The honest answer (and why every woman ends up Googling dementia at some point).
Who the f*** knows, and honey, that’s just a small part of the fun.
And no, it isn’t fun, but I was just preparing you to be gaslit in a way you never have been before, because that’s what everybody is going to do from now on.
What’s the Difference Between Perimenopause and Menopause?
Before we get stuck in, let’s get our language right. Menopause itself only lasts 1 day – yup, 1 day – and it’s the 366th day after your last period. And one of the things that has happened as perimenopause has become a longer and more symptomatic period (sorry) of a woman’s life, is that the words have got mangled.
Perimenopause is everything up to that 365th day.
Then day 366 – whoopee, you’ve completed menopause.
Post menopause – an undetermined abyss where symptoms may level out, but they never leave.
So, back to the question: how do you know when you’re in perimenopause?
Well my answer is going to be very different to your GP. They’re going to tell you “you’re too young dear” if you’re under 45, but peri can enter the chat from your mid 30s. And (for fun) it can last up to 10 years (although 4-6 is more common).
If you’ve already Googled the symptoms of perimenopause (and I know you have), you’ll be familiar with the main ones and the dozens of others, but I’m going to start you with my favourites.
How I Knew I Was in Perimenopause (My Symptoms)
The First Sign: An Itch I Couldn’t Explain
For me, it started with an itch. A great swathing itch across my torso and abdomen that I could not satisfy, even when I’d drawn blood. I hadn’t changed clothes washing liquid (whatever the proper name is), and I hadn’t changed bath or shower gel, so I was pretty confident it was hormones.
Then the Crying, and the Anxiety
Then I started crying a lot more. I was on the pill (and had been for 15 years) so my moods were relatively stable, but suddenly I would blub at anything – a movie, a sporting achievement, a cute cat lol. And especially if I was angry or frustrated.
And that was when I really knew. And I was lucky. I had a female GP who immediately put me on HRT, and that was that until my armpits REALLY started smelling and she put me on another one.
Because of the pill, I didn’t get the usual warning sign of irregular periods or a change in them or my cycle. And I also didn’t get a single hot flush (I assumed it would arrive with a certificate: You’re in peri / welcome to hell.)
My sleep – which is often the first thing that changes for women – wasn’t too bad, but I did have an odd pattern of waking up at 3am and taking 2 hours to get back to sleep. BUT it only happened on a Tuesday, and not even every Tuesday.
Anxiety is how peri really hunted me down, and it was probably my worst symptom. A lifelong sufferer with depression, I now had anxiety to deal with too, and the 2 are like 2 very combustible chemicals that shouldn’t really mix.
I remember being anxious for no known reason. A feeling of impending doom that I could feel in the pit of my stomach and the pulse of my veins.
I remember watching the clock, willing time away so that I could arrive in a new day, feeling calmer. And I remember sleep feeling like it was my only safe space, and drinking too much vodka to land there quicker.
But here’s the thing – every woman experiences peri and meno differently. These were my clues, but yours may be different. Some women really do sail through it, with almost no disruption, whilst others of us feel like we’ve lost control of our bodies, and lost ourselves in the process.
Why Perimenopause Symptoms Happen (Oestrogen, Progesterone & Your Nervous System)
So let’s start with why it gets so shit so quickly –
The graph above shows what happens as we enter peri – oestrogen starts to fluctuate (quite wildly) and progesterone literally falls off a cliff. And it’s funny, because most GPs will give you more oestrogen, but not more progesterone.
So why do we need progesterone? Because it’s the calming hormone. It helps us sleep and it helps with anxiety, and that’s exactly why these are often 2 of the very first symptoms to show.
The minute you start waking up at 3am – that’s your progesterone wandering off without so much as a goodbye. And that’s why all the herbal teas, magnesium and sleep podcasts can sometimes feel like they’re barely scratching the surface.
And then let’s talk about oestrogen, going up and down like the rollercoaster of hell, depositing mood swings, snappiness, the desire to kill your husband because he breathes too loudly – and brain fog.
Brain Fog: The Most Confusing Perimenopause Symptom
And brain fog is the scary one. I suspect there’s not a single perimeno woman who hasn’t Googled “signs of early dementia” because it seems a more rational explanation for what’s happening to us.
Brain fog is the Queen of my Symptom list, and this is how it feels for me –
- Having a thought and it literally evaporating before I’ve caught it
- Being unable to remember to do something unless I add it to my Notes app, write it on a Post It and/or my hand, and on my planner or in my notebook
- Calling people by the wrong name, and knowing that I’m doing it as the word is falling off my lips
- Waiting to say something in a meeting and then completely forgetting what it is when I’m asked for my thoughts
- Accepting that my once immaculate memory is no longer reliable, and just because I think that’s what happened, doesn’t mean it did
- A massively reduced ability to absorb information, whether from email, a conversation or a book (ah books, I wish I could devour you again)
Other Common Perimenopause Symptoms
And then let’s touch on some of the other fun symptoms –
- Itchy ears – literally, WTF
- Frequent UTIs
- Headaches
- Joint pain
- Facial hair (where every f*cker appears overnight, thick as a wire)
- Reduced libido
- Hair loss
- And weight gain, because that’s what every woman really wants, right?
So, Am I in Perimenopause?
Maybe.
Maybe not.
Who the fuck really knows?
But if you’ve reached the end of this blog and diagnosed yourself with approximately 27 symptoms then welcome – you are among friends.
And if you’d like to hang out with us, you can join us HERE in The No BS Menopause Club on Facebook.
Frequently Asked Questions
What age does perimenopause start?
Perimenopause can start from your mid-30s, though most GPs associate it with 45+. It typically lasts 4 to 10 years (commonly 4 to 6) and ends 366 days after your last period, which is the day you officially reach menopause.
What are the first signs of perimenopause?
The first signs are different for everyone. Common early ones include changes to sleep (especially waking around 3am), increased anxiety or tearfulness, skin or scalp changes, and irregular periods, though the pill can mask this last one.
Can you be in perimenopause without hot flushes?
Yes. Hot flushes are one of the more talked-about symptoms, but plenty of women go through perimenopause without them and experience anxiety, brain fog, or sleep disruption instead.
Why does perimenopause cause brain fog?
It’s linked to fluctuating oestrogen and falling progesterone, which affect memory, focus and word recall. It’s a real, physiological symptom, not “losing your mind.”
Ready to Stop Guessing? Book a Free Compass Call
And if you’re still unsure whether it’s perimenopause, burnout, stress, poor sleep, nutrition – or a glorious combination of all four – you deserve someone who’ll help you untangle it.
That’s what I do.
No judgement.
No eye-rolling.
No “you’re too young.”
Just someone who understands both the science, and what it actually feels like to live through it.
If you’d like to talk it through, book a free Compass Call.
Bring your symptom list.
Bring your questions.
Bring your husband if you want someone to explain why he’s breathing too loudly.
We’ll work it out together.
I’ll bring the science.
You bring the symptoms.
(And snacks. Always snacks.)