Am I in Perimenopause? 5 Early Signs Most Women Miss (Especially at Work)
If you have found yourself thinking, “Why does everything suddenly feel harder than it used to?”, you are certainly not the only one.
For many women, perimenopause does not arrive with an obvious moment when everything changes. It is usually much less dramatic than that. You might simply notice that your sleep is not quite the same, your patience is shorter, your periods are changing or you are having to work harder to find words and concentrate in situations that would never normally have bothered you.
And because these changes often arrive during an already busy stage of life, it can be remarkably easy to explain them away.
Work is intense. You are not sleeping because you have too much on your mind. You are more irritable because everyone is irritating. You cannot concentrate because you are juggling too much. You are exhausted because, well, life.
Sometimes those explanations are completely right.
But sometimes there is another piece of the picture.
Perimenopause can affect menstrual patterns, sleep, mood, memory and concentration, alongside better-known symptoms such as hot flushes and night sweats. The symptoms can also change over time, which is one reason the experience can be difficult to recognise at first.
This is not a checklist for diagnosing yourself. It is simply a way of noticing whether something has changed and deciding whether it might be worth a conversation with a healthcare professional.
First, what actually is perimenopause?
Perimenopause is the transition leading up to menopause, during which ovarian hormone patterns become more variable and menstrual cycles often begin to change. Menopause itself is reached retrospectively, once you have gone 12 months without a period.
For most women, the transition happens in midlife, usually beginning during the 40s, although there is plenty of individual variation. Symptoms can appear before periods stop completely, and the early stages do not necessarily look like the stereotype of menopause that many of us grew up with.
You may still be having periods. You may not be having dramatic hot flushes. What you notice first could be sleep, mood, concentration or a change in the pattern of your cycle.
That is part of what makes perimenopause easy to miss.
1. Your mood feels different, even though nothing obvious has changed
Sometimes the first thing women notice is not physical at all. They simply feel different.
Perhaps you are more irritable than usual, more easily overwhelmed or much more emotional about things you would previously have brushed off. Some women experience low mood or increased anxiety, and changes in mood are recognised features of the menopausal transition.
At work, that can be particularly unsettling because it may show up in places where you have historically felt very confident. Feedback lands harder. A busy diary suddenly feels overwhelming. You find yourself worrying about a meeting you would previously have walked into without a second thought, or replaying a conversation long after everybody else has forgotten about it.
The temptation is to turn that into a judgement about yourself: I am not coping as well as I used to.
I think a much more useful question is: what has changed?
Has work actually become more demanding? Are you sleeping badly? Is something difficult happening elsewhere in your life? Are you noticing changes in your menstrual cycle too?
Perimenopause may be one part of that picture, but it does not need to become the explanation for every difficult emotion a woman experiences in her 40s.
2. You are noticing changes in concentration or memory
This is probably one of the symptoms I hear women talk about most in relation to work.
You know the word, but it will not come quickly enough. You open a tab and forget why. You read the same paragraph several times before it sticks. You are halfway through explaining something in a meeting and suddenly lose your train of thought.
Problems with memory and concentration, commonly described as “brain fog”, are recognised symptoms of perimenopause and menopause, and they can feel worse when sleep is also disrupted.
What worries me is what sometimes happens next.
A woman who has spent twenty years building expertise suddenly starts wondering whether she is losing her edge. She prepares more, checks everything twice, works later and becomes increasingly anxious about making a mistake. What began as a frustrating cognitive symptom starts affecting confidence too.
That can be far more damaging than occasionally forgetting a word.
If this sounds familiar, try not to interpret every lapse as evidence that you are becoming less competent. A temporary change in concentration is not the same thing as a loss of knowledge, judgement or capability.
You are still the person who built all that experience.
3. Your sleep has changed
This one can sneak up on you because a “sleep problem” does not necessarily mean lying awake all night.
You might fall asleep perfectly easily and then find yourself wide awake at 3am. Your sleep may become lighter or more fragmented, or you might wake feeling as though you have barely rested despite spending eight hours in bed. Hot flushes and night sweats can contribute, but some women notice disrupted sleep without an obvious vasomotor symptom waking them. Sleep disturbance is a well-recognised part of the menopausal transition.
And of course, sleep affects almost everything else.
When you are tired, concentration becomes harder, emotional regulation becomes more difficult and normal workplace pressures can require much more effort. You may start thinking that you have become less resilient when, in reality, you are trying to do the same job on significantly less recovery.
That distinction matters.
Sometimes what looks like a performance problem is actually a sleep problem.
4. The amount of recovery you need has changed
There is a point in midlife when some women notice that things they used to recover from easily seem to cost a little more.
A packed week followed by a weekend of social plans suddenly feels less appealing. Work travel wipes you out. You can still do everything, but perhaps you need longer to recharge afterwards.
I would be careful about automatically labelling this as perimenopause because energy levels can change for a huge number of reasons. Poor sleep, iron deficiency, thyroid problems, workload, caring responsibilities, mental health and simply having too little recovery built into life can all contribute.
But when a change in energy appears alongside shifts in sleep, menstrual patterns, mood or temperature regulation, it is worth paying attention to the whole picture.
