“The first obvious sign is a change in period timing,” Dr. Dunham says. Your cycle might start to lengthen, shorten, or become irregular, and your periods can become shorter or longer. Tracking your cycle, starting now, gives you a baseline so you can spot deviations when they occur and report them to your provider, Dr. Minkin says.
Know the telltale physical symptoms.
Hot flushes are an incredibly common symptom of perimenopause. “They’re pretty unmistakable,” Dr. Adams says. “It’s not just feeling a little bit warm. It’s like somebody turned on a heat lamp.” You might get hot flashes mostly during the day, mostly at night (called night sweats), or both, Dr. Adams adds.
Keep more subtle symptoms on your radar, too, Dr. Dunham says—like trouble sleeping, fatigue, and joint aches. Sleep issues are often chalked up to life stressors common around that time, Dr. Minkin notes, like work, raising a family, or ageing parents. “It’s hard to say, ‘Oh, it’s my hormones.’”
Be aware that your emotions might run a little wild.
You’ll want to steel yourself for those mood changes you hear so much about—they’re extremely real. “The emotional roller coaster is very profound for some people,” says Dr. Minkin. (Though it varies, she adds—some lucky people feel just fine.)
She notes that knowing that there are biological reasons to explain seemingly “random” changes in your mood might help you be a little more compassionate with yourself—as well as seek help when you need it.
You might feel off in ways that seem an awful lot like PMS—maybe you’ll notice you’re unusually angry, irritable, moody, anxious, or depressed—except those moods will strike randomly throughout the month instead of tied to your cycle, Dr. Adams explains. “Some days, you feel better, some days, you don’t,” she says. You might feel like you’re not coping with the same everyday stressors as well, Dr. Minkin adds.
These mood shifts happen because the drastically fluctuating levels of oestrogen and progesterone in your body also impact serotonin, a chemical in the brain that influences your sense of well-being.
Those mood swings can also make you more likely to experience depression, especially if you have a history of it. A doctor can help you better evaluate if your mood shifts are tied to perimenopause or something else.
Look out for sexual symptoms, too.
In your 30s, you’re probably clued in to how you usually feel during sex. When that suddenly takes a turn, menopause might be the reason. Other signature signs of perimenopause include vaginal dryness and pain during penetration.
Falling levels of oestrogen—which helps keep the vaginal walls lubricated, elastic, and thick—can cause thinning, drying, and inflammation, according to the American College of Obstetricians and Gynecologists (ACOG).
You might also notice a difference in your libido. Some women have less of a desire to have sex, Dr. Minkin says, especially later in menopause. Vaginal dryness and painful sex can contribute to this, along with a lower sex drive (due to falling oestrogen) and arousal response (meaning blood flow to the vaginal tissues is slower).