Think You Might Be Perimenopausal? Here’s What To Do Next

Perimenopause has a way of creeping up and catching you by surprise.

One minute you’re getting on with life. The next you’re lying awake at 3am, snapping at people you love, forgetting words mid sentence and wondering…

“Is this just stress? Or is something else…”

I first started noticing shifts in my late 30s. And that’s not unusual. Subtle changes can begin from your mid 30s onwards – long before anyone starts using the word “menopause.”

Most women don’t realise what’s happening at first.

And most women have more symptoms than they think.

You Probably Have More Symptoms Than You Realise

There are over 40 recognised symptoms linked to perimenopause.

Not just the hot flushes everyone likes to talk about.

We’re talking:

• Anxiety that feels new or amplified
• Broken sleep
• Brain fog
• Heavier or irregular periods
• Thinning hair
• Mood swings
• Increased PMS
• Loss of confidence
• Low motivation

And often it’s not one big dramatic symptom.

It’s a slow erosion of how you used to feel. Many women I speak to, think they might have a serious illness before it dawns on them what’s actually happening.

Step 1: Start Tracking (Properly)

Before you do anything else – track.

Get an app, the Balance App is great for this. Over 2–3 months, you’ll often start to see patterns you hadn’t connected before.

If you’re going to see your GP, I recommend completing a full symptom checklist. It gives you clarity and something concrete to take into a GP appointment so you’re not trying to remember everything on the spot.

And it helps you see the full picture.

Step 2: Understand How Diagnosis Works

This is where confusion often kicks in.

There is no single “perimenopause test.”

• If you’re over 45, diagnosis is usually based on symptoms alone.
• Between 40–45, you may be offered two blood tests six weeks apart.
• Under 40, blood testing is recommended.

The tricky bit? Hormones fluctuate daily and often dramatically during perimenopause.

A blood test is a snapshot, not the full story.

I regularly meet women who have been told they are “definitely not perimenopausal” based on one set of blood results. But perimenopause is a clinical diagnosis, based primarily on symptoms ,especially over 45.

Blood tests can be useful to rule out other conditions (like thyroid issues or low iron), but they are not a definitive yes or no tool for perimenopause.

For clear, balanced information you can also look at:
👉 NHS menopause guidance
👉 Womens Health Concern

Go informed. It makes conversations easier

Step 3: If You’re Considering HRT – Go Prepared

If you think you might want to explore HRT, I find the whole conversation goes much easier if you have an idea of what you would like to try and outcomes you want.

Know what you want help with.

Is it:

• Sleep?
• Anxiety?
• Heavy bleeding?
• Brain fog?
• Joint pain?
• Vulval dryness?

Different symptoms respond differently.

Your prescriber would also want to know if you have any underlying health conditions, this may influence the type of HRT you take or extra monitoring required.

And if you’re younger, especially under 45, HRT can have important long term protective benefits for bone, heart and cognitive health.

You do not need to wait until your periods stop.

But equally, HRT isn’t the only option.

Which brings me to something important.

Step 4: Take This As Your Wake Up Call

Whether you choose HRT or not, this stage is an invitation to look at other areas in your life that could be having an impact on how you feel.

Because here’s what I see again and again:

Women existing on coffee until midday.
Skipping meals.
Punishing their body with cardio to ward off that creeping weight gain.
Trying to continue through like nothing’s changed.

Hormone fluctuations amplify what’s already there.

Your nervous system.
Your stress load.
Your sleep.
Your nutrition.

This is where small, properly implemented shifts can change everything.

Start here:

👉 Read: What’s the Best Diet for Menopause?
👉 Read: Menopause Anxiety – What’s Actually Causing It?
👉 Explore: Breathwork for Menopause

There is no one size fits all plan.

But there is always a next right step.

When to Push for More Support

If any of this feels familiar:

• Your symptoms are affecting your performance at work
• You’re avoiding social plans
• Anxiety feels out of character
• You’re exhausted but can’t switch off
• You keep telling yourself you should just cope

That’s your sign.

You don’t have to wait until things fall apart.

What Next?