Perimenopause: the first signs to watch for

Menopause does not happen overnight. It is not some sudden, dramatic change—it is much more a slow, gradual transition accompanied by subtle signals from the body. This period is perimenopause, which can start as early as the early forties, or even sooner in some cases.

At this time, the body seems to start whispering: something is transforming. Menstruation may become irregular, with alternating longer or shorter cycles; women may experience increased irritability, sleep disturbances, anxiety—and the feeling that their body is no longer functioning as it used to. It is as if well-established routines and habits—sleep patterns, exercise, diet—are becoming less effective. Many notice slow but stubborn weight gain that is not justified by any particular change in lifestyle.

Sleep becomes more restless, falling asleep becomes more difficult, and in the morning, it feels as if there is no real sense of rest. My clinical experience also confirms this: one day my patients are cheerful and energetic, and the next they are exhausted and depressed. This frequent mood swing is very characteristic, and it is no coincidence—in the background, there is a drastic fluctuation of hormones, which is a natural, yet stressful, phenomenon at this stage of life.

This period is a sort of exclamation mark: if we haven't paid enough attention to ourselves until now, we must start doing so. The time of perimenopause is an excellent opportunity to start dealing more consciously with our body and soul. You don't have to "do" lifestyle changes perfectly—but even small steps can make a huge difference.

What becomes more important:

• keeping body weight in check,
• regular exercise,
• getting the right amount of sleep,
• stress reduction,
• and the quality of nutrition.

Clinical experience also shows that more and more people are turning toward natural support: they try to keep themselves in balance with dietary supplements, vitamins, and herbs. These are not miracle cures—but with proper information and medical support, they can help a lot in ensuring the body gets what it needs during this time. Perimenopause is not only a hormonal transition but also an opportunity for a lifestyle redesign. And if we act in time, we can do a lot to ensure that the years of menopause are not about giving things up, but about awareness.