Pinkishe Foundation
31/10/2026
Dr. Shehla Jamal
If you are in your 40s, your body may have been doing new things lately. Your periods keep their own timetable. You wake at 3 in the morning for no reason. You snapped at someone at home over nothing and felt awful after. You lost a simple word mid-sentence. Your doctor says you are fine. Your mother says it is stress.
It may be perimenopause. Many of us have never heard the word, because we rarely talk about women's bodies after 40.
Menopause is when your periods have stopped for good. You know you have reached it when 12 months have passed without a period. Perimenopause is the time leading up to that. It often lasts several years.
In perimenopause, oestrogen does not fall smoothly. It goes up and down from month to month. These swings cause most of the symptoms. Perimenopause usually begins in your 40s. For some it starts earlier.
Often the first sign. Your cycle may get shorter or longer, or you may skip a month. Periods may be heavier than before, or lighter. Some changes are normal in this phase. Others need a doctor, so see the list at the end.
A wave of heat rises through your chest and face. You sweat in a cool room. At night you may wake with damp clothes. It is easy to blame the weather or the kitchen. Sometimes it is your hormones.
You fall asleep fine but wake at 2 or 3 in the morning, mind racing. Or you sleep but wake tired. Night sweats can add to this.
Anxiety out of nowhere. Irritability that feels too big. Tears at an advertisement. Oestrogen acts on the brain too, so when it swings, mood can follow. This is not a personality flaw.
You walk into a room and forget why. You lose common words. This is common in perimenopause and usually gets better. If memory problems are getting worse, or worry you or your family, see a doctor.
Aching joints. Weight settling around the middle. Less interest in sex. Vaginal dryness, which can make sex sore. These are common, and there are treatments for them.
There are a few reasons. Many of us keep going whatever our body is doing. At the clinic, basic tests often come back normal, and unless someone asks about perimenopause, it may not come up. And at home, we seldom talk about our bodies as we get older. Many of our mothers went through this with no one to explain it.
Write down your period dates, your sleep and your mood, in a notebook or on your phone. After a month or two you will see patterns. This also helps your doctor. You can use our period calculator for the dates.
Look for a doctor who listens to your symptoms, checks for other causes such as thyroid problems, and talks you through the options, including hormone therapy (HRT). There is no single blood test that confirms perimenopause, because hormone levels change from day to day. A doctor usually recognises it from your age, symptoms and periods. If you feel brushed off, ask your doctor to talk you through your symptoms, or ask for a second opinion.
Cut down on caffeine and alcohol. Walk briskly or do other exercise most days, including some that strengthens muscles. Eat enough protein and calcium. Keep regular sleep times.
You can still get pregnant in perimenopause, even if your periods are irregular. If you do not want to get pregnant, keep using contraception until your doctor says you no longer need it.
Tell a sister, a close friend or a colleague. There is a good chance one of them is going through the same thing.
Have a question about perimenopause or your periods? Call our menstrual helpline on 85888 70999. It answers at any hour.
A simple printable sheet that marks your period days, your fertile window and your ovulation day. We will email it to you now.
We will send the tracker and a few gentle menstrual health emails from Khyati at Pinkishe. No spam, unsubscribe any time.
Prefer to work out your dates now? Open the free ovulation calculatorUsually in your 40s, though for some it starts earlier. If your periods stop or symptoms begin before 45, see a doctor.
Perimenopause is the change. Menopause is when your periods have stopped for good, confirmed after 12 months without a period.
There is no single blood test that confirms it, because hormone levels change from day to day. A doctor usually recognises it from your age, symptoms and periods. Blood tests are used mainly to rule out other causes, such as thyroid problems, or if you are under 45.
Yes. Keep using contraception until your doctor tells you it is safe to stop.
Periods can get heavier, but very heavy bleeding, bleeding between periods or after sex, or any bleeding a year after your last period needs a doctor.
Perimenopause is a normal stage of life, but its signs are easy to miss. Keep a note of your periods and symptoms, see a doctor who listens, and know which bleeding needs a check. You do not have to go through it in silence.
Pinkishe Foundation is a specialist implementation organisation for menstrual health. We deliver, reliably, in schools and communities across India. Support our work with a donation.
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