Perimenopause: When Does It Start?
Are you in your thirties and starting to feel a little off? Perhaps your energy isn’t what it used to be, your mood feels less stable, or your body is responding differently than it once did. These changes are often brushed aside, but for many women, they can be early signs of perimenopause.
In Australia, perimenopause is frequently misunderstood and under-recognised, despite being a significant and very real hormonal transition. Perimenopause is the phase before menopause, during which hormones begin to shift, leading to a range of physical, emotional, and metabolic changes.
Perimenopause is more than just a hormonal transition. It is a critical window for long-term health, where existing imbalances may emerge or intensify if left unaddressed. Understanding when perimenopause begins, and recognising its early signs - allows for earlier support, symptom management, and a more empowered approach to this stage of life.
So, when does perimenopause actually start, and what does it really mean for you? Let’s explore the signs, timing, and why this stage matters more than you may have been told
When Does Perimenopause Begin - and Why It Matters
In Australia, the average age of menopause is approximately 51 years; however, a natural menopause can occur as early as your mid-40s. Because menopause is often viewed as a single event (12 consecutive months without a menstrual period), many women assume hormonal changes only begin close to this age.
In reality, the hormonal transition starts years earlier. The stage leading up to menopause, known as perimenopause, can begin in your mid-thirties or early forties and may last anywhere from two to ten years, making it a significant and often overlooked phase of a woman’s life.
Perimenopause is sometimes described as “puberty in reverse.” During this time, the body begins to recalibrate in response to changing hormone patterns. These shifts can affect energy levels, mood, sleep, metabolism, and emotional resilience, even while menstrual cycles may still appear regular.
As ovulation becomes less consistent, progesterone levels gradually decline, while oestrogen begins to fluctuate unpredictably. These hormonal changes are responsible for many of the symptoms women experience during perimenopause.
The Hormonal Dance: Oestrogen and Progesterone Fluctuations
Perimenopause is a period of significant hormonal change, driven by ongoing shifts in key reproductive hormones. These changes influence how you feel physically, emotionally, and mentally, and sit at the centre of many conversations around perimenopause and menopause.
Progesterone Decline
Often the first hormone to decline, progesterone levels fall as ovulation becomes less regular. Progesterone plays an important role in supporting calm, emotional stability, and sleep quality. When levels decline, many women notice increased anxiety, mood changes, and difficulty sleeping.
Oestrogen Fluctuations
During perimenopause, the brain sends stronger signals to the ovaries in an attempt to stimulate ovulation. With fewer eggs remaining, the ovaries respond less predictably, leading to irregular oestrogen fluctuations. At times, oestrogen levels may rise significantly, contributing to PMS-like mood changes and heavy or irregular periods. In later perimenopause, oestrogen levels decline more consistently, which may be associated with symptoms such as hot flushes, brain fog, joint pain, and changes in skin and tissue health.
Testosterone Changes
Although often overlooked, testosterone levels also decline during perimenopause. This can affect libido, energy, motivation, and overall vitality, playing an important role in how women experience this transition.
A Note on Fertility
Despite cycle irregularity, ovulation can still occur during perimenopause, and pregnancy remains possible until menopause is reached. This often surprises women who assume fertility has ceased as cycles change, making awareness and appropriate contraception important during this stage.
Perimenopause: Recognising the Shifting Landscape
Understanding where you are in the perimenopausal transition can bring a sense of clarity and reassurance. Perimenopause does not follow a single pattern, and symptoms may change as hormone levels continue to shift. Knowing what to look for and when, can be deeply validating and may encourage you to seek support.
Early Perimenopause: Subtle but Meaningful Signals
In the earlier stages, menstrual cycles may generally appear regular. However, many women may begin to notice subtle changes, some common early signs may include:
Intensified PMS
Premenstrual symptoms may feel stronger or more difficult to manage than before.Shorter Cycles
The time between periods may gradually shorten.Heavier Periods
Menstrual bleeding can become heavier or more prolonged.Mood or Mental Clarity Changes
Shifts in mood (including irritability, low mood, teariness, or sudden emotional reactions), emotional resilience, or concentration are common.Sleep or Energy Changes
Difficulty falling or staying asleep, along with fluctuations in energy levels, may appear early.A General Sense of Change
A feeling that “something has shifted” in the body is often one of the first signs women recognise.Metabolic Changes
Weight gain, particularly around the abdomen - may occur even without changes in diet or exercise. Some women also notice changes in blood glucose or cholesterol levels.