The important thing is not to turn needing more recovery into a moral failure.
There is a big difference between “I cannot do this anymore” and “I can still do this, but the way I recover from it has changed.”
That distinction can be really important at work, because the solution may be relatively small. Fewer unnecessarily early meetings for a period of time, slightly more control over travel, some flexibility around working location or simply recognising that a particularly intense period of work needs proper recovery afterwards may be enough to keep someone doing a role she loves.
5. Your menstrual cycle is changing
Changes to periods are one of the most useful clues that the menopausal transition may be beginning.
Your cycles may start getting shorter or longer, periods may become heavier or lighter, or the timing becomes less predictable than it used to be.
For women who already live with something like PMDD, this stage can also be particularly confusing. The familiar pattern you have learned to understand may become less predictable as cycle timing changes, making it harder to know when symptoms are coming.
But again, this is an area where I would avoid assuming that every menstrual change in your 40s is perimenopause.
Heavy bleeding, significant pain, very irregular periods or other noticeable changes can have other causes and deserve proper assessment. Conditions such as adenomyosis, endometriosis, fibroids and PMOS can also affect menstrual patterns, which is why getting curious about changes is more useful than simply assigning everything to hormones.
So how do you actually know whether it is perimenopause?
This is probably the question most women want answered, and frustratingly there is not always one neat test that gives you a yes or no.
Current NICE and British Menopause Society guidance recommends that, in otherwise healthy women aged 45 and over with typical symptoms, perimenopause is generally identified from symptoms and menstrual changes rather than routine hormone blood tests. Hormone levels fluctuate significantly during this transition, so a single measurement often tells you surprisingly little.
If symptoms begin earlier, the situation is different and clinical assessment becomes especially important. Other causes may need to be considered, and testing can be appropriate depending on age and circumstances.
That is also why I am slightly wary of the huge amount of perimenopause content now circulating online. Greater awareness has been hugely positive, but we have perhaps moved from one extreme, where women were told everything was stress, to another where almost every symptom between 35 and 55 risks being labelled perimenopause. Clinicians have recently raised concerns about exactly this kind of over-attribution.
Poor sleep deserves investigating.
Anxiety deserves investigating.
Changes in concentration deserve investigating.
Perimenopause might explain them, but so might something else.
The aim is not to find the hormonal explanation as quickly as possible. It is to understand what is actually going on.
Before you speak to someone, notice what has changed
You do not need to arrive at a GP appointment with a perfectly colour-coded symptom tracker, but it can be helpful to spend a little time noticing patterns.
Rather than asking yourself, “Is it perimenopause?”, try asking:
What feels noticeably different from a year or two ago?
Has my menstrual cycle changed?
Is my sleep different?
Are there particular symptoms that seem to occur together?
What is affecting me most day to day?
Is work actually more demanding, or does the same workload now feel harder to sustain?
What else is happening in my health or life that might be relevant?
That last question is important.
Sometimes the answer is perimenopause and a difficult job and poor sleep and caring responsibilities.
Human beings rarely experience one thing at a time.
If work is where you are noticing it most
Work can be one of the first places changes become obvious simply because work asks a lot of our cognitive and emotional resources.
We have to concentrate, remember things, regulate emotions, communicate clearly, make decisions and deal with other people's demands, often for hours at a time.
If sleep, mood or concentration has changed, a demanding working day can expose that very quickly.
But I would really resist the idea that this automatically means women need to step back.
Sometimes a small amount of flexibility during a difficult period is enough. Perhaps you need fewer early starts while sleep is poor. Perhaps working from home occasionally makes concentrating easier. Perhaps you need a conversation with your manager about workload rather than silently compensating by working longer hours.
Temporary changes in what you need from work do not have to become permanent judgements about what you are capable of.
And that is something I think both women and managers need to hear much more often.
A final thought
One of the hardest things about perimenopause is that so much of it can be invisible.
You can be highly experienced, successful and perfectly capable while privately wondering why work suddenly seems to require more effort than it used to. And because women are very good at compensating, the people around you may have absolutely no idea.
If something has changed, get curious about it rather than immediately blaming yourself.
Notice the patterns. Talk to an appropriate healthcare professional if symptoms are affecting you. Think about what is happening at work as well as what is happening in your body, and do not wait until everything has become unbearable before asking for support.
Perimenopause is a transition, not a verdict on your capability.
And sometimes understanding what is happening is enough to stop asking, “What is wrong with me?” and start asking the much more useful question:
“What do I need right now?”
Want support without the panic?
If you are reading this and thinking, “I just want someone to explain what is happening without making it scary,” there is plenty more support available through See Her Thrive.
Our resources are designed to make women’s health easier to understand without catastrophising normal life stages or turning every symptom into something to fear. You can explore the Library for practical, evidence-informed articles on perimenopause, menstrual health, hormones and work.
If you would rather learn with us live, take a look at our latest Training & Events, where we run workshops and programmes for women and organisations.
And if what you really need is some space to step away from the noise, reconnect with yourself and think about what you want from this next stage of life, you can also explore our Retreats. They bring together movement, reflection, conversation and proper time to slow down, without making midlife feel like something that needs to be fixed.