual" zone. I had a panic attack during perimenopause—only my second ever. I could identify the stressor, but wish I'd realized my intense reaction was abnormal for me. Knowing hormone fluctuations played a role would have helped me recover faster and possibly without the negative self-talk.
Brain fog – forgetfulness, trouble concentrating, or mental fatigue
Personal Note: This was my worst symptom! Luckily, a physician friend warned me that forgetfulness (especially losing proper nouns) was a perimenopause symptom and assured me words would return. My brain fog coincided with COVID, so when I returned to work, I felt like I'd lost my efficiency and multitasking abilities. I wish I'd connected this to the word loss—it would have spared me stress, frustration, and lost confidence in my abilities.
These symptoms often become the stereotype of a menopausal woman, but people wrongly associate them with older women when women in their late 30s through 40s commonly experience them. Whether you're experiencing these symptoms now or want to know what to expect, it is important to know that both medical and natural approaches can prevent symptoms and support wellness.
The Complete Picture
The list below includes all issues associated with perimenopause listed so far. Remember that our bodies are complex—many symptoms may have multiple causes, and fluctuating hormones can heighten our sensitivity to underlying issues. Being perimenopausal doesn't explain every symptom, but it should be a lens through which you and your physician examine what you're experiencing.
Please remember: While these symptoms may be related to perimenopause, they can also indicate other health conditions. This information is meant to help you have informed conversations with your healthcare provider, not replace professional medical advice. Always consult your physician for personalized evaluation and care.
I’m here to help!
Not sure what questions to ask?
Not sure what’s going on, whether perimenopause or not? Book a call. No swarmy sales, just a helpful conversation to start you on your path to feeling better.