Early Signs of Perimenopause in Your 40s (And What You Can Actually Do)

If you’re googling early signs of perimenopause in your 40s, chances are you’re wondering if it’s “just stress”… or if your hormones are quietly staging a coup.

Maybe your periods suddenly stopped playing by the rules.
Maybe you’re waking up at 3 a.m. for no good reason.
Maybe you’re snapping at your family and then crying in the pantry five minutes later.

Same, friend.

Here’s the wild part: perimenopause is a totally normal transition, but most of us were never actually taught what it is. One paper found that only about 20% of women were familiar with the term “perimenopause”, and more than half didn’t feel informed about what to expect.

So let’s fix that. Consider this your cheat sheet to what’s happening, what “early signs” can look like in your 40s, and what you can actually do next.

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Perimenopause 101 (Super Short Version)

Perimenopause is the transition phase leading up to menopause—the years when your hormones start shifting, and your ovaries are gradually clocking out, but you haven’t gone a full 12 months without a period yet.

A few key points:

• Perimenopause often starts in your 40s (sometimes late 30s).

• Hormones like estrogen and progesterone start to rise and fall in less predictable ways.

• You can still get pregnant in perimenopause, because ovulation can be erratic—not gone.

• You’re officially in menopause when you’ve gone 12 months in a row without a period.
  

If you still have ovaries and a uterus, you will go through this transition at some point (unless surgery or a medical condition stops ovarian function earlier). What varies is when it starts, how it feels, and what helps.

Early Signs of Perimenopause in Your 40s

Everyone’s experience is different, but there are some common patterns that show up first. Think of these as your body’s “heads up” notifications.

1. Your Periods Go Rogue

A change in your period is often one of the first signs of perimenopause.

You might notice:

• Cycles that get shorter or longer

• Skipping a period, then having a heavy one

• Spotting between periods

• Heavier or lighter bleeding than you’re used to
  

A little irregularity is common during this time. That said, super heavy bleeding, very frequent periods, or bleeding after sex are all reasons to check in with your doctor (we’ll talk more about that below).

2. Sleep Suddenly Gets Weird

You used to be able to fall asleep anywhere… now your brain throws a party at 1 a.m.

Perimenopause is linked with:

• Trouble falling asleep

• Waking up in the night and not being able to drift back off

• Night sweats or feeling overheated

• Waking up too early and feeling unrefreshed
  

Hormone fluctuations (plus the stress and mental load of midlife life) can all contribute to this.

RELATED: Perimenopause Sleep Toolkit: Comfort Items That Actually Help You Sleep Better at Night

3. Mood Swings, Anxiety, or “I Don’t Feel Like Myself”

Another big early sign: your mood starts feeling less… predictable.

Common complaints:

• Feeling more irritable or snappy

• Anxiety that seems to come out of nowhere

• Feeling weepy or low for no obvious reason

• Less patience, more overwhelm

Fluctuating estrogen and progesterone can affect brain chemicals involved in mood, and sleep disturbances make everything feel bigger. This doesn’t mean it’s “all in your head”—it means your brain is in your hormones, too.

4. Hot Flashes or Night Sweats Show Up

Those classic “menopause” symptoms? They often start in perimenopause, not after your periods stop.

You might notice:

• Sudden waves of heat, especially in your face, chest, or neck

• Flushing or sweating, then feeling chilled

• Night sweats that soak your PJs or sheets
  

Some women only get a few mild ones; others get frequent or intense episodes. If hot flashes are interfering with your sleep or daily life, that’s absolutely worth a conversation with your healthcare provider.

5. Brain Fog, Word-Finding Fails, and “Why Am I in This Room?”

Brain fog is another early perimenopause sign no one warned us about.

It can look like:

• Forgetting words mid-sentence

• Walking into a room and blanking on why you’re there

• Struggling to focus on tasks that used to be easy

Hormone changes, sleep issues, and stress seem to all play a role here.

If you’re worried about memory changes, especially if they’re severe or getting worse quickly, always bring that up with your doctor. But mild, annoying brain fog? Very common.

6.  New Belly Fat or Body Changes

Another early sign women notice: body changes, especially around the midsection.

As estrogen levels fluctuate and then trend lower, your body may start storing more fat around your abdomen, and you may lose muscle more easily.

You might feel like:

• Your jeans don’t fit the way they used to

• You gain weight more easily, even if your habits haven’t changed much

• Your body shape feels different
  

That doesn’t mean you’re doing anything wrong—it means your hormonal landscape has shifted.

RELATED: What a Hormonal Belly Really Means (It’s Not Just About Weight)

7. Changes in Libido or Vaginal Comfort

Fun times, right?

Because estrogen affects vaginal tissues and lubrication, you may notice:

• Lower libido

• Vaginal dryness

• Discomfort with intercourse
  

These changes are common, but still absolutely worth mentioning to your provider—there are options to make sex comfortable and enjoyable again.

