Could it be perimenopause? It might be earlier than you think

I hope you had a restful, peaceful, and joyful Christmas, and that you’re feeling revitalised as we step into 2026. And if you’re not feeling revitalised - if you’re feeling a bit jaded, a bit flat, or simply ready for a fresh start - that’s absolutely okay too. A new year often brings with it a natural pause, a moment to reflect, and perhaps the quiet desire to form some new habits or ask some new questions. 

Because it is the start of the year, I thought it might be a good time to take things right back to basics when it comes to menopause - and to ask a question I hear so often: 

At what point might changes in your health, or symptoms you’re experiencing, actually be related to perimenopause? 

And the honest answer is: possibly younger than you think. 

We know that menopause itself - defined as twelve months from your final period - naturally occurs somewhere between the ages of 45 and 55. Here in the UK, the average age is 51. Perimenopause, however, is the time before that point - when symptoms are present, but you are still having a cycle. That transition can last anything up to ten years. 

So if we work backwards from the earlier end of that range - age 45 - and take ten years off, then your mid-30s may already be a time when symptoms you’re experiencing could be linked to the menopause transition. 

So what might that look like? 

Of course, we are all different, but there are some common patterns. We often think first of the “classic” symptoms: changes to periods, hot flushes, night sweats, and disrupted sleep. And yes - those can absolutely show up. 

But perimenopause doesn’t always announce itself so clearly. 

You might start noticing digestive changes: reflux, indigestion, belching, bloating, cramps, constipation, diarrhoea, nausea. If you’ve historically struggled with IBS, you may find those symptoms are suddenly exacerbated. Similarly, anxiety can worsen - or appear seemingly out of nowhere. 

There may be cravings you don’t recognise. Changes in your skin. Aching joints or muscles. New food sensitivities that leave you wondering, Why is my body reacting like this now? 

Mood regulation can become more difficult - perhaps anger feels closer to the surface, quicker to fire. Brain fog, poor concentration, forgetfulness; heart palpitations, which can feel particularly alarming; irregular cycles, insomnia, headaches; changes in migraines if that’s something you’ve previously experienced; fatigue that drags on regardless of how well you sleep; weight gain that seems disconnected from your habits; breast tenderness. 

And that list isn’t exhaustive. 

So what do you do if you’re experiencing sustained, unexplained changes? 

First and foremost: regardless of your age, if something has been going on for weeks, or months, and it’s not resolving - please go and see your GP. Have the conversation. Explain how you’re feeling. Be clear about the impact on your wellbeing and your ability to function, personally or professionally. 

If your GP suggests blood tests to rule other things out, please don’t interpret that as being dismissed. Those tests can be incredibly valuable. There is significant overlap between menopause symptoms and things like thyroid dysfunction. Low iron doesn’t just contribute to fatigue - it can also play a role in aches, pains, and low mood. 

Be persistent if you need to be. Advocate for yourself. Follow up if you don’t get answers. 

Alongside that medical support, it’s also important - gently and honestly - to look at how you’re living. 

Are you moving enough? And if not, could that be contributing to low mood, musculoskeletal discomfort, poor sleep, difficulty concentrating, or digestive issues? 

Are you relying heavily on ready meals or processed foods? There’s no judgement here - but low vegetables, low protein, low fibre, and low nutrients will, sooner or later, take their toll. Energy dips, poor digestion, skin issues, low mood - all of these can be linked to what we’re feeding ourselves. 

How stressed are you? How much are you asking of yourself - and how much space are you giving your body to recover? 

These aren’t things you need to leap into fixing all at once. In fact, I’d strongly advise against that. Overwhelm helps no one. But being honest with yourself about the load you’re carrying is an important first step. 

Most GPs - whether or not menopause hormone therapy is prescribed - will also talk to you about movement, nutrition, rest and self-care. Because all of these things influence how manageable your menopause experience will be. 

And the good news is this: if you start putting those building blocks in place - slowly, steadily, realistically - you will start to reap the dividends. That might be after blood test results are addressed. It might be alongside hormone therapy if that’s appropriate for you. It might be through lifestyle changes alone, or a combination of everything. 

Over time, these shifts can lead to more manageable symptoms, more energy, improved mood, greater self-esteem, and renewed hope for the future. 

And if all of this still feels like too much - if you’re questioning your ability to stick with changes, or you’re unsure where to begin - please reach out. We can look at your current habits together, cut through the internet noise, and decide which changes will make the biggest difference for YOU. The goal isn’t perfection. It’s feeling empowered, energised, and confident that you’ve got this - not just for this year, but for the next decade. 

All that remains is to wish you a very, very happy New Year. May it bring you exactly what you need.