You've probably seen the videos — women talking about forgetting words mid-sentence, snapping over something small, waking up exhausted at 3 a.m. or wondering why they suddenly don't feel quite like themselves.
If any of that sounds familiar, there may be a reason.
Khai Ling Tan, MD, gynecologist at HonorHealth, says what often gets missed is that perimenopause is a real transition happening in the body. Understanding what's behind these changes is often the first step toward feeling more like yourself again.
What’s happening beneath the surface
Perimenopause is the time leading up to menopause when your hormone levels begin to shift. It often starts in a woman’s 40s, though some notice changes earlier. During this stage, cycles may become less predictable, and changes can show up in sleep, mood, memory and energy.
Perimenopause can last for several years before menopause, which is defined as 12 months without a period.
“Perimenopause is a normal transition, but that doesn’t mean the symptoms should be ignored,” says Dr. Tan. “The effects can show up in many different ways, and every woman’s experience is different.”
More than hot flashes: signs you might expect
When people think menopause, they often presume hot flashes. But many women may notice other changes, such as:
- Brain fog or forgetfulness
- Trouble sleeping or staying asleep
- Mood swings, anxiety or irritability
- Fatigue or low energy
- Changes in your menstrual cycle
- Night sweats
- Weight changes
- Joint aches
- Vaginal dryness
- Changes in libido
These changes are often easy to dismiss as stress, aging or not getting enough rest. That’s why it’s important to talk to your gynecologist about what you’re feeling.
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The truth is, perimenopause looks different for everyone. For some, symptoms are mild. For others, they begin to affect sleep, mood, focus and daily life.
You don’t have to just push through it
There’s no single way perimenopause shows up, and no single way to manage it.
Some women feel better with lifestyle changes like exercise, stress support and sleep habits. Others may benefit from medication or hormone therapy, depending on their symptoms and health history.
“Menopause and perimenopause can affect every woman differently, which is why individualized care matters,” says Dr. Tan. “At HonorHealth, we help women understand what is happening in their bodies, review evidence-based care options and connect with the right specialists when additional support is needed. We make it a point to support decisions that fit each patient’s symptoms, health history and goals.”