Perimenopause: The Symptoms You Might Have Missed

Most of us have heard of menopause — the point when periods stop for good, usually around the early 50s. What’s less often talked about is the “prequel”: perimenopause. This is the transitional stage leading up to menopause, when hormone levels start to fluctuate and symptoms begin to show. For some women, perimenopause starts earlier than expected, sometimes in the early 40s. For others, changes don’t kick in until much later, edging into the 50s. For many readers, the whole experience might already be behind you. So why talk about it now? Because understanding perimenopause not only helps make sense of what you’ve been through, but also equips you to support others — daughters, friends, or colleagues — who are now entering this stage. Knowledge really is power, and perimenopause is a part of the story that deserves more attention.

When Does Perimenopause Start?

The timing of perimenopause varies widely. On average, it begins in a woman’s mid-to-late 40s, but it can start as early as the mid-30s or as late as the mid-50s. This stage typically lasts anywhere from four to eight years, ending when a woman has gone a full 12 months without a period — the official marker of menopause. For women in their 50s today, that means you may still be in the tail-end of perimenopause, or you may already have moved beyond it. Either way, understanding the signs can bring clarity to those confusing “in-between” years.

Common Early Signs

Perimenopause often creeps in quietly, with symptoms that can be easy to dismiss. The most common early signs include: irregular periods — cycles may get shorter, longer, heavier, or lighter; hot flushes and night sweats — sometimes mild, sometimes dramatic; breast tenderness — linked to shifting oestrogen levels; mood changes — irritability, anxiety, or feeling more emotionally sensitive; sleep issues — trouble falling asleep or staying asleep; brain fog — difficulty concentrating or remembering things. Looking back, many women realise these symptoms started well before they thought “menopause” was on the horizon. In fact, you may have chalked them up to stress, age, or lifestyle — which brings us to another issue.

Why It’s Often Misunderstood

Perimenopause can be tricky to recognise because the symptoms overlap with so many other things. Feeling tired? Could be stress. Mood swings? Maybe work pressure or family demands. Poor sleep? Perhaps too much coffee or late-night screen time. Because of this, many women don’t connect the dots until much later. For those already post-menopause, recognising perimenopause was the cause of those earlier changes can be validating. It explains why you may have felt “not quite yourself” for several years. For those still going through it, realising these shifts have a hormonal basis can make the experience less bewildering.

Tracking Your Cycle and Symptoms

Whether you’re still having periods or already past them, tracking symptoms is a useful tool. For women still in perimenopause, keeping a simple record of your cycle — noting changes in flow, frequency, and associated symptoms — can help reveal patterns. For those who’ve already reached menopause, reflecting on past experiences can be enlightening. You might remember phases of poor sleep or emotional ups and downs and realise they were linked to hormonal changes rather than “just stress.” That hindsight can be powerful, especially when talking with younger women in your life who may now be going through similar experiences.

When to Talk to a GP

Even though perimenopause is a natural stage of life, it doesn’t mean you have to “just put up with it.” If symptoms are interfering with daily life — whether it’s disrupted sleep, anxiety, heavy bleeding, or anything else — it’s worth talking to a GP. Treatments and strategies are available, ranging from lifestyle approaches to hormone replacement therapy (HRT). For readers already post-menopause, the message is just as important: if symptoms linger or if you have concerns about bone health, heart health, or ongoing hot flushes, medical support is still relevant. Menopause isn’t a one-day event; it’s a long-term transition that can affect wellbeing well into later years.

Moving Forward with Knowledge

Perimenopause can feel like a confusing maze, especially when the signs are subtle or overlap with everyday stress. For those in their 50s and beyond, looking back at this stage with fresh understanding can bring relief and even a sense of closure. For those still in it, knowing what’s happening can make it easier to seek help, track changes, and take control. Most importantly, the conversation about perimenopause helps break the silence for the next generation. By sharing what we know, we make it easier for others to recognise the signs early and feel less alone. After all, the more we understand the “prequel,” the more prepared we are for every chapter that follows.