You might start noticing small but frustrating changes in your body, like shifts in your cycle, mood swings that feel unfamiliar, trouble sleeping, or energy that comes and goes. It’s easy to wonder what’s behind it all, whether it’s stress, hormones, or just part of getting older.

You’re not alone. For many people, these shifts are part of perimenopause, a natural but often misunderstood stage of life. That’s why we’ve partnered with the perimenopause experts at Oova to break down what perimenopause is, what’s happening in your body, and how you can recognize and manage symptoms with confidence.

What Is Perimenopause?

Perimenopause is the transitional phase of hormonal change that leads up to menopause (when menstrual periods stop entirely). During this time, hormones like estrogen and progesterone begin to fluctuate, causing periods, sleep, mood, and energy to shift.

When does it start? Perimenopause typically begins in your 40s, but it can start in your mid-30s or even earlier, especially if you have a family history of early menopause or certain medical conditions.

How long does it last? Perimenopause typically lasts 2 to 8 years. During this time, your body releases eggs less regularly, produces less estrogen and progesterone, becomes less fertile, and experiences shorter, longer, or more irregular menstrual cycles.

In short: hormones fluctuate, cycles change, and new symptoms may appear, all before your periods officially stop.

Why Is It Important to Understand Perimenopause?

Perimenopause can have a real impact on daily life and your long-term health. Often, people notice they’re experiencing different symptoms without realizing hormones are the root cause. As estrogen levels rise and fall, many people experience things like:

  • Irregular periods
  • Hot flashes and/or night sweats
  • Sleep disruptions
  • Mood changes or anxiety
  • Brain fog or memory changes
  • Sexual or pelvic discomfort

These symptoms can affect work, relationships, parenting, and emotional well-being, and are frequently misattributed to stress, burnout, or aging.

Beyond symptom relief, addressing perimenopause proactively is also an investment in long-term health. The menopausal transition is linked to:

  • Accelerated bone loss
  • Increased cardiovascular and metabolic risk
  • Changes in cognitive health

These symptoms can affect work, relationships, parenting, and emotional well-being, and are frequently misattributed to stress, burnout, or aging. In fact, many of the most challenging perimenopause symptoms are often dismissed or go unrecognized for what they truly are.

The Long-Term Health Connection

Beyond symptom relief, addressing perimenopause proactively is also an investment in long-term health. The menopausal transition is linked to:

  • Accelerated bone loss
  • Increased cardiovascular and metabolic risk
  • Changes in cognitive health

Supporting your body during this window, through nutrition, movement, sleep, and appropriate medical care, can positively shape your health for decades to come.

How Do You Know If You’re in Perimenopause?

There’s no single “aha” moment that you’re in perimenopause, but there are signs that suggest you might be. The earliest clues are often changes in your menstrual cycle. You might notice things like shorter or longer cycles, skipped periods, changes in bleeding, or more unpredictability in the timing of your periods. These changes can feel confusing or inconsistent, which is why understanding the underlying hormone shifts can be helpful.

What’s Actually Happening in Your Body During Perimenopause?

To understand why these symptoms show up so differently for everyone, it helps to look at what’s actually happening hormonally during perimenopause. As perimenopause begins, estrogen and progesterone levels become erratic. Over time, both hormones gradually decline until they eventually reach their lowest levels when you reach menopause.

These hormone shifts are responsible for all the symptoms that come along with perimenopause and can affect nearly every system in your body.

  • Progesterone changes may contribute to irregular or heavy periods, mood swings, fatigue, low libido, and breast tenderness.
  • Estrogen changes cause varied symptoms depending on whether levels are higher or lower. 
    • High estrogen can cause bloating and breast tenderness
    • Low estrogen phases may lead to hot flashes, night sweats, headaches, vaginal dryness, lower libido, and decreased bone density
    • Because estrogen fluctuates from cycle to cycle, symptoms can change month to month, adding to the confusion.

Common Signs and Symptoms of Perimenopause

We’ve talked about some of the early symptoms of perimenopause, but since perimenopause can affect the whole body, there are actually over 34 commonly reported symptoms. Because these overlap with mental health conditions, perimenopause is often misdiagnosed.

