7 signs of perimenopause every woman over 35 should look out for

When your hormone levels start to change perimenopause hits - here’s what to look out for…

By Dr Naomi Potter, Menopause specialist and award-winning author

Perimenopause often begins long before you have your final period, and for many women it can start in their mid- to late thirties. Because the symptoms can feel subtle or easy to dismiss, many women spend years thinking something is wrong with them rather than recognising it as a hormonal transition. Perimenopause isn’t a problem to fix, but understanding the early signs can make the experience far less confusing and far more manageable.

Here are seven signs of perimenopause to keep an eye out for in your thirties…

1. Anxiety creeping in

Many women describe a new or unfamiliar sense of anxiety during perimenopause. This is driven by fluctuating oestrogen, which affects brain chemicals like serotonin and GABA. You might feel suddenly more on edge, overwhelmed by things you used to cope with well or experience a racing heart or sense of dread for no clear reason. This can be one of the earliest and most overlooked signs.

2. Periods changing

Changes in your menstrual cycle are one of the most common early signs of perimenopause. Your periods might become heavier, lighter, more irregular, closer together or further apart. You may also notice more clotting or longer-lasting bleeding. These changes reflect unpredictable ovulation and fluctuating hormone levels, and they can happen years before your periods stop completely. Periods getting heavier should be investigated, so please speak to your doctor if this is happening to you.

3. Worse PMS

If your premenstrual symptoms suddenly feel more intense, longer-lasting or harder to manage, perimenopause could be the reason. Breast tenderness, bloating, irritability, low mood and fatigue can all worsen as progesterone levels drop and oestrogen fluctuates. Many women feel like their emotions and body reactions are more extreme in the lead up to their period.

4. Word-finding difficulty

That frustrating moment when the word is on the tip of your tongue becomes much more common in perimenopause. Hormonal shifts affect brain function, memory and concentration. You might feel foggy, forget appointments or struggle to find simple words in conversations. This can be unsettling, but it’s a recognised hormonal symptom that can be alleviated with treatment.

5. Libido disappearing

A drop in sexual desire is a very common but rarely discussed sign. Lower oestrogen and testosterone levels can reduce natural lubrication, make sex feel uncomfortable and dampen sex drive. This isn’t a reflection of your relationship or attraction but rather a biological change. And, yes, support is absolutely available.

6. Aching muscles and joints

Unexplained joint stiffness, aching muscles and slower recovery after exercise are classic perimenopause symptoms. Oestrogen has anti-inflammatory effects, so when levels fluctuate or decline, the body can feel more stiff, sore and inflamed. Many women notice morning stiffness, sore shoulders, hips or knees or more frequent injuries.

7. Weight gain

Many women find that weight begins to creep up during perimenopause, even when their diet and activity levels haven’t changed. Hormonal changes affect how your body stores fat, often moving it towards the abdomen. Metabolism can slow, and insulin sensitivity may change, making weight management more challenging and often more frustrating.

If you recognise these symptoms in yourself, it’s always worth seeking advice from a menopause doctor. You don’t have to just deal with symptoms that affect your sleep, work, relationships or confidence. Support and effective treatment options are available, and early intervention can make a real difference to your quality of life.

Dr Naomi Potter founded the UK’s leading menopause clinic - www.menopausecare.co.uk - and hosts Is It Hot In Here? Midlife Podcast for women navigating perimenopause, menopause, and midlife health.

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