What Is Perimenopause? The First Signs to Look For
Many women begin to notice shifts in their sleep, mood, or cycles in their 30s or 40s, and don’t realize these may be early signs of perimenopause. Without clear understanding, it’s common for these changes to be misattributed to stress or the “normal” aging process. In this article, we’ll demystify perimenopause: what it is, why it matters, and the first signs you should pay attention to.
What Is Perimenopause?
Perimenopause is the stage leading up to menopause when hormone levels, including estrogen, progesterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH), begin to fluctuate and ovarian function gradually changes.
Unlike menopause, which is confirmed when a woman has gone 12 consecutive months without a menstrual period, perimenopause is a process, not a moment.
Perimenopause can begin as early as mid-30s for some women and may last several years (sometimes even a decade or more).
Because hormone changes begin before periods become noticeably irregular, many women don’t realize they are in perimenopause for years.
Why It Matters
Perimenopause is common but under-recognized. Often, symptoms are not connected to the hormonal shifts happening inside your body. That gap can delay care, worsen symptoms, and contribute to confusion or frustration.
Recognizing perimenopause early has real benefits -
Earlier awareness: You're more likely to notice patterns and anticipate change
Better care & communication: You can bring data and context to conversations with your provider
Proactive health management: Many long-term health concerns (bone health, cardiovascular risk, metabolic changes) begin around midlife, and hormone shifts correlate with increased vulnerability in these areas
Understanding perimenopause gives you power, not just to cope, but to thrive.
The First Signs to Look For
Below are some of the earliest and most common indicators of perimenopause. Keep in mind, these can vary widely between individuals.
Cycle Changes
Periods may become irregular (sometimes heavier, sometimes lighter) and your cycle length may shorten or lengthen unpredictably.
These shifts happen because the communication system between the ovaries and the brain (i.e. feedback loops) and regular hormone patterns start to lose their usual consistency.
Hot Flashes & Night Sweats
Vasomotor symptoms (hot flashes, night sweats) often appear early, sometimes even before cycle changes become obvious.
These occur when changes in estrogen levels disrupt the body’s thermoregulatory (temperature control) system.
Sleep Disruption
Difficulty falling or staying asleep, and waking up in the early hours (2–4 a.m.), are common and often linked to hormonal shifts.
Sleep disturbance often interacts with other symptoms like hot flashes, mood, and stress, creating cycles that feed into each other.
Mood Changes & Brain Fog
Irritability, anxiety, forgetfulness, and trouble concentrating are frequently reported.
Fluctuating estrogen and progesterone levels influence neurotransmitters such as serotonin and GABA, which can affect mood and cognition.
Fatigue & Energy Shifts
Many women feel more tired, even with the same routines. Hormonal changes can influence metabolism, sleep quality, and mitochondrial function, contributing to persistent low energy.
Physical Changes
Skin may become drier or thinner, hair may thin, libido may shift and metabolism and weight distribution may change (especially abdominal fat).
These changes result from estrogen decline, androgen shifts, and other systemic changes.
How Play Health Helps
Play Health’s perimenopause care platform helps you build a fuller picture and take more informed steps for relief.
Symptom tracking: logging daily experiences helps reveal patterns over time
Hormone testing: objective data adds context to symptoms
Personalized insights: helps connect the dots between what you feel and what’s happening hormonally for your experience specifically
You need clarity, not confusion so you can navigate perimenopause with confidence.
Perimenopause is a normal stage of life, but that doesn’t mean you have to go through it in silence or uncertainty. Recognizing the first signs can help you lean into midlife with confidence.
