Plenty of women spend years living with these signs without connecting them to perimenopause. You might see a doctor about insomnia, anxiety, weight changes, joint pain or heart palpitations, and only later learn that shifting hormones were behind them. Perimenopause is the stretch leading up to menopause, and it can begin as early as your late 30s or early 40s.
What perimenopause actually is
Perimenopause means "around menopause." During this stage your estrogen rises and falls unpredictably, ovulation becomes irregular, your cycles change, and signs come and go. It can run for several years before menopause officially arrives.
The 40 most common signs
Cycle changes
- Irregular periods
- Heavier bleeding
- Lighter periods
- Shorter cycles
- Longer cycles
Sleep changes
- Trouble falling or staying asleep
- Waking early
- Restless sleep
Temperature changes
- Hot flushes
- Night sweats
Thinking and focus
- Brain fog
- Forgetfulness
- Trouble concentrating
- Losing words mid-sentence
Mood and emotions
- Irritability
- Anxiety
- Mood swings
- Low motivation
- Feeling more easily stressed
Physical changes
- Fatigue
- Weight changes
- More weight around the middle
- Joint pain
- Muscle aches
- Headaches
Sexual health
- Lower libido
- Vaginal dryness
- Discomfort during sex
Skin and hair
- Drier skin
- Thinning hair
- New facial hair
Bladder
- Needing to pee more often
- Sudden urgency
- More frequent UTIs
Heart and nervous system
- Heart palpitations
- Dizziness
Other signs
- Breast tenderness
- Digestive changes
- Bloating
- A dip in confidence
When does it start?
Most women start noticing changes between 40 and 45, though some see them earlier. If that's you, you're not too young — you're right on time.