You’re waking at 3:17 a.m. again. Heart fluttering. Brain lit like a motorway at midnight. The day after, you misplace words you’ve used since school and your temper flares at the tiniest nudge. It doesn’t look like menopause yet. And that’s the trick.
In the bakery queue, a woman fans herself with a folded receipt, cheeks flushed, eyes glossy. Her tote bag reads “Power Through” but she looks anything but. She forgot the sourdough she came for. She forgot why she walked in. The barista asks if she wants decaf and she stares, as if the letters themselves are slippery. Later she’ll google “why do I wake at 3am” and scroll through worry. It feels like the ground shifts under your feet—quietly, then all at once. She’ll blame work. She’ll blame winter. She’ll measure herself and come up short. Then she’ll hear a word she’s half-avoided for years, and stop. Perimenopause.
The subtle symptoms nobody warns you about
Perimenopause rarely arrives in a dramatic cape. It tiptoes in through the ordinary. One week it’s prickly skin that makes a bra clasp feel like nettles. The next, it’s ringing in your ears and your heart doing a tiny drum solo after coffee. Sleep shifts, not gone but fragmented, as if someone keeps nudging the mattress. You find sentences snagging on the way out. Vision feels grainy at 4pm. You snap at the people you love, then cry in the bathroom and don’t quite know why. We’ve all had that moment when the answer feels too small for the size of the feeling.
Louise, 44, told me she burst into tears over a single odd sock. “It was ridiculous,” she laughed, eyes shining. “I knew it was ridiculous while I was crying.” Her periods were still regular, which confused her. Day two had become a deluge. Her knees ached for no reason and her jaw felt tight at night. She chalked it up to stress, until the tinnitus and 3 a.m. wake-ups linked arms. Average perimenopause lasts four to eight years and can begin in the mid‑40s—sometimes earlier. Many never get the “classic” hot flush at first. They get the quiet chaos.
What’s happening is messy by design. Oestrogen doesn’t simply slide down a gentle slope; it zigzags. Progesterone, the calming counterpart, thins earlier, so you lose that buffer. Those fluctuations nudge brain chemistry—GABA, serotonin, even how you handle cortisol—so anxiety spikes on Tuesdays for no obvious reason. Blood sugar gets bouncier; histamine sensitivity can flare, so you itch after wine or tomatoes. Joints notice dips in oestrogen, so everything creaks more after a bad sleep. It’s why symptoms arrive like weather fronts. Which also explains why standard blood tests can look “normal” while your lived experience shouts otherwise.
What genuinely helps—small moves, big ease
Start by plotting the pattern, not the perfect plan. Two minutes a day, tops. Note sleep hours, mood tone (one word), and one body signal: cramps, racing heart, itchy skin, fog. Add a quick tag—A, B, or C—for likely triggers: Alcohol, Blood sugar, Caffeine. In a fortnight you’ll spot repeats. Then nudge your day: eat 25–30g of protein at breakfast to steady glucose, take a 10‑minute walk after meals, add leafy veg or beans for fibre. Cool your bedroom to 17–19°C, dim lights an hour before bed, park your phone outside the room. If you consider magnesium glycinate at night, speak to your GP or pharmacist first.
Go gentler on exercise when your sleep is fractured. Swap daily HIIT for two strength sessions and one brisk walk; sprinkle in yoga or mobility. Many push harder just when their system asks for steady. Cutting all carbs often backfires, wrecking sleep and mood. Aim for slow-release carbs—oats, wholegrain, lentils—especially on active days. Build “anchors”: morning daylight on your face, meals at roughly the same times, a wind-down you actually enjoy. Let’s be honest: no one does that every day. The win is consistency most days, not sainthood.
“Track the rhythms, then adjust one lever at a time. That’s how women get their footing back—through patterns, not perfection,” a GP specialising in women’s health told me.
A few red flags deserve quick attention. Don’t musc through them. Check in with a clinician promptly if any of these crop up or escalate fast:
- Bleeding that soaks through a pad or tampon every hour for several hours, or bleeding after sex.
- Chest pain, shortness of breath, or new, severe palpitations that don’t settle.
- Sudden migraines with neurological symptoms, or headaches that change character.
- Low mood that veers into hopelessness, or intrusive thoughts.
- Unintentional weight loss, persistent abdominal pain, or new bowel changes.
A wider lens, a kinder story
Perimenopause isn’t a malfunction. It’s a transition that modern life makes louder. Work deadlines don’t care about 3 a.m. wakefulness. Kids, parents, bills—none of it pauses. Still, cultures that speak about this openly seem to suffer less in silence. Start where you are. Name the weirdness. Share the pattern. Ask for a little more patience at home and work. Sometimes just saying “I’m in it” takes the shame out of the room.
Maybe you’ll try a walking meeting instead of another coffee. Maybe you’ll find a strength class where everyone admits their hips hurt. Maybe you’ll realise that carbs are not the enemy and neither is crying over a sock. This is biological turbulence with a flight path. There are medications, therapies and supports that can help, from HRT to CBT to pelvic physio—your choices, your pace. What changes everything is not pretending you’re fine when you’re not. The whisper gets louder, then clearer, until it’s a map.
| Point clé | Détail | Intérêt pour le lecteur |
|---|---|---|
| Track tiny patterns | Two-minute daily log: sleep, mood word, one body signal, plus ABC triggers | Spots your personal “why today?” and guides practical tweaks |
| Steady your glucose | Protein-led breakfast, slow carbs, 10-minute post‑meal walks | Smoother energy, calmer mood, fewer 3 a.m. wake-ups |
| Sleep and stress anchors | Cool, dark room, dim lights, phone out, gentle strength and breath work | Builds resilience against hormonal zigzags with realistic habits |
FAQ :
- What exactly is perimenopause?The transition years before periods stop, when oestrogen and progesterone fluctuate. It can last 4–8 years and symptoms often ebb and flow.
- Can I be perimenopausal if my periods are still regular?Yes. Many women have regular cycles while experiencing anxiety, night sweats, brain fog, or heavy day‑two flow.
- Are heart palpitations normal in perimenopause?They can be, due to hormone shifts and stress. New or severe palpitations need a GP review to rule out other causes.
- What helps with brain fog at work?Front‑load complex tasks, take short movement breaks, hydrate, and stabilise blood sugar. Track patterns—then ask for work flexibility where you can.
- When should I see a doctor?Red flags: very heavy or irregular bleeding, chest pain, severe headaches, low mood with hopelessness, or symptoms that disrupt daily life.
