When you’re in your 30s or 40s, it can be easy to brush off menopause as something you only need to start thinking about once you enter your 50s, but your body often starts changing long before that. If you’re in your late 30s or 40s and feeling “off”— maybe your periods are irregular, your sleep is disrupted, or your moods are all over the place — you could be experiencing perimenopause.

Perimenopause is a natural transition, but it can catch many women by surprise. Learn more about what you should know to feel in control and supported during this stage of life.

What Is Perimenopause?

Perimenopause simply means “around menopause.” It’s the time leading up to your final period, when your ovaries gradually produce less estrogen. This stage typically begins in your 40s, but for some women, it can start as early as their mid-30s. On average, perimenopause lasts about four to eight years. Once you’ve gone 12 consecutive months without a period, you’ve officially reached menopause, and perimenopause is over

During this time, hormone levels fluctuate — sometimes a lot — which is what causes the wide range of symptoms women often experience.

Common Symptoms of Perimenopause

The symptoms of perimenopause can vary widely from person to person, and they often show up gradually. Some of the most common include:

• Irregular periods – They might be shorter, longer, heavier, lighter, or more spaced out.
• Hot flashes and night sweats – About 75% of women experience them at some point.
• Mood changes – You may feel more irritable, anxious, or down than usual.
• Sleep issues – Trouble falling or staying asleep is common, even if you’ve always been a good sleeper.
• Brain fog – Difficulty concentrating or memory lapses can be frustrating and confusing.
• Changes in libido – Your interest in sex might increase or decrease, and vaginal dryness can also affect comfort.
• Fatigue and body aches – Lower energy and more soreness are often part of the mix.

While these symptoms are all normal, they can still feel overwhelming, especially when you’re juggling work, family, and everything else life throws your way.

When Should You Talk to a Doctor?

If your symptoms are affecting your quality of life, it’s a good idea to check in with your doctor. Irregular periods could also signal other issues like thyroid problems or fibroids, so it’s important to rule those out.
You don’t have to wait until you’re “officially” in menopause to get help. In fact, the earlier you bring up perimenopause with your provider, the more proactive you can be about managing your symptoms and protecting your long-term health.
Your doctor may recommend:

• Lifestyle changes, like improving sleep, nutrition, and exercise habits
• Non-hormonal treatments, such as supplements or medications to manage specific symptoms
• Hormone therapy, if appropriate for your health history and needs

Supporting Your Body During This Transition

Taking care of your physical and mental health can make a big difference in how you feel during perimenopause. Here are a few steps you can take:

• Prioritize sleep – Aim for 7–9 hours of rest and create a calming bedtime routine.
• Move your body – Regular exercise can improve mood, sleep, and bone health.
• Eat for hormone balance – Focus on whole foods, fiber, and healthy fats.³
• Reduce stress – Mindfulness, journaling, or simply taking breaks can support emotional well-being.
• Stay connected – Whether it’s friends, family, or a support group, you’re not in this alone.

What’s Next?

Perimenopause is a normal, natural part of life, but it’s often misunderstood or overlooked, especially in younger women. If you’re noticing changes and wondering if it could be perimenopause, start the conversation with your doctor. With the right support and strategies, you can feel like yourself again — even as your hormones shift.

To find an OB/GYN or family practice physician on staff with Texas Health, visit TexasHealth.org/Doctors.