In brief
In brief
Perimenopause symptoms can begin in the late thirties or early forties, although menopause itself most often happens later. That does not mean every change is hormonal. Period changes, disrupted sleep, temperature changes, low mood, anxiety, brain fog and joint or intimate symptoms can overlap with pregnancy, thyroid conditions, anaemia, medicine effects, sleep disorders and other causes. The useful next step is to notice the pattern and discuss it—not to diagnose yourself from a checklist.
Signs worth noticing together
- Periods becoming less predictable, much heavier or lighter, closer together or further apart.
- Hot flushes, night sweats or waking suddenly feeling hot, cold or unsettled.
- Sleep, mood, anxiety, concentration or memory changing at around the same time.
- New joint discomfort, headaches, palpitations, vaginal dryness, urinary changes or reduced desire.
- A clear effect on work, relationships, exercise, confidence or ordinary daily tasks.
NICE advises that assessment before 45 can differ from the usual symptom-led approach used for many people over 45. A clinician may consider blood tests or other investigations, particularly when menopause is suspected under 40, while also checking for other explanations. Home hormone tests cannot give a complete answer because hormone levels can fluctuate and contraception can make cycles harder to interpret.
Sources
Where this guidance comes from
GlowUp checked this article against the sources below on 26 August 2026. This is source-checked editorial information, not a claim of independent medical review.
- Perimenopause / Menopause Oxleas NHS Foundation Trust · updated 26 August 2026 · accessed 26 August 2026
- Early or premature menopause NHS · updated 5 February 2025 · accessed 26 August 2026
- Menopause: identification and management (NG23) National Institute for Health and Care Excellence · updated 15 April 2026 · accessed 25 August 2026
- Symptoms of menopause and perimenopause NHS · updated 19 May 2026 · accessed 25 August 2026