Many women begin experiencing changes in their 40s, and sometimes earlier, finding themselves wondering whether what they are feeling is hormonal or something else entirely.
Sleep may become lighter or broken. Mood may feel more fragile. Concentration may be harder than it used to be. Energy levels can drop. Aches and pains may appear without a clear reason. Periods may change, or they may still be regular.
Often, women are told this is simply stress, a busy life, or part of getting older. We want to reassure you: if you feel different and do not recognise yourself, it is worth exploring further.
What Is Perimenopause?
Perimenopause is the transitional phase before menopause, when the ovaries gradually begin to produce lower and more fluctuating levels of hormones, particularly oestrogen and progesterone.
These fluctuations, rather than a steady decline, are why symptoms can feel unpredictable. Some days you may feel fine. Other days, symptoms can feel overwhelming.
Perimenopause can last several years before menopause, which is defined as twelve consecutive months without a period.
Why Hormonal Changes Affect So Many Areas of the Body
Hormones influence far more than reproductive function. Oestrogen receptors are present throughout the body, including in the brain, joints, muscles, skin, heart and digestive system.
When hormone levels fluctuate, it can affect:
- Sleep quality
- Mood regulation and emotional resilience
- Temperature regulation
- Pain sensitivity
- Metabolism
- Cognitive function
This is why symptoms can feel widespread and disconnected, even though they may share a common underlying contributor. If you are experiencing unexplained back pain or joint discomfort alongside other symptoms, hormonal changes could be playing a role.
Signs Your Symptoms May Be Hormonal
Women commonly describe:
- Disrupted sleep or waking during the night
- Increased anxiety or low mood
- Reduced energy and motivation
- Brain fog and difficulty concentrating
- Hot flushes or night sweats
- Joint or muscle aches
- Headaches
- Changes in weight
- Changes in menstrual cycle pattern
- A general sense of not feeling like themselves
Some women experience physical symptoms first. Others notice emotional or cognitive changes first. There is no single typical presentation, and you do not need to experience all of these for hormones to be a possible contributor.
Quick Tip: Keep a simple symptom diary for two to four weeks, noting sleep quality, mood, energy levels and any physical symptoms. Patterns often become clearer over time and can help guide discussions with your GP.
Why So Many Women Feel Dismissed
Across many healthcare systems, menopause and perimenopause have historically received limited formal training. As a result, symptoms may be considered in isolation rather than as part of a hormonal transition.
Women may be offered sleeping tablets, antidepressants or pain relief without discussion of possible hormonal involvement. This can leave women feeling unheard, confused or doubting themselves.
You deserve to be listened to. You deserve explanations. You deserve options.
Conditions That Can Look Similar
Some medical conditions can cause symptoms that overlap with perimenopause, including:
- Thyroid disorders
- Anaemia
- Vitamin deficiencies
- Autoimmune conditions
- Chronic stress
This is why a proper medical discussion is important rather than assuming or self-diagnosing. A good assessment looks at the whole person, not just one symptom. Understanding which clinician is right for your concerns can help ensure you receive appropriate care.
Why Assessment Matters
A thoughtful assessment allows your GP to explore symptoms, medical history, medications, family history and lifestyle factors.
Blood tests may be helpful in some situations, but they are not required for everyone. Perimenopause is often diagnosed based on symptoms and clinical judgement rather than a single hormone level.
The goal is clarity, not labelling.
What You Can Do If You Are Struggling
Start by acknowledging that how you feel matters.
- Keep a simple symptom record, as noticing patterns over time often brings clarity
- Seek a GP who will take time to listen and discuss possibilities openly
- Avoid assuming you must simply tolerate symptoms
- Consider whether musculoskeletal symptoms might benefit from physiotherapy support alongside medical guidance
Small steps can lead to meaningful improvements.
Quick Tip: When booking a GP appointment, mention that you would like to discuss possible perimenopause symptoms. This helps ensure adequate time is allocated for a thorough conversation.
How Dr Melanie Lake Can Help
Dr Melanie Lake offers calm, unhurried consultations for women who are unsure whether hormones may be contributing to how they feel.
Her approach focuses on listening first, understanding your concerns, and explaining what may be happening in your body. Together, you can discuss appropriate, evidence-based options and decide what feels right for you.
Consultations are available online or in person at our clinic in Riviera del Sol.
You Do Not Need to Guess
If something feels different, it is reasonable to seek support.
Menopause is a natural stage of life, but struggling is not something you have to accept. With the right guidance, many women feel more informed, more in control and more like themselves again.
If you are also experiencing neck pain or shoulder tension alongside hormonal symptoms, our multidisciplinary team can provide comprehensive support.
You can book an appointment with the online doctor here: https://costahealthlasala.es/book
Frequently Asked Questions
At what age does perimenopause usually start?
For many women, perimenopause begins in the early to mid-40s, but it can start earlier or later. Some women notice changes in their late 30s, while others do not experience symptoms until their late 40s. Age alone does not determine when symptoms begin.
Can perimenopause start in your 30s?
Yes. While less common, some women do experience early perimenopause. If you are in your 30s and noticing persistent changes in sleep, mood, energy or cycle pattern, it is reasonable to explore whether hormones may be contributing.
Do I need blood tests to diagnose perimenopause?
Not always. Blood tests can sometimes be helpful, but perimenopause is primarily diagnosed based on symptoms and clinical history. Hormone levels fluctuate daily, so a single test does not always give a clear answer.
Can perimenopause cause anxiety or low mood?
Yes. Hormonal fluctuations can affect brain chemistry and emotional regulation. Many women report increased anxiety, low mood, irritability or feeling more emotionally sensitive than usual during this stage.
Can perimenopause affect sleep?
Yes. Difficulty falling asleep, waking during the night or waking too early are very common. Night sweats and temperature changes can also disrupt sleep.
Can weight change during perimenopause?
Yes. Hormonal changes can influence metabolism, appetite and where the body stores fat. Many women notice weight gain around the abdomen despite no major lifestyle changes.
Can joint or muscle aches be hormonal?
Yes. Oestrogen plays a role in joint and tissue health. Fluctuating or declining levels can contribute to increased aches, stiffness or discomfort.
Can I talk about HRT?
Yes. Hormone replacement therapy is one possible option and can be discussed alongside other approaches. The aim is to provide balanced, evidence-based information so you can make an informed decision.
Can I speak to a GP online about menopause or perimenopause?
Yes. Online consultations are suitable for many hormone-related concerns and can be a convenient way to access support.
Will I need ongoing support?
Some women benefit from follow-up appointments to review symptoms and adjust plans, while others may only need occasional guidance. This varies from person to person.