What Are the Symptoms of Perimenopause?

What Are the Symptoms of Perimenopause?

Because you’re actually not too young to be peri.

If you’re in your 40s (or even your late 30s) and feeling a little off—but being told you’re “too young” or “probably just stressed”—you’re not alone.

Maybe your periods are still regular, but something’s changed. You’re waking up drenched in sweat. Your patience is wearing thin. You’ve got a libido that’s gone missing and a brain that feels foggy on the best of days.

Welcome to perimenopause. It’s real. It’s hormonal. And it doesn’t care if your cycle is still showing up on time or if your doctor says you’re too young.

In fact, a recent survey found that 45% of women said their doctor didn’t take their menopause or perimenopause symptoms seriously. That’s nearly half of us being dismissed or misdiagnosed when we ask for help.

But thanks to new Australian research led by Professor Susan Davis—a global leader in women’s midlife health—we now know much more about how perimenopause really shows up.

What is perimenopause?

Perimenopause is the hormonal transition that leads up to menopause (which is defined as 12 months without a period). This phase can last anywhere from two to ten years. It usually begins in your 40s, but some women notice changes earlier.

Hormones like estrogen and progesterone start to fluctuate, triggering all kinds of symptoms—even when periods are still regular. And because blood tests generally look “normal,” many women are told there’s nothing wrong.

What the new research found

In July 2025, Professor Susan Davis and her team published a major study in The Lancet Diabetes & Endocrinology. They analysed data from over 5,000 Australian women aged 40–69, and what they found challenged how we think about perimenopause.

For decades, irregular periods were considered the hallmark of perimenopause. But this study showed:

• Hot flushes and night sweats are the strongest and earliest clues—even if your cycle is still regular.
• Changes in period flow (heavier or lighter) matter as much as cycle timing changes.
• Many women with textbook “normal” cycles are still experiencing significant hormonal symptoms.

This means that relying on your period to tell you whether you’re in perimenopause is outdated—and often misleading.

Key symptoms to look for:

Hot flushes and night sweats

These were five times more common in women in early perimenopause than in those not yet in transition. They can strike at night, during meetings, or in the middle of a quiet dinner—and they’re one of the clearest indicators that your hormones are shifting. Initially, they often come and go randomly.

Vaginal dryness

Women in perimenopause were two and a half times more likely to report this. It’s linked to dropping estrogen levels and can cause itching, discomfort, or pain during sex. It’s common, it’s early, and it’s treatable.

Mood changes and brain fog

Symptoms like irritability, anxiety, forgetfulness or low mood are real—but they’re less specific to perimenopause. The study found they were slightly more common than in women not yet in transition. That said, when these show up alongside other symptoms, they often form part of the picture.

Changes in period flow

Even if your cycle is still regular, shifts in flow—heavier, lighter, longer or shorter—can signal hormonal change. This is obviously more difficult for women using IUDs or those who’ve had a hysterectomy, who may notice a change in their overall hormonal symptoms.

Why so many women are dismissed

Part of the problem is medical education. Some GPs get less than an hour of menopause training during their degree. If your symptoms don’t match the outdated model, you might be told:

• “You’re too young.”
• “It’s just stress.”
• “Your blood tests are fine.”
• “It’s probably anxiety. Would you like an anti-depressant?”
• “It’s just part of getting older.”

And yet, 45% of women say their symptoms were not taken seriously by their doctor. That’s a systemic issue. And it needs to change.

Why this matters

Perimenopause can affect your sleep, energy, memory, periods, mood, and sex life. But too many women are left to figure it out on their own. They’re offered anti-depressants instead of hormone options. Or they’re told to return in a year “if it worsens.” Sadly, during this time, your bone density, relationships and mental health may suffer.

This new study matters because it proves what many of us already knew: your period doesn’t need to vanish before your body starts changing. And no, you’re not too young.

The bottom line

If you’re in your late 30s, 40s or early 50s and feeling off—but can’t quite explain why—there’s a good chance your hormones are shifting.

You don’t need to wait until your period disappears. You don’t need to suffer in silence. And you don’t need to accept vague answers like “it’s just stress” or “that’s normal for your age.”

Because you’re actually not too young to be peri.