When most people think of menopause, they picture hot flushes in their 50s. But for many women, the hormonal rollercoaster actually begins much earlier—sometimes in their late 30s or early 40s. This transitional phase is called perimenopause, and it can be just as disruptive as menopause itself, especially if you’re not expecting it.
What is Perimenopause?
Perimenopause is the stage before menopause when the ovaries begin to slow down. It’s marked by fluctuating oestrogen and progesterone levels, leading to irregular cycles and a wide range of symptoms. This stage can last for several years, and for many women, it begins well before the age of 45.
A 2022 review published in The Lancet highlighted that perimenopausal symptoms are often under-recognised in women in their 30s and early 40s, which can delay effective management and affect quality of life.
Common Signs & Symptoms
Perimenopause doesn’t look the same for everyone. You may still be having regular periods but still experience:
- Irregular or heavier/lighter periods
- Increased PMS symptoms or mood swings
- Poor sleep or waking in the night
- Anxiety or irritability and rage
- Brain fog or forgetfulness
- Vaginal dryness or discomfort
- Reduced libido
- Weight changes or bloating
- Hot flushes or night sweats (not always present early on)
Why It’s Often Missed
Because women in their 30s and early 40s are often juggling work, children, and household responsibilities, many symptoms are dismissed as “just stress,” “burnout,” or even early signs of depression or ADHD. But if these changes are cyclical or worsening over time, hormonal shifts could be the real cause.
Unfortunately, many women are told they’re “too young” for perimenopause and don’t get the answers—or support—they need.
How is Perimenopause Diagnosed?
There’s no single test for perimenopause. Hormone levels fluctuate from day to day, so a blood test isn’t always helpful. Instead, diagnosis is based on your symptoms, cycle patterns, and medical history.
If you’re over 35 and experiencing disruptive symptoms, it’s appropriate to speak to your GP, women’s health specialist, or a menopause-trained provider. They may still run blood tests to rule out other causes like thyroid issues, but perimenopause is largely a clinical diagnosis.
Treatment Options
The good news? There are safe, effective options to manage perimenopausal symptoms and improve quality of life—whether or not your periods have stopped.
1. Lifestyle & Holistic Approaches
- Prioritising sleep hygiene and stress management
- Regular exercise and strength training
- Balanced nutrition with increased protein, fiber, calcium and vitamin D
- Mindfulness or cognitive behavioural therapy (CBT)
2. Medical Therapies
- Menopausal Hormone Therapy (MHT/HRT): Low-dose hormonal therapy can be used even while you’re still having periods, and it’s effective for treating mood, sleep, hot flushes, and more.
- Non-hormonal medications: Certain antidepressants or other medications can help with specific symptoms like night sweats or anxiety.
- Vaginal estrogen therapy for dryness or discomfort.
3. Complementary Therapies
- Acupuncture, naturopathy, and herbal treatments may help some women—but always discuss these with your healthcare provider to ensure safety and avoid interactions.
When to Seek Help
If your symptoms are affecting your work, relationships, or emotional wellbeing—don’t wait. You don’t need to “push through” or wait until menopause to get help. Support is available now.
The Takeaway
Perimenopause can begin earlier than expected, but that doesn’t mean you have to suffer in silence. With the right knowledge and care, you can navigate this transition with confidence—and feel more like yourself again.
If you’re concerned about symptoms or want a tailored management plan, book an appointment with our specialists today.