How do I know if I’m perimenopausal?
Many women ask us this.
Often, it is not one clear symptom, but a general sense that something has shifted. You may feel more anxious, more tired, or simply not quite yourself.
Perimenopause can be difficult to recognise, particularly in the early stages, and it is very common to wonder whether what you are experiencing could be hormonal.
What is perimenopause?
Perimenopause is the time leading up to menopause, when hormone levels begin to fluctuate.
It can start several years before periods stop completely. For most women, this is in their 40s, although it can begin earlier.
If you would like a more detailed explanation, you can read our full guide here:What-is-perimenopause?
Common signs of perimenopause
Symptoms can vary from person to person, but some of the most common include:
Changes to your periods, such as irregular, heavier or lighter bleeding
Sleep disturbance
Anxiety or low mood
Brain fog or difficulty concentrating
Hot flushes or night sweats
Low energy or fatigue
Reduced motivation or confidence
Joint aches or stiffness
Changes in libido
You may experience just a few of these, or several at once. Symptoms can also come and go, which can make things feel confusing.
If you are starting to recognise some of these changes, it can be helpful to track your symptoms over time. We have created a simple symptom checker to support this.
It’s not always obvious
One of the reasons perimenopause can be hard to identify is that symptoms are often subtle at first.
You may still be having regular periods.
You may feel fine one week and very different the next.
You may put symptoms down to stress, work or everyday life.
For many women, it is only with time that a clearer pattern begins to emerge.
Do I need a blood test?
In most cases, perimenopause is diagnosed based on your symptoms and menstrual history.
Blood tests are not usually helpful in your 40s, as hormone levels can fluctuate significantly from day to day.
Blood tests can be really useful though to exclude other medical conditions that can also occur in our mid-life - such as low iron levels, an under active thyroid, low vitamin D etc all of which can cause symptoms.
When to seek advice
If your symptoms are affecting how you feel day to day, it is worth speaking to a healthcare professional.
You do not need to wait until your periods stop.
Getting the right support early can help you understand what is happening and explore options to help you feel better.
What to do next
If you think you may be perimenopausal, the next step is not necessarily treatment, but understanding.
Tracking your symptoms, noticing patterns, and having a conversation with a clinician can make a real difference.
At Lemala Health, we take time to listen, understand your experience, and offer personalised, evidence-based advice to support you through this stage of life.
Article written by Dr Emma Ginns and Dr Mari Walling, British Menopause Society Registered Specialist GPs, Co-founders of Lemala Health, April 2026
This information is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your healthcare provider for personalised guidance.