Perimenopause can feel like your body suddenly switched operating systems without giving you the manual. If you’re noticing irregular periods, brain fog, mood swings, or hot flashes and wondering, “What is happening to me?”—you’re absolutely not alone. I put together a small guide for you to refer to if you're having some similar symptoms.

What Perimenopause Actually Is

Perimenopause is the transition phase leading up to menopause, when your hormones start fluctuating and your period becomes less predictable. It can last 4–8 years for many women, and sometimes even longer! I know, being a woman is awesome......lol.

A few grounding facts:

• Symptoms can start as early as your 30s, not just your 50s.

• In one large survey, over half (55.4%) of women aged 30–35 reported moderate to severe menopause-related symptoms.

• Symptoms often peak in the early 50s, but emotional and mental symptoms can show up years before that.

So if you’re in your late 30s or 40s and feel “off,” you’re not imagining it.

Irregular Periods During Perimenopause:

This is often one of the first signs that something’s shifting. Irregular periods during perimenopause happen because estrogen and progesterone start swinging up and down instead of following their old, predictable pattern.

Common changes:

• Periods that are closer together or farther apart than your usual cycle.

• Heavier or much lighter bleeding than you’re used to.

• Skipped periods or cycles where you spot, stop, and then start again.

A 2025 study of over 4,400 women found that irregular cycles and longer gaps between periods (60+ days) were strongly linked with perimenopause status. That means if your period has suddenly stopped playing by the rules, it’s a pretty classic sign.

When to talk to a doctor:

• Bleeding is so heavy you’re soaking through pads or tampons every hour.

• You’re having bleeding after sex or between periods in a way that feels new or different.

• Your gut says, “this doesn’t feel right.”

You deserve to ask questions and get clear answers—this isn’t “just in your head.”

Brain Fog:

• Trouble concentrating

• Losing words mid-sentence

• Forgetting names or appointments

• Feeling like their brain is wrapped in "cotton"

Research shows that perimenopause can affect attention, processing speed, and working memory, largely due to fluctuating estrogen levels. These hormonal shifts also affect sleep and mood, which then make brain fog even worse.

Some encouraging news:

• Studies suggest these cognitive changes are usually temporary and tend to improve in the later stages after hormones settle.

• You’re not “losing it” or “getting old too fast”—your brain is reacting to real biological changes.

Things that can help:

• Protecting sleep as if it’s medicine (because it basically is).

• Gentle movement or strength training to boost blood flow to the brain.

• Writing things down, using reminders, and giving yourself grace instead of beating yourself up.

Depression, Anxiety, and That Heavy Emotional Fog

Mood changes in perimenopause are a real phenomenon, not a character flaw. Hormones are shifting, sleep may be a mess, and life stress (careers, kids, aging parents) are all often peaking at the same time.

What the numbers say:

• Perimenopause is the stage with the highest risk of depression compared with pre- and post-menopause.

• Studies report depression symptoms in about 18–26% of perimenopausal women and anxiety in a similar range in some groups.

• One study found that about 1 in 10 women fell into a “severe depression and anxiety” group.

Top emotional symptoms women report:

• Low mood or depression fatigue—feeling exhausted and flat, not just physically tired

• Irritability and rage that feel out of character

• Anxiety, worry, or a sense of dread that wasn’t there before

• Feeling “not like myself anymore”

In a large US survey, 71% of women said they weren’t prepared for how disruptive their menopause symptoms would be, and many reported feeling generally negative about the whole experience. That’s a lot of women feeling blindsided!

*Please hear this:

If your mood feels heavy, it doesn’t mean you’re weak. It means your body and brain are going through something big—and you’re allowed to ask for help. Therapy, support groups, lifestyle changes, and sometimes medication or hormone therapy can all be part of a valid, evidence-based plan.

Hot Flashes During Perimenopause:

• A sudden wave of heat rising from your chest to your face

• Flushing, sweating, and sometimes a pounding heart

• Followed by chills once the surge passes

Medical guidelines describe hot flashes as one of the most common perimenopause symptoms, and their severity tends to peak between ages 51–55. Night sweats are the nighttime cousins of hot flashes, and they can wreck sleep.

A big international analysis found that bothersome hot flushes jumped from about 8.8% in premenopause to much higher rates as women moved through the transition. They can stick around for years if not addressed.

Things that often help:

• Keeping your bedroom cool, using breathable fabrics, and layering clothes.

