Top Signs of Perimenopause: What Every Woman Should Know (and a Few That Might Surprise You!)

“The changes are real. You’re not imagining things. And you’re definitely not alone.”

If you're in your late 30s or 40s and feeling off, there’s a good chance you’re in perimenopause—the often confusing, sometimes comical, and completely normal transition leading up to menopause.

While every woman’s journey looks different, there are some telltale signs (and a few that will totally catch you off guard). Let’s break down the big ones, the weird ones, and the ones no one warned us about—so you can ride this wave with confidence, connection, and maybe a cooling mist in your purse.

🔥 1. Irregular Periods (aka Your Cycle’s New Personality)

Your cycle is now the unreliable ex who disappears without warning, then shows up out of nowhere, dramatic and over-the-top. From heavy to light, frequent to freakishly absent—this is often one of the first signs perimenopause is knocking.

Real talk? This part was brutal for me. My period turned into something straight out of a horror movie—“Carrie,” but on repeat. It was unpredictable, had a mind of its own, and when it arrived, it was heavy, intense, and relentless. I never knew if I was safe wearing light-colored pants or if I’d need to cancel plans… again. An IUD ended up being a total lifesaver, giving me back a sense of control when everything else felt chaotic.

Why it happens: Progesterone starts to dip first, and with estrogen going rogue, your cycles get thrown out of sync. That hormonal imbalance leads to periods that can be longer, heavier, or wildly irregular.

👉 If your period has become a total nightmare, you’re not alone. I share my own hormonal horror story in this blog: So. Much. Blood. My Real-Life Fix for Heavy Bleeding in Perimenopause

💦 2. Hot Flashes & Night Sweats (Bring a Fan, Babe)

You’re sitting in a meeting and—bam!—a wave of fire rises from your chest to your cheeks. Sound familiar? Hot flashes and night sweats are classic signs that your internal thermostat is in full rebellion.

I’ve been there. I used to wake up drenched—soaked sheets, soaked pajamas—the whole deal. It was like my body hit the “sweat” button and forgot to turn it off. Night after night. But once I started taking bioidentical progesterone, the night sweats completely stopped. It was a game-changer.

Why it happens: Estrogen levels fluctuate wildly, impacting your hypothalamus (aka the thermostat in your brain). Translation: your body thinks you’re overheating even when you’re not, cueing those sweats.

👉 Waking up drenched or burning up out of nowhere? Check out: Midlife Meltdown? Your Guide to Managing Hot Flashes & Night Sweats

😭 3. Mood Swings & Irritability (Snap One Minute, Cry the Next?)

Feel like your emotions have gone from Netflix drama to full-on soap opera? Thanks to hormone fluctuations, even minor stressors can feel massive.

This one’s a big one for me. I swear, some days I feel like a ticking time bomb of emotions. The tears, the rage, the overwhelm—it’s like my inner calm packed its bags and left without warning. One minute I’m Marie Kondo-ing the spice drawer, the next I’m sobbing over a dog food commercial. My hormones clearly missed the memo on emotional stability.

You’re not losing it. You’re shifting. Your nervous system is working overtime to keep up.

👉 For support, check out:
Why Am I Crying Again?! Understanding and Easing Perimenopausal Mood Swings

🌙 4. Sleep Disturbances (Counting Sheep Not Working?)

Falling asleep like you used to? Not so much. Perimenopause brings with it restless nights, 3 a.m. wakeups, and racing thoughts—especially if you're prone to anxiety.

I’m still trying to figure this one out. Some nights I feel like I’m doing everything right—early wind-down, no wine, magnesium, and still I wake up wired at 2 a.m. What helps? Michelle’s Sanctuary on Insight Timer. Her meditations are like a soft hug for my nervous system and help me ease into rest.

Try this: Dial in your sleep hygiene, stay cool at night, and avoid late-day caffeine or sugar spikes. Progesterone and magnesium can help too.

👉 For real-life tips and a whole lot of empathy, visit:
Wide Awake and Hormonal: The Truth About Perimenopause and 3 AM Insomnia

🍑 5. Vaginal Dryness & Discomfort (Even if You’re Not in the Mood)

Let’s normalize talking about this! Vaginal tissue gets thinner and drier during perimenopause, leading to irritation, itching, or painful sex.

I experience this occasionally, and when it hits? It’s no joke. What’s helped me the most? Bioidentical vaginal estrogen. It’s been a total game-changer—restoring comfort, moisture, and making me feel like myself again down there. Go talk to your doctor and grab yourself some!

