The Surprising and Unsurprising Signs You May Be in Perimenopause

Some call the menopause transition adolescence in reverse. In spirit, that feels somewhat true. The actual experience, of course, is notably different: your female sex hormones are not just surging, they are also dropping, normalizing, dropping, surging, dropping, normalizing, dropping, and mostly dropping again (and not in tandem, I might add)—until they “flatline.”   How can you determine whether or not you are in perimenopause? How will a physician determine if you are in perimenopause? If you are a woman 40 and older, largely by taking note of the signs (or “symptoms” – note: you are not ill) that start to appear.

Is Your Period an Indicator?

It can be—if you are not currently on hormonal birth control—but sometimes signs of the transition can appear well before the first skipped period. That said, observing changes in your cycle, from the amount of days between periods, the number of days of flow, and the amount of flow can provide telltale signs that the transition is afoot—and even what stage of the transition you may be in. The criteria established by the medical community for entry into perimenopause is the onset of irregular or “variable length” menstrual cycles with at least 7-day differences in cycle length (for example, a cycle of 26 days followed by a cycle of 33 days).  Individuals experiencing cycle lengths of 60 days or greater are considered in late stage perimenopause.¹

Recognizing (and Talking About) the Signs  

Estrogen and progesterone are hormones that play a role in numerous functions of the body, so as they start to swing and/or recede, you can see effects across a broad spectrum of your being.  Signs, however, are easy to explain away—as I came to learn—when a lack of knowledge combines with the other myriad demands of life.  

Eighty percent (80%) of women experience “symptoms” as part of their menopause transition.²  To help shine a light on some of them, I’ve included a helpful list below of some of the most commonly reported, plus how you may want to make note of them should you need to discuss with your healthcare provider.

There are reportedly more than 30 signs associated with the menopause transition so this list is by no means exhaustive.  If you are experiencing something not included above, definitely note it and discuss it with your healthcare provider.  And remember: while menopause and the menopause transition are normal, inevitable occurrences that happen in the lifespan of a woman, dismissing the experience of signs or symptoms as simply “normal” and “something you’ll get used to” is not an acceptable response to your pursuit of solutions.  (It may, in fact, lead to another change: that of your physician.) 

Spend your money on yourself, not on a menopause test

As happens when companies see a consumer need, they bring forth “solutions”—some well intended, some entirely utile.  An over-the-counter test that measures hormone levels falls firmly into the “well-intentioned” camp.  As I indicated earlier, your sex hormones are all over the place—day by day, hour by hour—which means getting any meaningful data during the menopause transition is nearly impossible. With the myriad of signs that can appear, your body is giving you all you need to reach a conclusion—without having to pay for the result. 

All signs point to a “new you”

Like puberty, the menopause transition is a period of recalibration that will ultimately bring you into a new version of yourself. As with any journey involving change, having the right type of support can make all the difference in how you experience it and what else results.  Find those who will rally in your corner—from empathetic and proactive healthcare providers to peers, social groups, “tribes” and coaches, like me, who can help support your vision of a next level self.  This change is inevitable, but as one of my first female mentors used to say (and often): “change breeds opportunity.” Thanks to perimenopause, signs of opportunity abound.

1. Contraception During Perimenopause: Practical Guidance, Int J Womens Health. 2022
2. Moilanen JM, Aalto A-M, Raitanen J, Hemminki E, Aro AR, Luoto R. Physical activity and change in quality of life during menopause – an 8-year follow-up study. Health Qual Life Outcomes. 2012;10:8.