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Menopause, perimenopause

Perimenopause starts earlier than most people expect

It can begin years before periods stop, and it rarely announces itself. The changes to watch for, and why a blood test often settles nothing.

Reviewed against NICE Guidelines, 1 min read, published

Three women of different generations smiling together

Perimenopause is the long approach rather than the arrival, and for many people it begins in their forties, while everything else in life is at its busiest.

The early signs

Cycles change first — closer together, further apart, heavier, lighter. Then the rest:

  • Hot flushes
  • Disturbed sleep
  • Mood that swings further than it used to
  • Aching joints
  • A memory that drops words mid-sentence

Your periods may become heavy or irregular before they stop. You may also have other symptoms, such as hot flushes.

— NICE, Menopause: identification and management – Information for the public

Why it gets missed

Very few people connect that list to hormones straight away, and a surprising number are told it is stress. It may be both.

Quick summary

  • When: for many people it begins in their forties
  • First sign: cycles change: closer together, further apart, heavier or lighter
  • Then: hot flushes, disturbed sleep, bigger mood swings, aching joints, lost words
  • Over 45: usually recognised from symptoms alone, so keep a short record

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