👉 Want to dive deeper into this topic? Don’t miss:
Is Your Vagina Talking? Here’s How to Listen and Thrive

🛑 6. Low Libido (And It’s Not Just “In Your Head”)

Maybe it’s hormones. Maybe it’s fatigue. Maybe it’s the fact that your brain is juggling 87 tabs. A drop in desire is incredibly common—but treatable.

I’ve struggled with this for years—honestly, ever since giving birth to my kids (who are now 18 and 20!). My poor husband—he’s been a trooper. But the truth is, fatigue plays a huge part in this. When you’re constantly exhausted, touched out, or overwhelmed, feeling sexy isn’t exactly top of the list.

You’re not broken. Hormonal shifts, low energy, and emotional burnout all affect your sex drive.

👉 Learn more in this blog:
Midlife, Moisture & the Missing Mojo: Sex & Relationships After 40

🧠 7. Brain Fog (Where Did I Put My... Wait, What Was I Saying?)

If words are hiding, and focus is elusive, welcome to the land of fog. This can be one of the most frustrating (and often under-discussed) symptoms.

This one has really hit me in the past year. Add that on top of my already overwhelmed and unorganized ADHD brain, and it’s a real challenge. Some days, just stringing a sentence together or remembering why I walked into a room feels like Olympic-level effort. It’s not just forgetfulness—it’s like my mental clarity packed a bag and left without a forwarding address.

Good news: Protein, omega-3s, sleep, and perhaps a bit of estrogen support (hello doctor!) may all help your brain bounce back.

😬 8. Electric Zaps, Itchy Skin & Tingling (Wait, What?!)

One of the lesser-known (and totally bizarre) symptoms of perimenopause? Random itching. Skin that suddenly feels dry, irritated, or just plain weird. Some women even report itchy ears or creepy-crawly sensations on their skin.

I get this too—and living in a dry climate makes it a total double whammy. Sometimes I feel like I’m scratching more than a cat on a bad day. It’s not just the weather—it’s hormonal shifts messing with collagen, hydration, and nerve endings.

What helps: Stay hydrated inside and out. Omega-3s, hyaluronic acid-rich skincare, gentle exfoliation, and moisturizing often can help keep the itch at bay.

😱 9. Increased Anxiety & Panic (Especially in the Middle of the Night)

Suddenly feeling anxious for no reason? Waking up with your heart racing or feeling like something terrible is about to happen? Yep—perimenopause anxiety is real, and it doesn’t always play fair.

This one’s been a huge pain for me—especially at night. I can lie awake catastrophizing about anything and everything. The smallest thought spirals into a full-blown worst-case scenario before I even realize it’s happening. It’s exhausting—and scary.

Why it happens: As progesterone drops (our naturally calming hormone), and estrogen fluctuates, your nervous system becomes more sensitive. Add in life stressors and midlife demands, and your body can slip into fight-or-flight mode without warning.

👉 Want the full breakdown? Read:
Panic, Periods & Perimenopause: How ADHD and Hormones Hijacked My Brain

💩 10. Digestive Drama (Bloating, Constipation, and Gas—Oh My)

Gut health and hormones are tightly linked. As estrogen and progesterone fluctuate, your digestion can suddenly feel... completely unrecognizable. Bloating, gas, constipation, diarrhea—sometimes all in the same week.

My gut is basically that one friend who suddenly can’t handle brunch anymore—moody, dramatic, and very picky about what we eat. And it’s incredibly frustrating to watch my family enjoy things I love—but know would absolutely torment me. Am I a bit bitter about it? Yes. Yes, I am. When even your “safe” foods feel like a gamble, it’s hard not to feel defeated.

Why it happens: Hormones affect gut motility, enzyme production, and even your microbiome. So when they go haywire, your digestion often does too.

👉 Get the full story here:
Gut Instincts: How Hormones Hijack Your Digestion in Perimenopause (and What You Can Do)

Final Thoughts: You’re Not Broken—You’re in Transition

Perimenopause is messy, magical, and 100% real. If you’re experiencing a mash-up of these symptoms, know this: you’re not alone, and you’re not imagining things.

📌 Advocate for yourself.
📌 Track your symptoms.
📌 Read the books.
📌 Find the doctor who listens.
📌 Lean on your girlfriends who get it.

Because this isn’t just the end of something. It’s the beginning of a new, powerful chapter.

Grab my free guide, Perimenopause Power Moves, today!

Hormonally Yours,

Kimberlee Erin

Just a heads-up: I’m a Certified Menopause Coaching Specialist and Holistic Nutritionist, and while I love sharing what’s worked for me and my clients, this blog is for informational purposes only. It’s not a substitute for medical advice. Always check in with your healthcare provider before starting new supplements, hormones, or treatments—especially since every woman’s perimenopause journey is different. You deserve personalized care that truly fits you.