How to tell if your symptoms are related to perimenopause, according to doctors

You’ve been feeling off lately. Maybe your cycles are irregular, you’re suddenly waking up drenched in sweat at night, or your mood swings seem to have a mind of their own. Could it be stress? Or could it be something more?

If you’re in your late 30s or 40s, there’s a good chance you’re experiencing perimenopause, the transitional phase before menopause. But how can you tell for sure? 

To help you identify the signs and understand what’s happening in your body, we’ve gathered insights from medical research and expert recommendations.

What is perimenopause?

Perimenopause is the time leading up to menopause when your hormone levels - particularly oestrogen and progesterone - begin to fluctuate. This phase can last anywhere from a few months to over a decade, and it officially ends when you’ve gone 12 consecutive months without a period.

According to Dr. Jennifer Payne, a leading menopause specialist, “Perimenopause is a period of unpredictability. Your hormone levels rise and fall, causing a range of physical and emotional symptoms that can sometimes feel like a rollercoaster.”

Common symptoms of perimenopause

1. Irregular periods

One of the first signs of perimenopause is changes to your menstrual cycle. Periods may become shorter, longer, heavier, or lighter. Some months, you might even skip a period entirely.

Why it happens: Oestrogen and progesterone levels fluctuate, which disrupts the regular rhythm of your cycle.

Tip: Track your cycle with an app to identify irregularities. If you’re unsure, consult your doctor to rule out other causes like fibroids or thyroid issues.

2. Hot flashes and night sweats

Suddenly feeling like you’re sitting in a sauna? Hot flashes are a classic symptom of perimenopause, often accompanied by night sweats that can disrupt your sleep.

Why it happens: Your brain’s temperature regulation is affected by fluctuating oestrogen levels, causing sudden heat surges.

Tip: Dress in layers, use breathable bedding, and keep a fan or cooling spray nearby.

3. Mood swings and irritability

Feel like you’re laughing one minute and crying the next? Shifting hormones can take a toll on your mood, increasing irritability, anxiety, or even triggering depressive feelings.

Why it happens: Oestrogen influences neurotransmitters like serotonin, which regulate mood.

Tip: Incorporate relaxation techniques like mindfulness or yoga into your routine, and don’t hesitate to reach out for professional support if mood changes feel overwhelming.

4. Fatigue

Unexplained exhaustion that no amount of coffee seems to fix? Fatigue is a common complaint during perimenopause and is often linked to sleep disruptions, hormonal imbalances, or low iron levels.

Why it happens: Oestrogen fluctuations and night sweats can impact sleep quality, leaving you feeling drained.

Tip: Prioritise sleep hygiene—keep a consistent sleep schedule, avoid screens before bed, and try magnesium or herbal teas to relax.

5. Weight gain and changes in metabolism

If you’re noticing weight gain, especially around your midsection, it’s not your imagination. Perimenopause can slow down your metabolism, making it harder to maintain your usual weight.

Why it happens: Hormonal changes can shift where your body stores fat, often increasing abdominal weight.

Tip: Focus on strength training and a balanced diet rich in protein, healthy fats, and fibre to support your metabolism.

6. Brain fog and memory issues

Struggling to concentrate, remember names, or focus on tasks? Many women report brain fog as a frustrating symptom of perimenopause.

Why it happens: Oestrogen plays a key role in brain function, and its decline can affect cognitive clarity.

Tip: Stay mentally active with puzzles or learning new skills, and incorporate foods like salmon, walnuts, and leafy greens to support brain health.

7. Changes in libido and vaginal dryness

Lower sex drive or discomfort during intimacy may also be linked to perimenopause. Vaginal dryness and thinning tissues are common, but many women are hesitant to discuss it.

Why it happens: Declining oestrogen levels reduce blood flow and natural lubrication.

Tip: Over-the-counter moisturisers, lubricants, and supplements like omega-3s can help. Talk to your doctor about treatment options like vaginal oestrogen if needed.

When to see a doctor

While perimenopause is a natural process, it’s essential to speak with a healthcare provider if:

• Your symptoms are significantly impacting your daily life.

• You’re experiencing unusually heavy or prolonged periods.

• You’re unsure whether symptoms are related to perimenopause or another condition.

Dr. Payne advises, “Perimenopause can mimic other health issues, like thyroid disorders or anaemia. If you’re in doubt, a doctor can run tests to rule out other causes and offer tailored solutions.”

Listening to your body

Perimenopause can feel confusing, but you don’t have to navigate it alone. By understanding the symptoms and seeking medical guidance, you can take proactive steps to manage this transitional phase. Your body is giving you signals - it’s up to you to listen and act.

From tracking your cycle to prioritising sleep, small lifestyle adjustments can make a world of difference. And remember, whether you’re seeking natural solutions or medical treatments, support is out there.

For more resources on navigating menopause and perimenopause, explore February Bloom’s expert advice and wellness products here.