Later Perimenopause: More Noticeable Changes
As perimenopause progresses, declining and fluctuating oestrogen and progesterone levels tend to produce more recognisable symptoms.
These may include:
Irregular or Spaced-Out Periods
Cycles become increasingly unpredictable, with longer gaps between periods.Lighter or Absent Periods
Bleeding may become lighter over time, eventually stopping as menopause approaches.Hot Flushes
Sudden waves of heat, often accompanied by flushing or sweating.Brain Fog
Changes in memory, focus, and mental clarity may become more noticeable.Vaginal Dryness and Urogenital Changes
Reduced oestrogen can affect vaginal and urinary tract tissues, impacting comfort and intimacy.
Finding Your Balance: Navigating Your Perimenopausal Phase
Perimenopause can feel unfamiliar or overwhelming at first, but it also offers an opportunity for greater self-awareness and proactive health support. When women understand what perimenopause is, and recognise when it may be beginning - they often feel more empowered and better equipped to respond to the changes they’re experiencing.
One of the most important steps during this time is learning to advocate for your own health. This means openly discussing symptoms with trusted healthcare professionals, whether they present as subtle mood changes or more noticeable concerns such as skin changes, sleep disruption, or cycle irregularity. If something doesn’t feel right, it’s appropriate to ask questions, seek further support, or explore approaches that align with your values and needs.
It’s also important to remember that perimenopause is not a one-size-fits-all experience. Hormonal patterns, symptoms, and responses to treatment vary widely between women. A personalised and compassionate approach - one that considers your unique physiology, lifestyle, and health history, is key to navigating this transition with greater ease.
You deserve to feel heard, understood, and supported throughout perimenopause. With the right guidance, this phase can become less about uncertainty and more about restoring balance and wellbeing for the years ahead.
Seeking Support: A Proactive Approach to Perimenopause
There is an important message that deserves to be stated clearly: you do not need to wait for your period to stop to seek support. The earlier a woman recognises and responds to perimenopausal changes, the more empowered and proactive her experience can be.
For many women, frustration arises from a lack of clear guidance or validation. Symptoms are often subtle, variable, and difficult to measure, which can leave women feeling dismissed or unsure of what is happening in their bodies.
As a naturopath, I also speak from personal experience. I’ve navigated periods of anxiety, fatigue, bloating, weight changes, poor sleep, and burnout - all while medical investigations repeatedly returned “normal” results. That experience highlighted how significant these symptoms can be, even when they fall outside conventional diagnostic markers, and reinforced the importance of looking beyond standard pathology.
Understanding perimenopause helps validate what so many women experience but struggle to articulate. It reframes symptoms often dismissed as “just part of getting older” and places them within a meaningful physiological context. With understanding comes reassurance, and the confidence to seek support that is personalised and appropriate.
While perimenopause can be challenging, it is not an ending. It is a transition - one that invites reflection, adjustment, and a renewed focus on wellbeing.
Your Journey, Reclaimed
Throughout this article, we’ve explored when perimenopause can begin and the many ways this transitional phase may unfold. From the early, often subtle changes that can appear in the mid-thirties to the more noticeable shifts of later perimenopause, understanding what’s happening in your body is a powerful first step toward reclaiming your wellbeing.
Perimenopause is a time of significant change. It can feel confusing at times, but it also offers an opportunity to tune in, reassess priorities, and make informed, proactive choices that support long-term health. Knowledge brings clarity, and clarity creates confidence.
You do not have to navigate this transition alone or simply endure symptoms as something to “push through.” With the right support, perimenopause can be approached with compassion, understanding, and a sense of empowerment. This stage is not an ending; it is a meaningful new chapter that invites greater self-awareness and care.
If you’re seeking personalised guidance and support through perimenopause and beyond, I invite you to explore my resources or work with me directly. You can book a 1:1 consultation for personalised support, or for those wanting deeper, structured care, explore my Perimenopause Reset Package.