Could Your Symptoms Be Perimenopause? Take the Quiz

Maybe you’re feeling more tired than usual, or a little foggy and irritable. Or your periods, once like clockwork, have become erratic. Or maybe you just haven’t felt like yourself lately. 

All of these symptoms could indicate perimenopause, the transition leading up to menopause, says Kanchi Chadha, M.D., an OB-GYN at Hackensack Meridian Health in Hackensack and assistant professor at Hackensack Meridian School of Medicine.

Because symptoms vary, start at a wide range of ages and can be mistaken for other issues, it’s often hard to tell whether perimenopause is really what’s going on. 

Take our quiz to learn the signs to look for and when it might be a good idea to make an appointment with your doctor. 

When Does Perimenopause Start?

“Perimenopause usually begins in your 40s,” says Dr. Chadha. 

It most likely occurs between 45 and 55, since that’s roughly five years on either side of the average age of menopause, which is 51 in the U.S. The transition can last anywhere from a few years to 10 years, running until 12 months after your final period.

If you’re younger than 40, perimenopause is less likely. Instead, your doctor may investigate a different diagnosis called ovarian insufficiency, which is when your ovaries stop functioning normally before 40, causing symptoms similar to perimenopause. 

No matter your age, it’s important to book an appointment with your OB-GYN if your symptoms are affecting your quality of life.

Common Signs of Perimenopause

Perimenopause shows up differently for everyone. These are some of the most common symptoms, along with other conditions that could be causing them.

Irregular Periods

Hormone fluctuations can change the timing and flow of your cycle, bringing shorter or longer cycles, skipped cycles, heavier or lighter bleeding or longer or shorter periods. Any change from your lifelong pattern is worth a conversation with your OB-GYN. Other possible causes of irregular periods include pregnancy (still possible in your 40s and 50s), structural changes like fibroids or polyps, thyroid issues or medication side effects.

Hot Flashes and Night Sweats

These vasomotor symptoms come from shifting hormone levels. If you’re having these symptoms, there’s a good chance perimenopause is the trigger. But a thyroid issue could also be to blame, notes Dr. Chadha.

Sleep Changes

Waking regularly between 1 a.m. and 3 a.m.? That can happen as progesterone drops and cortisol rises, changing your sleep cycles. But it’s worth ruling out other causes, especially obstructive sleep apnea, which is often underdiagnosed in perimenopausal women — and not everyone who has it snores.

Mood Changes

“Estrogen influences the neurotransmitters in our brains, such as dopamine, GABA and serotonin,” says Dr. Chadha. As those levels shift, you may feel a persistent low mood or a surge of anxiety — and disrupted sleep and midlife stress can make it worse. If low mood or anxiety lingers without an obvious cause, that’s a reason to reach out to your doctor.

Weight Changes

A slower metabolism, more belly fat, muscle loss and rising insulin resistance can lead to weight gain even when your diet and exercise haven’t changed. That pattern can point to perimenopause. Unintentional weight loss, on the other hand, is less common during perimenopause and should be discussed with your doctor.

Brain Fog

Trouble finding words and difficulty focusing are classic perimenopause complaints, tied to declining estrogen. These symptoms are usually temporary and tend to improve after menopause. If they are severe enough to disrupt your work or home life, it’s important to mention them to your doctor.

Vaginal, Urinary and Sexual Changes

Known together as genitourinary syndrome of menopause (GSM), these symptoms can include vaginal dryness or irritation, urinary urgency and frequency, recurrent urinary tract infections, lower sex drive or painful intercourse. 

When Should You See a Doctor?

“If any of your symptoms are affecting your quality of life, you should seek the help of a doctor,” Dr. Chadha says. 

For more general whole-body symptoms, you can start with your primary care doctor, who can rule out other causes like thyroid disorders, anemia, or chronic stress. If you strongly suspect perimenopause, go straight to your OB-GYN.

And remember: You don’t have to tough it out. “While perimenopause symptoms are frequently dismissed or misdiagnosed, perimenopause and menopause are clinical diagnoses with real and treatable symptoms. It is not something you have to ‘push through’ anymore,” Dr. Chadha says. 

Options have expanded in recent years and include both hormonal and nonhormonal treatments, so there’s no reason to suffer in silence.

Next Steps & Resources:

• Meet our source: Kanchi Chadha, M.D.
• Make an appointment online with an OB-GYN near you, or call 800-822-8905.
• Learn more about our OB-GYN services.