8. Sneakier “Wait, Is This Perimenopause?” Symptoms

On top of the big ones, some women experience more subtle or surprising symptoms as hormones shift, like:

• Headaches or migraines that change pattern

• Joint aches or muscle pain

• Heart palpitations that are new to you

• Changes in skin or hair

• Increased anxiety or panic-like episodes

These can overlap with lots of other conditions, which is exactly why perimenopause is often misdiagnosed or missed.

RELATED: Wait, That’s Perimenopause? 19 Weird Symptoms No One Warns You About

What’s “Normal-ish” vs When to Call Your Doctor

Perimenopause is normal. Suffering in silence is not.

You should always talk with a healthcare provider if:

• Your periods are very heavy (soaking a pad/tampon every 1–2 hours, large clots) or last longer than 7 days

• You have bleeding between periods or after sex

• You have sudden, severe mood changes, depression, or anxiety that affects daily life

• You have new, severe headaches, chest pain, or persistent palpitations

• You’re unsure whether symptoms could be related to thyroid issues, pregnancy, PCOS, or something else
  

This blog is here to give you language and tools—not to replace medical care. If something feels off, trust your gut and get checked.

First Steps to Start Feeling More Like Yourself

You don’t have to overhaul your entire life tomorrow. Small, targeted shifts can make a big difference over time.

1. Support Your Blood Sugar and Gut (Without Dieting)

Hormone changes can make your blood sugar more dramatic, which can worsen mood swings, cravings, and energy crashes.

A few gentle tweaks:

• Aim for protein + fiber at most meals

• Try to pair carbs (like bread, rice, pasta, sweets) with protein and healthy fats

• Include fiber from veggies, fruits, beans, and whole grains to support hormone metabolism and gut health

RELATED: The Fiber Fix: A Simple Way to Support Your Hormones Naturally

2. Move Your Body in Ways That Feel Sustainable

You do not need a 6-day-a-week bootcamp schedule.

What helps most in perimenopause tends to be:

• Regular walking or light cardio for mood and stress

• Strength training a couple of times a week to protect muscle, bone, and metabolism

• Gentle stretching or yoga to help with sleep and joint aches
  

Think of movement as a way to give your hormones better scaffolding, not punishment for your body.

3. Guard Your Sleep Like It’s One of Your Kids

We’ve already talked about how sleep can go sideways, but anything you can do to support it will pay off in mood, cravings, and resilience.

Start small:

• Try a consistent bedtime and wake time (even on weekends, as much as life allows)

• Keep your bedroom cool and dark

• Swap late-night doom scrolling for something boring and calming the last 20–30 minutes

Once your dedicated sleep post is live, you can link it here for women who want a full “sleep reset” step-by-step.

4. Lighten the Mental Load (Even a Little)

This one isn’t in medical textbooks, but it should be.

Most women in this season are juggling:

• Work

• Kids

• Partner

• Household

• Parents

• All the invisible planning and remembering -The Mental Load is Real!!

Chronic stress can worsen hot flashes, sleep, and mood.

Tiny ways to push back:

• Start a shared family calendar or task app

• Delegate one recurring task (meals, laundry, school forms)

Give yourself one non-negotiable pocket of time each day that’s yours—even 10–15 minutes counts

How to Track Symptoms Without Losing Your Mind

You don’t need a fancy tracker (unless you like them). But a simple log can make patterns easier to see and gives you better info for your doctor.

In a notebook or app, jot down:

• Date and cycle day (if you’re still bleeding)

• Flow: light / medium / heavy

• Sleep: decent / meh / awful

• Mood: stable / edgy / low / anxious

• Any notable symptoms (hot flashes, night sweats, brain fog, etc.)

Even 2–3 months of notes can be incredibly helpful.

What to Ask Your Doctor

You don’t have to walk into your appointment and whisper “perimenopause?” like it’s a secret code.

You can say something like:

“I’m in my 40s, my periods and sleep have changed, and I’m noticing mood shifts and [insert other symptoms]. I’m wondering if this could be perimenopause. What should we be looking at, and what options do I have?”

Questions to consider:

• Could my symptoms be perimenopause, or do we need to rule out thyroid issues, anemia, PCOS, etc.?

• Are there lifestyle changes, non-hormonal options, or medications that might help?

• Is hormone therapy an option for me, and what are the pros/cons in my situation?

• What should I watch for that would need follow-up sooner?

Bring your symptom log, list of meds/supplements, and any specific worries. You’re not being “dramatic”—you’re advocating for yourself.

You’re Not Broken—You’re in a New Season

Here’s what I want you to hear most:

You are not “too young.”
You are not going crazy.
You are not failing at life because your hormones decided to remix the playlist.

Perimenopause is a universal transition for anyone with ovaries and a uterus. The problem isn’t that your body is changing; the problem is that most of us were never given a roadmap.

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