If you’ve started to feel like your body is changing faster than you can explain — your sleep is off, your moods are unpredictable, or your energy has vanished despite doing “all the right things” — it might not be stress, burnout, or just getting older.
It could be perimenopause.
This transition is natural, but it’s also often confusing. Many women miss the early signs or are told they’re “too young” — leaving them feeling lost and frustrated when their body suddenly starts behaving differently.
Let’s break down what’s really happening, and how to recognise the signs early so you can take control rather than feel caught off guard.
What Is Perimenopause?
Perimenopause is the phase that leads up to menopause — when your hormone levels (especially oestrogen and progesterone) start fluctuating.
It usually begins in your early to mid-40s, though it can start earlier or later. These hormone shifts can last several years, causing physical and emotional changes that can easily be mistaken for stress, overwork, or simply “life.”
You’re officially in menopause only once you’ve gone 12 months without a period. But the real turbulence often happens well before that — during perimenopause.
The Subtle Signs to Look Out For
Perimenopause can look different for everyone, but here are some of the most common early changes I see in clinic:
Changes in your cycle
Your period might arrive earlier or later than usual. You may notice heavier bleeding, spotting between cycles, or shorter cycles overall (less than 21 days apart).
These shifts are one of the first clues that your hormones are in flux.
Sleep that suddenly goes missing
You feel exhausted — but can’t stay asleep. Night sweats, restlessness, or waking at 3 a.m. wide awake are all common.
Oestrogen and progesterone both influence your sleep–wake hormones, so when they fluctuate, your circadian rhythm can too.
Mood and anxiety changes
If you find yourself snappier, tearier, or more anxious than usual, it’s not all in your head — it’s in your hormones.
Oestrogen supports serotonin and dopamine, your brain’s “feel-good” neurotransmitters. As estrogen dips unpredictably, your emotional balance can go with it.
Brain fog and focus issues
You walk into a room and forget why. You lose your train of thought mid-sentence.
It’s called “menopause brain” — but it’s really about fluctuating estrogen levels affecting blood flow and glucose uptake in the brain.
Good news: it’s temporary and can improve with support.
Energy dips and fatigue
Even with enough sleep, your energy might feel flat. Hormonal fluctuations can affect your thyroid, iron levels, and metabolism — all of which control energy production.
Weight or body changes
You may notice more abdominal fat or bloating, even without changing your diet.
That’s partly due to lower oestrogen levels and shifting insulin sensitivity.
Skin, hair, and libido changes
Your skin may feel drier or more sensitive, hair thinner, or libido less spontaneous.
These are all signs of declining oestrogen’s effect on collagen, circulation, and nerve sensitivity.
Why Recognising It Early Matters
When women don’t realise they’re in perimenopause, they often blame themselves — for being moody, tired, or unmotivated.
But these are biological shifts, not personal failures.
Spotting the signs early means you can:
- Support your hormones naturally through nutrition, movement, and sleep
- Seek medical advice sooner if symptoms are affecting daily life
- Feel more empowered and less confused by what’s happening
Knowledge really is power here — and early understanding changes everything.
Where to Start
Here’s how to take back control of your hormones:
Track your symptoms.
Patterns tell the real story — use an app or journal to note sleep, mood, and cycle changes.
Eat for blood sugar balance.
Pair protein and fibre with carbohydrates to prevent cortisol spikes that worsen symptoms.
Prioritise sleep and recovery.
Ten minutes of morning sunlight, less caffeine after lunch, and winding down without screens all make a difference.
Move often, not perfectly.
Strength training and gentle cardio help stabilise mood, support bone health, and balance insulin.
Seek professional support.
A GP, pharmacist, or menopause practitioner can guide you through testing, treatment options, and hormone therapy if appropriate.
The Takeaway
Perimenopause isn’t a sudden cliff — it’s a transition, and the sooner you recognise it, the smoother it can be.
If something feels “off,” trust yourself. Listen to your body’s cues and take action early — because thriving through midlife isn’t just possible, it’s your new baseline.
Want to Go Deeper?
My book, It’s Not You, It’s Perimenopause, is a science-based, practical guide to understanding your hormones and building your own personalised action plan.
You’ll learn how to interpret your body’s signals, what actually helps, and how to stop blaming yourself for what’s really hormonal.
About the Author
Sarah Gray is a dual-qualified Pharmacist, Nutritionist, and Certified Menopause Practitioner. She helps women understand their hormones and feel like themselves again through evidence-based, compassionate care.
