Perimenopause can begin as early as your mid-30s or early 40s, yet many women spend years searching for answers. Symptoms are often subtle at first, fluctuate month to month, and are frequently dismissed as stress, aging, or lifestyle-related.

Perimenopause is not a disease—it’s a hormonal transition. The challenge is that hormone levels don’t simply decline; they swing unpredictably, which is why symptoms can feel confusing and inconsistent.

15 Early Symptoms of Perimenopause

  1. Irregular periods – shorter cycles, missed periods, heavier or lighter flow
  2. Increased anxiety – especially new-onset or worsening anxiety
  3. Insomnia – difficulty falling or staying asleep
  4. Night sweats or hot flashes – often mild at first
  5. Weight gain – especially around the abdomen
  6. Brain fog – memory lapses or difficulty concentrating
  7. Low libido – decreased desire or pleasure
  8. Persistent fatigue – even with adequate rest
  9. Headaches or migraines – often tied to hormonal shifts
  10. Breast tenderness – similar to PMS but more frequent
  11. Worsening PMS – mood swings, bloating, irritability
  12. Joint or muscle pain – estrogen has anti-inflammatory effects
  13. Digestive changes – bloating, constipation, food sensitivities
  14. Hair thinning or skin changes – dryness, loss of elasticity
  15. Feeling “off” or not like yourself – even when labs look “normal”

Why These Symptoms Are Missed

Many women are told:

  • “Your labs are normal”
  • “This is just stress”
  • “You’re just getting older”

Standard lab ranges often miss functional hormone imbalances, especially during perimenopause when levels fluctuate daily.

Internal link: Hormone Testing: Why ‘Normal’ Labs Don’t Always Mean Optimal

What Helps

Early intervention can reduce symptom severity and prevent years of unnecessary suffering. A personalized hormone evaluation looks beyond one lab value and considers symptoms, patterns, and lifestyle.

Think this might be perimenopause?
Schedule a personalized hormone consultation with one of our providers to understand what’s happening in your body and explore treatment options that actually help.