Perimenopause usually starts in your 40s, though for some women it begins in their late 30s. It's the transition leading up to menopause, and it can last anywhere from a few months to ten years or more. Because it creeps in gradually, many women spend a long time wondering whether what they're feeling is stress, ageing, or something else entirely, before realising it's perimenopause.
The signs are wide-ranging, and you won't necessarily experience all of them. The most common include:
- Periods becoming shorter, longer, heavier, lighter, or less predictable
- Hot flushes and night sweats
- Sleep that's harder to fall into or stay in
- Mood changes, irritability, low mood, or anxiety that feels new
- Brain fog, forgetfulness, or trouble concentrating
- Joint aches and unfamiliar fatigue
- Changes in libido or vaginal dryness
- Headaches or migraines that shift in pattern
Perimenopause isn't a straight, gradual decline, it's more of a wobble. Oestrogen and progesterone levels rise and fall unevenly, sometimes month to month, which is part of why symptoms can feel so unpredictable.
In the earlier years, progesterone tends to drop first. This is often what causes shorter cycles, heavier bleeding, or more noticeable premenstrual symptoms. As perimenopause progresses, oestrogen levels start to fluctuate more dramatically too, sometimes spiking higher than usual before dropping. These swings are commonly behind hot flushes, mood changes, and disrupted sleep.
Broadly, women move through:
- Early perimenopause — cycles are still fairly regular, but subtle changes begin.
- Late perimenopause — cycles become noticeably irregular, and symptoms tend to intensify.
- The approach to menopause — periods space out further until they stop for 12 consecutive months, which marks menopause itself.
Every woman's timeline looks different, and that's completely normal. Understanding the pattern of hormonal change, rather than expecting a smooth, predictable decline, is often the first thing that makes the experience feel less alarming.
When to start a resource audit
There's no single "right" moment, but a few signs tend to mean it's time to get some personalised guidance rather than continuing to piece things together alone:
- You've noticed changes but don't know which ones matter or what to do about them
- You've got a GP appointment coming up and want to walk in feeling prepared
- You're overwhelmed by conflicting information online and want a trusted, non-clinical starting point
- You want a plan, not just information, but a sense of what to try first
A Menopause Resource Audit is a one-to-one session where we look at what you're experiencing and match it to the right information, tools and support, nutrition guidance, sleep strategies, community resources, or simply a clearer sense of what to ask your GP. It's not a diagnosis or a treatment plan; it's a starting point that saves you months of searching alone.