  • Physical symptoms may include: 
    • Changes in periods, like irregular or skipped periods, or changes in flow
    • Hot flashes & night sweats
    • Bladder changes like burning when urinating, changes in frequency, or leaking
    • Vaginal dryness or discomfort that can make sex uncomfortable or painful
    • Breast tenderness
    • Weight gain & bloating
    • Joint & muscle pain
    • Skin changes like acne, itchiness, or dry skin
    • Thinning hair
  • Emotional & cognitive symptoms may include:
    • A worsening of PMS symptoms
    • Mood swings & irritability
    • Anxiety & low mood 
    • Sleep disturbances
    • Brain fog, memory lapses & trouble concentrating
    • Decreased libido
  • Other Health Changes may include:
    • Increased cholesterol
    • Decreased bone density

Can You Test for Perimenopause?

There is no single test that definitively diagnoses perimenopause. Instead, health care providers look at a combination of age, menstrual changes, symptoms, and hormone levels.

Because hormone levels fluctuate so much during perimenopause, a single blood test often doesn’t tell the full story. Some people choose to use at-home hormone tracking tools, like Oova, to observe patterns over time and better understand how their hormones are changing.

Understanding Your Hormone Patterns with Oova

Oova has an at-home, clinical-grade Perimenopause Test designed to track the daily fluctuations in estrogen, progesterone, and luteinizing hormone (LH) that characterize the perimenopause transition. 

Rather than traditional testing, which provides only a single snapshot, Oova collects repeated, quantitative hormone data so you can understand what’s happening in your body across your entire cycle, month after month. This kind of hormone tracking gives you real hormone intelligence to:

  • Understand your unique hormone patterns
  • Identify where you are in the perimenopause transition
  • Make more informed decisions about symptom management and treatment

This kind of hormone intelligence can be a powerful tool when navigating this stage of life.

Managing Perimenopause Symptoms

There’s no one-size-fits-all approach to managing perimenopause symptoms, but many people find relief through a combination of strategies. Medical options include hormone therapy (HRT), targeted supplements, and prescription treatments for specific symptoms. Lifestyle support includes a variety of things, like:

  • Nutrition: supporting blood sugar, bone health, and inflammation
  • Movement: strength training, walking, and gentle cardio
  • Sleep support: prioritizing rest and recovery
  • Complementary therapies, such as acupuncture

Many people find that a layered approach, combining medical care with lifestyle support, offers the most relief.

When Should You Talk to a Doctor?

It’s time to seek medical care if:

  • Symptoms interfere with daily life or feel unmanageable
  • Periods become very irregular (bleeding more often than every 21 days, going more than 60 days without a period, or very heavy/prolonged bleeding)
    You develop new or worsening mood changes
  • Symptoms like anxiety, sleep disruption, or night sweats affect your quality of life or ability to function
  • You experience persistent pelvic pain, bleeding after sex, or bleeding after menopause.
    Because perimenopausal symptoms can overlap with other medical conditions like thyroid disorders, anemia, or mood conditions, checking in with a clinician ensures nothing else is being missed.

If you’re considering hormone therapy, supplements, or your current approach isn’t helping, a doctor can tailor care based on your symptoms and hormone patterns.

The bottom line is, if something feels “off,” keeps worsening, or disrupts your wellbeing, it’s worth talking to a healthcare provider.

Finding the Right Provider

It’s important to note that not all clinicians are trained in menopause care. When possible, look for a provider certified by the North American Menopause Society (NAMS).

Menopause education was not historically part of standard medical training, so specialized expertise matters. Bringing symptom tracking, cycle notes, or hormone data to appointments can also help guide productive conversations.

Final Thoughts

Perimenopause is a normal stage of life, but that doesn't mean you have to push through symptoms without support. Understanding what's happening in your body can make it easier to seek care and find approaches that help you feel more like yourself.

Whether you're just starting to notice changes or you're deep into the transition, remember: knowledge is power, and you deserve support every step of the way.


Want to learn more about your unique hormone patterns? Explore Oova's perimenopause hormone tracking kit to gain insights that can help you navigate this journey with confidence.