If you’re in your 30s and experiencing brain fog, anxiety, or waking up at 2 am for no reason, you’ve probably blamed it on stress or burnout. But if your periods are also unpredictable, your body might be trying to tell you something else: perimenopause has entered the chat. Also read | Perimenopause ‘isn’t same for everyone’: Radiologist shares why you shouldn’t rely on online trends to manage symptoms
According to the World Health Organisation (WHO), menopause marks the end of a woman’s reproductive years, typically occurring naturally between ages 45 and 55 due to a decline in oestrogen levels and loss of ovarian function. However, the menopausal transition — known as perimenopause — is a gradual process that can begin years earlier, starting with subtle shifts in your menstrual cycle.
When symptoms start creeping in during your 30s, it’s easy to miss the connection. In an interview with HT Lifestyle, Dr Shivika Gupta, fertility specialist at Birla Fertility and IVF, Gurgaon Sector 51, broke down what’s actually happening behind the scenes.
The hidden symptoms you’re probably ignoring
While hot flashes get all the attention, Dr Gupta pointed out that early signs are far more covert. “Hot flushes and night sweats are what most people associate with perimenopause, but the symptoms that most often go unrecognised are of a different kind,” she said, adding, “These include sleep disturbance without obvious cause, cognitive changes such as difficulty concentrating and memory lapses, new-onset anxiety or mood instability, joint pain and stiffness, and changes in skin and hair texture.”
Because these issues seem so common, women routinely brush them off. “Women frequently attribute these to stress, overwork, or ageing in general, and that delays recognition of a hormonal pattern,” Dr Gupta said.
Why your sleep, brain and mood feel disrupted
It turns out that shifting hormone levels impact everything from your nervous system to your joints. Oestrogen and progesterone regulate your sleep architecture. As levels drop, Dr Gupa highlighted, you might experience lighter sleep or early waking — even without night sweats. Oestrogen directly supports neurotransmitters. Fluctuations can lead to memory lapses or word-finding struggles. “These are not early dementia and they are not imagined. They are documented neurological effects of hormonal transition,” Dr Gupta said.
Oestrogen influences serotonin and dopamine pathways. “Women who have never experienced anxiety or significant mood instability can develop both during this phase,” Dr Gupta said, adding, “The pattern is often cyclical. Women are frequently referred for psychological support for symptoms that are primarily hormonal in origin.” Oestrogen acts as a natural anti-inflammatory. A decline removes this protection, leading to joint stiffness in hands, knees, and hips, she added.
How to spot the hormonal pattern
Connecting the dots comes down to tracking timing and clusters. “What distinguishes perimenopausal presentations is their cyclical nature, their tendency to cluster together, and their correspondence with menstrual irregularity,” Dr Gupta shared. However, you don’t have to wait for skipped periods to take note. “Symptoms can also begin while periods are still regular, because the hormonal fluctuations precede cycle irregularity by months or years,” Dr Gupta said.
When to see a doctor
Because symptoms mirror other health conditions — like thyroid dysfunction — a structured medical evaluation is essential to get real answers. “A woman should consult a gynaecologist when symptoms are affecting her quality of life, or when she is uncertain whether what she is experiencing is hormonal in origin,” Dr Gupta advised. “Waiting until symptoms become severe before seeking assessment is a pattern worth changing,” the doctor concluded.
Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.
