Is It Perimenopause? 10 Early Clues to Watch For (other than hot flushes)

“Menopause doesn’t happen overnight — and the signs can show up years before your last period.”

Perimenopause can begin up to 10 years before menopause, and every woman will go through it. It’s not a matter of if, but when—and how you navigate it.

While hot flushes are often the most talked-about symptom, they’re far from the only sign. In Asian women, joint pain is often one of the earliest red flags. Hormonal changes during this stage can impact everything from your sleep and mood to your bones and libido.

1. Changes in Menstrual Cycle

Your cycle may become shorter, longer, heavier, or lighter. Skipped periods become more common. A woman is considered in Menopause when she ceases to have her period for 12 months.

2. Achy or Stiff Joints

Sudden joint aches, especially in the knees, hips, or hands, are common and often mistaken for the effects of general ageing or overuse injuries.

3. Trouble Sleeping or Staying Asleep

Difficulty falling asleep, waking frequently, or feeling unrefreshed in the morning can appear even if you’ve always been a good sleeper. The drop is progesterone leads to sleep difficulties.

4. Unexplained Weight Gain

The same diet and exercise routine you’ve followed for years may suddenly stop working, with fat gain, especially around the midsection, becoming more noticeable. The reason for weight gain is due to muscle loss and hormonal shifts, which can result in fat storage especially around the belly.

5. Frozen Shoulder or Reduced Mobility

Hormonal changes can affect connective tissue, increasing your risk for stiffness, reduced range of motion, and slow injury recovery.

6. Brain Fog & Low Energy

You may find yourself forgetting simple things, struggling to focus, or feeling drained, even without major changes in your lifestyle. Hormones play a huge role in brain function, keeping brain receptors active and responsive.

7. Vaginal Dryness & Discomfort

Lower estrogen can cause thinning and dryness in vaginal tissues, leading to discomfort during intimacy and increased susceptibility to infections.

8. Low Libido

Shifting hormones, especially declining testosterone and estrogen, can reduce sexual desire and arousal.

9. Bone Density Loss

Estrogen plays a key role in protecting bone mass. Perimenopause marks the start of more rapid bone loss, increasing the risk of osteoporosis later in life.

10. Mood Changes & Anxiety

Fluctuating hormones can affect brain chemistry, leading to increased irritability, anxiety, or mood swings, sometimes without an obvious trigger.

The Bigger Picture: Perimenopause is not a disease or deficiency; it’s a natural life stage that happens to every woman when the hormones in her body start to decline. Some women transition with ease, while others, particularly those under chronic stress, find it more challenging.

The good news? There are evidence-based tools from targeted nutrition, strength training, stress management, hormone therapy and medical support that can help you move through midlife stronger, healthier, and more confident than ever.

Take our comprehensive perimenopause test today to find out if you may be experiencing symptoms!