<< Back

4 Signs of Perimenopause (and How to Manage It)

April 18, 2025

Are night sweats and mood swings catching you off guard? If menopause feels like a distant worry, think again — perimenopause could be the reason, and it can begin earlier than you think.

To help you navigate this new chapter, we turned to Amy M. Johnson, MD, an obstetrician and gynecologist with Hartford HealthCare Medical Group. She shared a few tips to help you feel your best during perimenopause.

Perimenopause happens before menopause.

Menopause typically occurs around age 51, but it can happen anytime between 40 and 57. But – perimenopause symptoms can start as early as your late 30s.

During perimenopause, fertility declines and cycles become irregular as hormone levels fluctuate. You might ovulate some months but not others. Over time, estrogen drops, periods space out and eventually stop. Menopause occurs when you go 12 months without a period, and symptoms typically last an average of 7.5 years afterward.

“Perimenopause symptoms tend to show up gradually, so it’s not always easy to connect the dots right away,” says Dr. Johnson. “Many patients initially come in thinking their concerns might be from something else.”

4 signs of perimenopause to know.

So, what should you watch for? Here are four common symptoms of perimenopause:

1. Irregular menstrual cycles.
2. Hot flashes, night sweats and feeling uncomfortably warm.
3. Trouble sleeping, often waking up in the middle of the night with night sweats or anxiety.
4. Mood swings, depression and anxiety.

“There are also additional symptoms that aren’t as commonly described but frequently reported,” adds Dr. Johnson. “These include brain fog, fatigue, joint pain, weight gain, decreased libido and increased headaches.”

> Related: What Is the Best Temperature to Sleep In? 

Do you think you’re experiencing perimenopause?

Your first step is to talk to your doctor. They’ll start by reviewing your symptoms and taking a detailed history.

“Blood hormone levels aren’t usually needed to diagnose perimenopause, but your doctor will decide if testing is necessary,” explains Dr. Johnson.

The good news? Simple lifestyle changes are often the first step to feeling better.

9 tips for managing perimenopause.

While your doctor can provide tailored advice, there are steps you can start today to feel your best during perimenopause.

Dr. Johnson suggests these easy, everyday strategies:

1. Eat well: Focus on a Mediterranean-style diet high in protein and veggies and low in carbs.
2. Stay active: Stick to a consistent cardio and strength training exercise routine.
3. Cool down: Dress in breathable layers, turn down the thermostat and avoid hot foods and drinks.
4. Cut back: Minimize alcohol and avoid tobacco.
5. Sleep smarter: Stick to a regular sleep schedule, use cotton sheets, keep a fan by the bed and lower the temperature at night to ease night sweats.
6. Stay consistent: Keep a regular daily routine to help balance your body and mind.
7. Lower stress: Find ways to relax, whether meditation, yoga or simply taking time for yourself.
8. Build connections: Set boundaries, foster supportive relationships and lean on your social circle.
9. Get expert care: Consult a specialist trained in perimenopause and menopause care.

> Want more health news? Text StartHere to 85209 to sign up for text alerts

Is perimenopause starting to disrupt your daily life?

If the symptoms feel too much, it’s time to talk to your doctor.

“There are plenty of hormonal and non-hormonal therapies we can use to help you feel better during perimenopause,” says Dr. Johnson.

One tip? Skip the online search for answers.

“There’s a lot of misinformation out there on the internet and social media, and all treatments come with potential risks and side effects,” Dr. Johnson explains. “Treatment is highly individualized, so it’s important to partner with your healthcare provider to find the best options for you.”