Perimenopause: What to Expect, What’s Normal, and Why It May Start Earlier Than You Think

On a recent episode of Amy Poehler’s Good Hang podcast, guest Jennifer Lawrence (Hunger Games, Silver Linings Playbook, Die My Love), shared how she’s been experiencing a bizarre symptom: itchy ears. Amy Poehler was quick to point out that this could be a sign of perimenopause. Lawrence, 35, was visually in shock, most likely from learning that the transition to menopause can happen as early as in your 30s.

She wasn’t alone in that shock. 

For many women, menopause feels like a distant milestone. Something to think about “later.” But what often goes unrecognized is the phase that comes before it: perimenopause. This transitional season can begin quietly, sometimes years earlier than expected, bringing physical, emotional, and hormonal shifts that can feel confusing if you don’t know what’s happening.

So, let’s dive in.

What Is Perimenopause?

Perimenopause means “around menopause.” It’s the time when your body begins transitioning toward the end of your reproductive years. Hormones—especially estrogen and progesterone—start to fluctuate unpredictably, leading to a wide range of changes.This phase can last anywhere from a few years to over a decade, ending when you’ve gone 12 consecutive months without a menstrual period (menopause).

It Can Start Earlier Than You Think

Many women expect perimenopause to begin in their late 40s, but it can actually start as early as your mid-30s.

Early signs are often subtle and easy to dismiss:

• Slight changes in your menstrual cycle
• New or worsening PMS symptoms
• Sleep disturbances
• Mood shifts that feel “out of the blue”
  

Because these symptoms don’t always look dramatic, women are often told they’re just stressed, busy, or aging, when in reality, their hormones are already shifting.

What’s “Normal” at Different Stages

Perimenopause isn’t a one-size-fits-all experience, but it often unfolds in stages:

Early Perimenopause

• Periods may still be regular, but cycles can shorten or lengthen slightly
• PMS symptoms may intensify
• Subtle mood changes or anxiety may appear
• Energy levels may fluctuate

Mid Perimenopause

• Periods become more irregular (skipped cycles, heavier or lighter bleeding)
• Hot flashes or night sweats may begin
• Sleep issues become more noticeable
• Brain fog or forgetfulness may increase

Late Perimenopause

• Long gaps between periods
• More intense symptoms (hot flashes, mood swings, fatigue)
• Vaginal dryness or changes in libido
• Increased emotional sensitivity

Also read: A Heart Check This February: Why Emotional Self-Checks Matter

Common Symptoms of Perimenopause

Many women are familiar with the “classic” symptoms of perimenopause:

• Hot flashes
• Night sweats
• Irregular periods
• Mood swings
• Sleep disturbances
• Weight gain (especially around the midsection)
• Decreased libido
• Fatigue

Less Talked About (But Very Real) Symptoms

Perimenopause can also show up in ways that aren’t widely discussed:

• Anxiety or panic attacks (even if you’ve never had them before)
• Heart palpitations
• Joint pain or stiffness
• Itchy or dry skin 
• Tingling sensations (hands, feet, or face)
• Burning mouth syndrome
• Increased sensitivity to stress
• Changes in body odor
• Hair thinning or loss
  

These symptoms are often linked to fluctuating hormone levels, particularly estrogen, which affects multiple systems in the body—not just reproduction.

Why Perimenopause Awareness Matters

Too many women go through perimenopause feeling confused, dismissed, or alone. Without awareness, it’s easy to internalize these changes as something being “wrong” with you. But this is not a failure of your body. It’s a transition. And with the right knowledge, it can be a powerful one.

Also read: New Year, New Care: Reproductive Health Resolutions Every Woman Should Consider

How to Prepare and Feel Empowered

While you can’t stop perimenopause, you can support your body through it.

1. Start Tracking Your Symptoms

Keep a simple log of your cycle, mood, sleep, and physical changes. Patterns will help you understand what your body needs, and advocate for yourself.

2. Prioritize Hormonal Health

Focus on:

• Balanced nutrition (protein, healthy fats, fiber)
• Strength training and movement
• Quality sleep
• Stress management
  

These aren’t just “nice to have,” they’re essential during this transition.

3. Find the Right Support

Not all healthcare providers are well-versed in perimenopause. Seek out professionals who take your symptoms seriously and are open to discussing options: from lifestyle changes to hormone therapy if needed.

Also read: How to Advocate for Yourself at Your OB-GYN Appointment

4. Talk About It

Break the silence. Talk to friends, sisters, mothers, and coworkers. The more we normalize these conversations, the less isolating this experience becomes.

5. Redefine This Season

Perimenopause is often framed as an ending of your “fertile” or “young” years. But this time can also be the beginning of something good. After all, women are more than their reproductive systems, and as a society, we need to empower women in later stages of life.

Perimenopause can be  time to:

• Reconnect with your body
• Set new boundaries
• Prioritize your well-being
• Step into a deeper sense of self

You Are Not Alone Or Powerless

Perimenopause may arrive earlier than expected. It may feel unpredictable. At times, it may even feel overwhelming.But knowledge changes everything. When women understand what’s happening in their bodies, they move from confusion to clarity, and from frustration to empowerment.

Although medically it may look like a hormonal shift, it is actually something much more than that: it’s a time to celebrate how far your body has come, what it’s capable of, and all the value it still has to offer. And you deserve to move through it informed, supported, and strong.

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