Perimenopause Care
You do not have to wait until menopause to ask for help.
One of the most common things I hear from women is, “I thought I was too young for this.”
They might be in their mid-30s, late 30s or early 40s. They might still be having regular periods. They might have been told their symptoms are just stress, busyness, ageing, parenting, work pressure or simply “normal”.
But perimenopause can begin earlier than many women expect.
If your sleep, mood, cycle, energy, body or sense of self has changed, it is worth a proper conversation.
When can perimenopause start?
Perimenopause is the transition before menopause, when your hormones begin to shift and fluctuate.
For many women, perimenopause begins in their early 40s. For others, symptoms can start earlier, sometimes from the mid-30s.
This is one of the reasons it can be missed. You may not look like the picture of menopause you had in your mind. You may still be getting your period. You may be busy with work, family, relationships and life, and it can be easy to explain symptoms away.
But if something feels different, it deserves to be understood properly.
What is happening during perimenopause?
During perimenopause, your hormones do not always decline in a neat, predictable way.
Oestrogen and progesterone can rise and fall unevenly during this time, which is why symptoms can feel inconsistent. You may feel fine for a few weeks, then suddenly notice changes in your sleep, mood, cycle, temperature regulation, energy or concentration.
That inconsistency can make perimenopause confusing.
Your symptoms may come and go. Blood tests may not always give a simple answer. You may wonder whether it is hormonal, stress-related, mental health-related or something else entirely.
My role is to help you make sense of those changes in the context of your whole health, not just one symptom or one test result.
Common symptoms of perimenopause
Perimenopause can look different for every woman.
Some women notice obvious changes. Others only realise something has shifted when they look back and see a pattern.
You may be experiencing:
Changes in your cycle
Heavier, lighter, shorter or more irregular periods
Hot flushes or night sweats
Sleep disruption
Anxiety, low mood or irritability
Feeling more overwhelmed than usual
Brain fog or difficulty concentrating
Fatigue or low energy
Weight changes
Headaches or joint aches
Reduced libido
Vaginal dryness or discomfort
Feeling unlike yourself
Changes in your cycle
Heavier, lighter, shorter or more irregular periods
Hot flushes or night sweats
Sleep disruption
Anxiety, low mood or irritability
Feeling more overwhelmed than usual
Brain fog or difficulty concentrating
These symptoms are not always dramatic at first.
Sometimes they arrive quietly. Sometimes they are explained away for years. Sometimes the biggest sign is simply the feeling that something is not quite right.
Fatigue or low energy
Weight changes
Headaches or joint aches
Reduced libido
Vaginal dryness or discomfort
Feeling unlike yourself
How do I know if I’m perimenopausal?
You may be perimenopausal if you are noticing changes in your cycle, sleep, mood, energy, body temperature, concentration or sense of wellbeing, especially if these changes feel new, persistent or are starting to affect your daily life.
You may still be having regular periods. You may also have normal blood test results. That does not automatically mean your symptoms are not hormonal.
The most important starting point is your story, your symptoms and the pattern of change over time.
When should you seek support?
You do not need to wait until your symptoms are severe.
It is worth seeking support if you have noticed changes in your cycle, sleep, mood, mental health, energy, concentration, hot flushes, night sweats, libido, weight or general sense of wellbeing – especially if those changes feel new, persistent or are starting to affect your daily life.
It is also worth coming in if you have been told you are “too young” for perimenopause, or if you feel your symptoms have been explained away without anyone looking at the full picture.
Sometimes the answer is perimenopause.
Sometimes there are other things we need to check, such as thyroid function, iron levels, mental health, medication effects or other health conditions.
Either way, you deserve clarity.
My approach to perimenopause care
I practise whole-person medicine.
That means I do not look at perimenopause as one isolated hormone problem. I want to understand your symptoms, cycle, sleep, mood, stress, family history, medications, lifestyle, previous health checks and what is happening in your life.
Women’s health stories are layered.
The hormone shift may be part of the story, but it may not be the whole story.
In your consultation, I will listen carefully to what has been happening and help connect the dots. Sometimes something that feels small to you can be clinically important. Sometimes the pattern only becomes clear when there is enough time to tell the full story.
My role is not to rush you into one treatment or send you away with a generic answer.
My role is to help you understand what may be happening, make sure we are not missing anything else, and work with you to decide what support feels right for where you are now.
You have options before menopause
There is a misconception that you have to wait until full menopause before treatment can be considered.
That is not true.
If you are symptomatic, we can talk about your options now.
For some women, that may include menopause hormone therapy. For others, it may include support for sleep, mood, mental health, lifestyle, nutrition, movement, stress, iron levels, thyroid function or other underlying contributors that may be making symptoms worse.
Sometimes treatment is about one clear intervention. Sometimes it is about building the right team around you.
I am honest with my patients about what I know and what needs another expert. If I think you would benefit from a gynaecologist, psychologist, dietitian, pelvic health physiotherapist, psychiatrist, endocrinologist or another practitioner, I will help guide that process.
I see myself as your co-pilot.
You are not expected to navigate this on your own.
What makes this care different?
Time to tell the full story
Perimenopause rarely fits neatly into a rushed appointment. I give you the time to explain what has been happening properly, not just list the most urgent symptom.
A full history
I consider hormones, mood, sleep, stress, metabolism, lifestyle, mental health and life context together.
Your understanding
I want you to understand the reasoning behind your care, not leave with more confusion.
A written summary
After your appointment, you receive a written summary of what we discussed and the next steps.
Team-based support
If another specialist or practitioner is needed, I will help guide that process.
What to expect
Before your appointment
You will complete a patient form so I can understand your symptoms, medical history, medications, previous tests, family history and relevant women’s health checks before we meet.
During your consultation
We will talk through your story in detail. I will ask targeted questions, explore possible causes and discuss your options clearly.
You may feel like you are talking too much. You are not.
That is often where the important information lives.
After your appointment
You will receive a written summary, any relevant test forms or referrals, and a clear plan for what happens next.
If something does not make sense, you can ask. I want the care to feel connected, not like you have been handed a plan and left alone with it.
Perimenopause FAQs
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Yes. For many women, perimenopause begins in their early 40s, although symptoms can sometimes start earlier. You may still be having periods while noticing changes in sleep, mood, cycle, energy or temperature regulation.
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Yes, some women begin noticing symptoms from their mid-30s. This is one of the reasons perimenopause can be missed or explained away as stress, ageing or being busy.
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You may be perimenopausal if you have noticed new or changing symptoms such as irregular periods, heavier bleeding, hot flushes, night sweats, poor sleep, anxiety, low mood, brain fog, fatigue or feeling unlike yourself.
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During perimenopause, oestrogen and progesterone can fluctuate unevenly. This can affect your cycle, sleep, mood, temperature regulation, energy, concentration, libido and overall wellbeing.
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Not always. Blood tests can be helpful in some situations, especially to rule out other causes of symptoms, but they do not always give a simple answer during perimenopause. Your symptoms, age, cycle pattern and health history all matter.
Perimenopause can be a turning point
Perimenopause can feel unsettling when nobody has explained what is happening.
But with the right care, it can also become a time of understanding your body more clearly, strengthening your long-term health and making decisions with more confidence.
You do not need to have the perfect words for what is happening.
You do not need to wait until things are unbearable.
You just need a place where the full story can be heard.