Most women expect perimenopause to start with hot flushes or noticeable period changes, but for many, the earliest signs appear long before that. They often feel subtle, confusing and sometimes completely unrelated to hormones.

Women tell me all the time,
“I thought this was stress.”
“I thought something was wrong with me.”
“I thought it was in my head.”
“I did not think this could be perimenopause.”

Perimenopause begins when your hormones start to shift, not when your period stops. For some women this can begin in their mid to late thirties.

Once you know the early signs, everything makes so much more sense.

1. Sudden Anxiety or Emotional Sensitivity

One of the earliest indicators of perimenopause is a change in how you respond to stress.

You may notice:
• increased worry or racing thoughts
• feeling overwhelmed by things you used to handle easily
• sudden emotional reactivity
• a shorter fuse or lowered tolerance

This is often linked to fluctuating oestrogen and declining progesterone. Progesterone has a calming effect on the nervous system, so when it decreases you can feel more anxious, restless or emotional even if your life has not changed.

This is not a personality change.
It is physiology.

2. Disturbed Sleep

If your sleep suddenly becomes lighter, broken or disrupted, hormones are often the cause.

Common patterns include:
• waking at 2 or 3 am with a wired mind
• difficulty falling asleep
• nights of deep sleep followed by nights of no sleep
• waking unrefreshed

Progesterone supports deep sleep.
Oestrogen influences how you regulate temperature at night.
Changes in both make sleep irregular long before period changes occur.

3. Fatigue That Feels Different

Many women describe this fatigue as:
• heavy
• unmotivated
• unpredictable
• like their battery never fully recharges

This is not standard tiredness.
This is hormonal, nervous system and metabolic all at once.

Your body is using more energy to regulate the instability created by hormone fluctuations.

4. Changes in Your Cycle That Seem Minor

Your period may still arrive on time but:
• flow may become heavier or lighter
• cramps may intensify
• premenstrual symptoms may worsen
• spotting may appear
• your cycle length may shorten

These small changes often show up two to four years before any major shift in menstruation.

5. Weight Changes Especially Around the Belly

Even with the same eating or exercise patterns, many women notice:
• belly fat increase
• bloating
• fluid retention

This happens because:
• insulin sensitivity often decreases
• cortisol increases
• oestrogen becomes unpredictable
• inflammation may rise

It is not loss of discipline.
It is hormone driven.

6. Reduced Stress Tolerance

Women who have always coped well may suddenly say:
“I cannot handle pressure the way I used to.”

This is connected to:
• nervous system sensitisation
• progesterone decline
• changing brain chemistry

It does not mean you are weak.
Your internal system is recalibrating.

7. Gut Upset and New Food Sensitivities

Hormone receptors exist throughout the digestive system.

Sudden symptoms may include:
• constipation or loose stools
• increased bloating
• reflux
• shifts in appetite
• reacting to foods that were fine before

The gut brain hormone connection becomes more sensitive during this phase.

8. Joint Pain, Aches or Stiffness

Oestrogen has an anti inflammatory effect. When levels fluctuate, inflammation and tissue sensitivity can increase.

Women often notice:
• morning stiffness
• new aches
• pain after doing nothing unusual

This is not ageing.
It is hormone related.

9. Loss of Confidence or Feeling “Not Like Myself”

This is one of the most common signs and the least talked about.

Women describe:
• self doubt
• feeling disconnected from their body
• questioning their decisions
• a sense of losing themselves

This is partly hormonal and partly nervous system related, especially when progesterone decreases.

Understanding this creates enormous relief.

You Are Not Imagining It

How I Support Women Through This Transition

I am Anca Vereen, an Accredited Practising Dietitian and somatic psychotherapist with a special interest in women’s health, hormones and nervous system regulation.

I help women navigate:
• early perimenopause symptoms
• hormonal and metabolic changes
• weight changes and insulin resistance
• anxiety, overwhelm and emotional shifts
• gut and inflammatory issues
• low energy and burnout

My approach blends:
• evidence based nutrition
• somatic therapy
• nervous system regulation
• emotional processing
• lifestyle medicine

Together we create a personalised plan that supports your body, mind and energy so you can move through perimenopause with clarity and confidence.

Book an Appointment

If these symptoms feel familiar and you want support that is grounded, compassionate and tailored to your body, you can book a session here:

👉 Book a consultation with Anca

You do not need to navigate perimenopause alone.
Support is available.
Your body can feel clear, strong and centred again.