4 Clues You May Be In Perimenopause


Sometimes it can be hard to know if you’re approaching menopause. It may not even be on your radar, or you may have a small inkling that the signs might be beginning to show, or you may just be in total denial because you feel way too young to be even thinking about menopause!

You might be saying to yourself: “My cycle is just a little bit weird this month”, or “Whoa, the thermostat in this room must be set to a really high temperature”, or “I’m really stressed right now so my body’s out of balance.” 

And these things may be true! But, you may be entering the time of hormonal, emotional, mental and spiritual transition that eventually leads to menopause- a significant, inevitable and totally natural phase of every woman’s life. 

But, how do you know for sure? 

Well, first let’s talk about what perimenopause even means. Many people say they’re going through “menopause” because they’re experiencing “menopausal symptoms,” when in fact they’re going through perimenopause. 

Did you know the term menopause actually only refers to the moment you haven’t had a period for one year (12 consecutive months in a row)? 

Everything before that is technically perimenopause. 

What is Perimenopause? 

Perimenopause means “around menopause” and is the phase that leads up to menopause, also known as the “menopausal transition”(6). Menopause itself occurs the day you officially haven’t had a period for one year. Perimenopause typically starts on average 4 years before menopause, but is super variable from woman to woman. It’s when estrogen is starting to decline (or go up and down like a rollercoaster, sound familiar?) and can be accompanied by significant physiological body changes, emotional, mental and even spiritual shifts. 

4 Clues You May be in Perimenopause

1) Your Age

The average age for a woman to go through menopause is around 51 years old. But every woman is different and perimenopause can start in a woman’s early-forties to mid-fifties, with some women noticing symptoms as early as their 30’s. Some women go into menopause “prematurely,” which is menopause before age 40, so just because you haven’t hit 40 yet, doesn’t mean this shouldn’t be on your radar. 

2) Family History

One of the first ways you can figure out if you’re in perimenopause is by asking your mother (or sister) when she went into menopause. Family history and genetics is one of the determining factors for when a woman will go into menopause (4). If the women in your life have gone into menopause earlier, and you start to notice some of the signs, then that can be another clue. 

3) Changes to Your Menstrual Cycle 

As hormone levels shift leading up to menopause, ovulation becomes more erratic and your menstrual cycle can start to change in ways that are unfamiliar to you. It’s normal for a woman’s cycle length to shorten or lengthen, and for irregularities in the cycle to occur. In fact, many women will experience erratic ovulation and menstruation as the only features of their approaching menopause (5). 

Heavier cycles, spotting, skipping periods entirely and your menstrual cycle changing, are all normal features of perimenopause.  

Heavy bleeding or “flooding” can be a normal feature of perimenopause, but if it’s happening often, then getting yourself checked out by a doctor is definitely in order, just to make sure there’s no underlying issue to be concerned about. 

4) You Have New Symptoms Commonly Associated With “Menopause” 

If you have new symptoms popping up that you’ve never really dealt with before, and they’re from the list below, it may be a sign you’re in the menopausal transition. 

Of course, some of these can occur outside of perimenopause, so it’s important to check with your family doctor, gynecologist or naturopathic doctor to rule out any underlying health condition that may be of concern. 

What Can I Expect During Perimenopause? 

You might have a smooth and graceful transition with very mild, or no symptoms at all! That is possible, especially if your diet and lifestyle are geared towards health and wellness. However, some women experience really troublesome symptoms that impact their daily lives. It can be different for every woman and the severity can vary, but here are some typical features that can accompany this transitional phase: 

Hot flashes and Night Sweats

If this is you, you’re in good company! Apparently, 75% of US women experience hot flashes, with 15% of them having really severe symptoms (1). Hot flashes can be uncomfortable, and even feel like anxiety or panic rising in the body. They can also lead to embarrassment when they happen in public places, or at the workplace. Night sweats make sleeping really difficult! When you’re busy throwing the blankets off all night because you’re so hot, just to put them back on again because the sweat cools you down, it’s really hard to rest. This creates a cycle of fatigue during the day and can contribute to mood disturbances, such as irritability, anxiety and depression. 

Memory Problems 

When this starts to present itself, it can be terrifying! You think to yourself: “Am I losing my marbles? Or worse, is this early onset Alzeihmer’s?” It’s thought that the change in hormones, specifically estrogen, plays a role in this cognitive decline. Plus, if you’re getting no sleep or are under a lot of stress (or have been in the recent past), then this is aggravated even further. Lack of concentration, focus and short-term memory lapses (“Seriously, what’s her name again? Where the heck are my keys?! Really, I said that?”) can all be features of perimenopause. 

Sleep Disturbances & Insomnia 

Super common, but not easy! Sleep issues or insomnia can lead to stress, daytime fatigue, irritability, anxiety and depression. As I mention in my article Menopause 101: What is Happening to me?, a surprising reason for sleep disturbance (that often gets missed during perimenopause) is sleep apnea. As estrogen and progesterone drop, sleep apnea can develop and contribute to a poor night’s sleep, daytime fatigue and lack of energy. Menopausal women are two to three times more likely to develop sleep apnea than non-menopausal women, so keeping this in mind is important!

Other Common Symptoms: 

  • Vaginal dryness
  • Decreased libido
  • Heart palpitations
  • Weight gain
  • Loss of bone density
  • Changing cholesterol levels 
  • More frequent UTI’s (Urinary Tract Infections) or bladder issues 

Is Menopause Experienced Differently in Cultures Around the World?

Not all women experience menopause the same, and then interestingly enough, cultural differences play a role too! 

According to the Canadian Women’s Health Network, here are some intriguing differences about how women experience menopause across different cultures:

  • Japanese women report fewer hot flashes and other symptoms (the leading thought on this is that their diet is naturally rich in phytoestrogens such as soy, which lessens the effects of declining estrogen) 
  • Thai women record a high incidence of headaches
  • Scottish women record fewer severe symptoms
  • Greek women report a high rate of hot flashes
  • Mayan women report no symptoms

Not surprisingly, like all things related to our health and well-being, “women’s experiences of menopause can be related to many things, including genetics, diet, lifestyle as well as social and cultural attitudes toward older women” (3).

I find this last part particularly fascinating. If we lived in a culture that embraced aging as a valuable time of life, and honored women for the wisdom and experience that comes with age, would embracing menopause be easier? Would women experience less symptoms?  I really think so. 

Click here to check out my article: Menopause 101- What is Happening to me? where I dive into my Top 5 Favorite Herbs for Menopause

BONUS- My Favorite Hot Flash Herb: 

I love this herb so much it needed its own whole write up!

Check out my FREE GUIDE here>>> A Clinical Herbalist’s #1 Herb for Hot Flashes 


  1. Romm, A. (2010) Botanical Medicine for Women’s Health, Churchill Livingstone.  

  2. University of Pittsburgh Medical Center (UPMC)-  Perimenopause: How to Spot the First Signs of Menopause

  3. Canadian Women’s Health Network- Menopause

  4. Oxford Academic- The role of genetic factors in age at natural menopause

  5. Trickey, R. (2003) Women, Hormones & the Menstrual Cycle. Griffin Press.  

  6. Mayo Clinic- Perimenopause

1 comment

  • Thank you Bree, for the very helpful information!

    Judith Ewaniuk

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