• Avoiding big triggers for some women like alcohol, spicy foods, or very hot drinks.

• Talking with your clinician about options like hormone therapy or non-hormonal medications if hot flashes are impacting your daily life.

You don’t “have to just live with it” if it’s affecting your sleep, mood, or relationships.

Fatigue:

When you're tired down to your bones. Fatigue in perimenopause is the perfect storm of poor sleep, hormonal chaos, emotional load, and sometimes nutrient shifts.

How common is it?

• Fatigue is listed among the top five perimenopausal symptoms (along with insomnia and emotional instability).

• Many women describe it as more than just tired—it’s like the battery never fully recharges, no matter how much they rest.

Why it happens:

• Estrogen drops affect sleep quality, body temperature regulation, and mood.

• Night sweats and hot flashes wake you up repeatedly, even if you don’t always remember it.

• Mood changes and anxiety make it harder to fall and stay asleep.

Small steps that can help:

• Gentle movement most days (even walking) can paradoxically boost long-term energy.

• Eating enough protein, fiber, and iron-rich foods to steady blood sugar and support energy.

• Keeping a simple sleep routine: dimmed lights, screens away, wind-down rituals.

And again, if fatigue feels extreme or sudden, get labs done—things like thyroid issues, anemia, or sleep apnea can also be part of the picture.

You’re Not Imagining This—And You’re Not Alone

Depression, Anxiety, and That Heavy Emotional Fog

Mood changes in perimenopause are real, not a character flaw. Hormones are shifting, sleep may be a mess, and life stress (careers, kids, aging parents) is often peaking at the same time.​

What the numbers say:

• Perimenopause is the stage with the highest risk of depression compared with pre- and post-menopause.

• Studies report depression symptoms in about 18–26% of perimenopausal women and anxiety in a similar range in some groups.​

• One study found that about 1 in 10 women fell into a “severe depression and anxiety” group.

A few stats that might make you feel a little less alone:

• More than half of women 40–64 have symptoms related to perimenopause or menopause, yet many never get an official diagnosis or clear explanation.

• In one survey, 59% of women said they didn’t even know about perimenopause until they were already in it.

• Over 70% said they weren’t prepared for how disruptive the symptoms would be to their daily lives.

So if you’ve been thinking, “Why did no one warn me?”—you’re echoing millions of other women.

How to Advocate for Yourself:

You deserve care that takes you seriously. When you talk to a healthcare provider, it can make things easier if you:

• Track your symptoms for a few weeks: irregular periods, brain fog, mood, sleep, hot flashes.

• Bring a simple list: “These are the things affecting my daily life the most.”

• Ask directly: “Could this be perimenopause?” and “What are my options for treatment or support?”

If you feel dismissed, it’s okay to seek a second opinion or look for someone who specifically mentions menopause. If you take nothing else from this, let it be this, you are not “too young,” you are not “overreacting,” and you are definitely not alone in this. Your body is hugely shifting gears, and you deserve information, validation, and support every step of the way.

**Please remember, do not take this as medical advice. I am not a medical doctor. Please seek a physician's advice or call 911 if you feel it necessary.**

Sources:
Mayo Clinic – “Perimenopause: Symptoms and Causes”​
NewYork-Presbyterian – “What Is Perimenopause and How Do You Know If You’re in It?​
Nature (2025) – “Perimenopause symptoms, severity, and healthcare seeking in midlife women”​
Contemporary OB/GYN (2025) – “Perimenopause symptoms common in women as young as 30​
Carrot Fertility – “The Menopause Report: 2025 trends and statistics”​
Bonafide Health – “State of Menopause” survey ​
NIH / PMC – “Insights into Perimenopause: A Survey of Perceptions, Opinions on Menopause”​
NIH / PMC – “Cognitive Problems in Perimenopause: A Review of Recent Evidence​
Frontiers in Psychiatry (2025) – “Latent profile analysis of symptoms of depression and anxiety across the menopausal transition”​
Systematic review – “The risk of depression in the menopausal stages”​
Women’s Mental Health (MGH Center) – “Who Is at Risk for Depression During the Perimenopause?”​
Natural Cycles – “Perimenopause and Fatigue: Symptoms, Causes & How To Treat”​
NPR – “Perimenopause symptoms can be a drag. Here’s when to seek help”​
Evernorth – “Research finds that few women receive diagnoses of perimenopause or menopause​

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