11 Signs Your Body Is Transitioning Into Perimenopause
- Sara Taher
- Jun 9
- 4 min read
Perimenopause is the natural transition period before menopause, when a woman’s body gradually shifts away from its reproductive years. This phase typically begins in your 40s but can start earlier or later, lasting anywhere from a few years up to a decade. During perimenopause, hormonal fluctuations, especially in estrogen and progesterone can cause a variety of physical, emotional, and cognitive changes. Recognising these signs can help you understand what’s happening and seek the right menopause management support.
11 Common Signs of Perimenopause
Irregular Periods
Your periods might become irregular, with changes in timing, duration, and heaviness. You may notice cycles that start earlier or later than normal, vary in flow, or occasionally stop altogether.
Hot Flashes and Night Sweats
Hot flashes are sudden, intense feelings of heat that commonly affect the face, neck, and chest. They can cause flushing, sweating, and sometimes a rapid heartbeat. When these episodes occur during sleep, they are called night sweats and can disrupt rest, leading to fatigue and reduced sleep quality.
Sleep Problems
Many women experience difficulty falling asleep or staying asleep during perimenopause. Factors such as night sweats, increased anxiety, hormonal fluctuations, and restlessness can contribute to disrupted sleep patterns, which may affect daytime energy levels and overall wellbeing.
Mood Swings and Anxiety
Hormonal imbalances during perimenopause can influence neurotransmitter activity in the brain, leading to mood changes such as irritability, increased anxiety, mood swings, and feelings of sadness or depression. It’s important to monitor these changes as they can impact daily functioning and relationships.
Vaginal Dryness and Irritation
Declining estrogen levels cause the vaginal walls to thin and produce less natural lubrication. This can result in dryness, itching, and discomfort, particularly during sexual activity. These symptoms may increase the risk of irritation and infections, but treatments such as vaginal moisturizers or estrogen creams can provide relief.
Bladder and Urinary Issues
Estrogen helps maintain the strength and elasticity of the tissues around the bladder and urethra. As levels drop, women may experience increased urgency and frequency of urination, occasional leakage (urinary incontinence), or a higher incidence of urinary tract infections. These symptoms can significantly affect quality of life and should be discussed with a healthcare provider.
Cognitive Fog
Many women report experiencing difficulties with concentration, memory lapses, or a general sense of mental cloudiness, often referred to as "brain fog." These cognitive changes are believed to be related to hormonal fluctuations and can be temporary but may cause frustration and decreased productivity.
Weight Gain and Body Shape Changes
During perimenopause, hormonal changes combined with a natural decline in metabolic rate can lead to increased fat accumulation, particularly around the abdomen. Muscle mass may also decrease, which can further slow metabolism. Maintaining a healthy diet and regular physical activity can help manage these changes.
Joint and Muscle Discomfort
During perimenopause, it’s common for women to notice more joint stiffness, muscle aches, or general soreness. These symptoms may be linked to reduced estrogen levels, which can affect joint lubrication and inflammation. Differentiating these changes from normal ageing is important for appropriate management.
Changes to Skin and Hair
Estrogen helps boost collagen production, which keeps your skin firm and elastic. As estrogen levels drop during perimenopause, you might notice your skin becoming drier, thinner, or more sensitive. Hair can also become finer, more brittle, or prone to shedding.
Changes in Libido
Sexual desire often changes during perimenopause due to hormonal shifts, physical symptoms such as vaginal dryness, and psychological factors including mood changes. It is common for libido to fluctuate or decrease, but addressing symptoms with your healthcare provider can improve sexual health and wellbeing.
How to Manage Perimenopause Symptoms
There is no one-size-fits-all solution, but many women find relief with a combination of lifestyle changes and treatments:
Maintain regular exercise to support mood and metabolism.
Eat a balanced diet rich in calcium, vitamin D, and whole foods.
Limit caffeine, alcohol, and sugar intake.
Practice stress-reduction techniques like mindfulness or yoga.
Prioritise good sleep hygiene.
Discuss hormone replacement therapy (HRT) with your doctor if symptoms are moderate to severe.
Explore non-hormonal options like low-dose antidepressants or cognitive behavioural therapy.
Can Perimenopause Begin Before Age 40?
Yes, perimenopause typically starts in the mid-40s but can begin in the late 30s for some women, known as premature perimenopause. Genetics, lifestyle, and medical history can influence this early onset.
Are Blood Tests Effective in Diagnosing Perimenopause?
Because hormone levels fluctuate, blood tests alone are often unreliable for diagnosing perimenopause. Diagnosis is usually based on symptoms and menstrual history.
What Are Some Lesser-Known Symptoms of Perimenopause?
Beyond common symptoms, some women experience joint pain, dry or itchy skin, vision changes, digestive issues, altered body odour, hair thinning, and memory difficulties.
How Long Does Perimenopause Last?
The duration varies widely, anywhere from 4 to 10 years with the average around 4 years. Individual factors influence this timeline.
Get Support and Guidance Through Every Stage of Perimenopause
Perimenopause can be a challenging phase, but you don’t have to face it alone. Our experienced female GPs at Glen Iris General Practice provide compassionate, personalised GP care to support women through every stage of life. Whether you want advice, symptom management, or ongoing health checks, we’re here to help you feel informed, comfortable, and confident in your health.
