What No One Tells You About Perimenopause (Until It Happens to You)

What No One Tells You About Perimenopause (Until It Happens to You)

Diverse women navigating perimenopause with awareness and support.

You’re Not Crazy. It’s Probably Perimenopause.

It doesn’t hit like a single moment. It sneaks in—subtle, weird, and often misread. One day your cycle’s reliable, your moods are manageable, and your brain is sharp. Then slowly, unpredictably… things start shifting. You’re forgetting words mid-sentence. You cry during commercials. Your joints ache after a walk. One month you skip your period entirely, the next it floods in like a tidal wave.


This is perimenopause. And most women don’t even realize they’re in it until they’re well into the hormonal freefall.


Here’s what no one really prepares you for: perimenopause can start as early as your mid-30s. You may still be getting your period, but your hormones are already running a new playbook behind the scenes. And if you’ve ever felt blindsided by your own body or brushed off by a healthcare provider, you’re far from alone.


What’s Actually Happening In Your Body

Let’s break it down. Perimenopause is the transitional phase before menopause, and it can last anywhere from 2 to 10 years. Estrogen and progesterone—the two main hormones that regulate your cycle—start to fluctuate. Sometimes wildly. Ovulation becomes more erratic. This hormonal rollercoaster sends ripples through nearly every system in your body.


Here’s what often starts showing up:

  • Irregular periods (shorter, longer, skipped altogether)
  • Sleep disturbances (hello, 3 a.m. wide-awake anxiety)
  • Hot flashes or night sweats (even before full menopause)
  • Increased irritability or rage (this isn’t “just PMS” anymore)
  • Brain fog and memory lapses
  • Changes in libido or vaginal dryness
  • New or worsening anxiety
  • Aches and joint pain that feel suspiciously like aging


The hormonal decline isn’t linear, which makes it maddening to track. One month you feel like yourself again, the next you’re wondering if you’re losing your mind. You’re not. This is a physiological shift—not a personal failure.


Why Most Women Miss the Signs

The big myth? That perimenopause = hot flashes + periods stopping. That’s menopause—and it’s just one day: the 12-month mark since your last period. Everything before that? Perimenopause. And it can begin while you’re still “regular.”

Women often spend years in perimenopause without realizing it. Partly because we’re taught to expect these changes in our 50s—not our 30s or early 40s. And partly because the symptoms mimic everything from burnout and stress to thyroid dysfunction or depression.


Add in the cultural silence and medical gaslighting (“You’re too young for that,” “It’s just stress,” or “Maybe try an antidepressant?”), and you’ve got millions of women second-guessing their intuition.


How to Track What’s Going On

You don’t need to wait until everything’s unmanageable. You can start gathering data now:

  • Cycle tracking apps like Clue, Flo, or MyFLO can reveal subtle shifts in period length, symptoms, and mood patterns.
  • Symptom journaling helps connect dots across sleep, stress, cognition, and emotions.
  • Lab testing—especially if you suspect hormonal imbalance—can provide a snapshot, though timing matters. Estrogen, progesterone, FSH, and LH can fluctuate daily.


If you're in your late 30s or 40s and suspect perimenopause, ask for a full hormone panel—don’t settle for a basic blood draw that skips sex hormones. Saliva and dried urine (DUTCH) testing can also offer deeper insight into hormone metabolites and adrenal health.


When to Push for Hormonal Testing

If you feel off and your regular labs keep coming back “normal,” push harder. Ask for:

  • FSH, LH, Estradiol, Progesterone (mid-cycle is best)
  • Thyroid panel (TSH, Free T3, Free T4, reverse T3, thyroid antibodies)
  • Cortisol (morning or 4-point curve) if stress is wrecking you
  • Vitamin D, B12, and ferritin—low levels can mimic or worsen fatigue, anxiety, and cognitive symptoms


You may need to advocate for yourself more than you expect. It’s frustrating—but worth it.


Real Talk: What Women Say It Feels Like

There’s power in shared experience. Here’s what women often report once they finally put the pieces together:

“I thought I was losing it—crying at work, forgetting names, lashing out at my partner. I had no clue it was hormonal.”
“My doctor said I was ‘too young,’ but I knew something was off. My joints hurt, my sleep was wrecked, and I was ragey all the time. It was perimenopause.”
“The anxiety came out of nowhere. I’d never had panic attacks before. Turns out my estrogen was crashing.”


These stories are common—and often dismissed. The more we talk about them, the faster we normalize perimenopause as a natural (but messy) chapter—not a silent struggle.


You Deserve to Feel Informed, Not Blindsided

No one hands you a manual for this stage of life. But imagine if they did. Imagine if we were taught:

  • That perimenopause can start before 40.
  • That your mood swings aren’t just “emotional”—they’re biochemical.
  • That you’re allowed to ask for labs, second opinions, and support.
  • That you’re not broken—you’re transitioning.


The silence around perimenopause isn’t just inconvenient. It’s harmful. But awareness changes that. When you understand what’s happening in your body, you can respond instead of just endure.


So, What Can You Do Now?

Here’s a start:

  1. Start tracking your symptoms and cycles—even if they seem minor.
  2. Speak up if you feel dismissed or unheard. You know your body best.
  3. Find a practitioner who listens and specializes in hormone health.
  4. Support your system with sleep, strength training, blood sugar balance, and stress reduction.
  5. Connect with other women—you’ll realize you’re not the only one navigating the chaos.


You’re not making it up. You’re not alone. You’re not crazy.
You’re in perimenopause—and now, you know what that means.