Perimenopause: What It Is and How to Recognise It (Even When You’re Not Expecting It)

While most people have heard of menopause, perimenopause the transition phase leading up to it can feel far more confusing and unexpected. It often begins in the late 30s or 40s, but can start earlier, and many women don’t realise that the symptoms they’re experiencing may be hormone related. 

Understanding what perimenopause is and how it can show up can help you feel more prepared and supported during this natural life stage. 

What Is Perimenopause? 

Perimenopause is the time before menopause when hormone levels, especially oestrogen and progesterone, begin to fluctuate. You haven’t reached menopause yet (which is confirmed after 12 months without a period), but the body has started to transition. 

This phase can last several years and is a natural part of ageing. The hormonal shifts during perimenopause may contribute to changes in your menstrual cycle and a range of physical or emotional symptoms. 

Why It Often Goes Unnoticed 

Many women don’t expect perimenopause to begin while they’re still having periods—or raising children, building careers, or managing busy lives. Some common reasons it’s missed: 

• You're in your 30s or 40s and still menstruating regularly. 

• You use hormonal contraception, which may mask cycle irregularities. 

• You believe menopause only happens after 50. 

• Your symptoms don’t fit the typical “hot flush” image. 

• Stress or lifestyle factors seem like more obvious explanations. 

Signs of Perimenopause You May Not Have Considered 

Perimenopause doesn’t always present in obvious ways. Below are some commonly reported signs: 

1. Irregular Periods 

• Cycles may become shorter, longer, heavier, lighter, or more unpredictable. 

• Skipping a period and then resuming is not unusual during this phase. 

2. Mood Changes 

• Some women experience increased anxiety, irritability, or low mood. 

• These changes may be linked to hormone fluctuations, but other factors such as stress or sleep disruption may also contribute. 

3. “Brain Fog” 

• Difficulty concentrating, forgetfulness, or losing your train of thought may occur. 

• These cognitive changes are commonly reported but not often discussed. 

4. Sleep Disturbances 

• You may find it harder to stay asleep or feel rested. 

• Night-time awakenings, early waking, or restlessness are frequent experiences. 

5. Body Composition Changes 

• Changes in fat distribution particularly around the waist may become noticeable. 

• These shifts are common with ageing and may be influenced by hormone levels, metabolism, and lifestyle. 

6. Skin and Hair Changes 

• Drier or more sensitive skin and changes in hair texture or shedding may occur. 

7. Worsened PMS or Breast Tenderness 

• Some women report more intense premenstrual symptoms than they previously experienced. 

8. Joint or Muscle Discomfort 

• Aches, stiffness, or general soreness may become more noticeable, though they are often attributed to other causes. 

What to Do If You Think You’re in Perimenopause 

If several of the above signs resonate with you, here are some supportive steps to consider: 

✅ Track your cycle and symptoms: Apps or journals can help spot patterns over time. 

✅ Speak with a qualified healthcare professional: Blood tests aren’t always conclusive, but a specialist in menopause can offer personalised support. 

✅ Focus on nutrition, physical activity, and stress management: These lifestyle factors can influence how you feel during this phase. 

✅ Explore options that support your wellbeing: Some women explore hormone replacement therapy (HRT), while others include food supplements, yoga, or mindfulness as part of their daily routine. 

✅ Learn more about your options: Education is key knowing what’s happening in your body can help you make informed choices. 

A Note on Supplements 

Menopause by Hazel offers a range of food supplements formulated with carefully selected vitamins, minerals, and botanicals. These are designed to support general wellbeing in midlife as part of a healthy lifestyle. They are not intended to treat or prevent symptoms of perimenopause or menopause. Always speak with your GP, pharmacist, or menopause specialist before starting any new supplement, particularly if you are on medication or have an underlying health condition.