Perimenopause

Perimenopause

What Is Perimenopause?

Perimenopause is the earliest stage of the menopausal transition, often starting in your 40s—but sometimes even in your 30s. It can last several years, and it’s when hormone levels begin to fluctuate in unpredictable ways.

During this phase, your body is adjusting to a new hormonal rhythm. Ovulation becomes irregular, estrogen levels rise and fall, and symptoms may come and go without warning.

  • Irregular or heavier periods
  • Hot flashes and night sweats
  • Mood swings or anxiety
  • Breast tenderness
  • Brain fog or forgetfulness
  • Sleep disturbances

These changes can be confusing. It’s easy to assume they’re caused by stress, aging, or lifestyle—but in many cases, they are your body’s signal that the menopause transition has begun.

Because hormone levels are still cycling, symptoms may respond differently than they would during menopause or postmenopause. Supportive care may include:

  • Tracking your cycle and symptoms with a menopause journal

  • Trying lifestyle strategies like reducing caffeine or managing stress
  • Exploring BHRT in low doses, if symptoms are moderate to severe
  • Using non-hormonal treatments for sleep, mood, or anxiety

The Menopause Association offers resources and expert tools to help you identify this stage and take early steps toward symptom relief. Knowing where you are in the journey can bring much-needed clarity and reassurance.