When Does Perimenopause Really Start? Welcome to The Shift.

Lack of sleep, lower sex drive, mood swings and brain fog can begin long before your periods change or age 50. Is this perimenopause? Learn about this season we call The Shift.



"My doctor said I'm too young for menopause, come back when my period changes. But I know things are off."

"My PMS hasn't been this bad since high school."

"My body has an internal alarm clock set to 3 am." 

"I'm only 43. Menopause hits around 50. So what's happening to me?"

Sound familiar? 

It’s not you. It’s your hormones. Even if your period's "regular" and you're far from 50.

If you notice things changing around 40 (or 38 or 43) but your period isn’t one of them, there’s little guidance on what’s going on. Even though changes are surprisingly common. 

Ask for help and you may get put on an antidepressant or a diet. Or that other old standby for “female problems”: The Pill. 

What’s really happening? Your hormones are shifting. 

We’re more than periods & fertility.

Our culture quickly files women’s health under periods and pregnancy. Maybe breasts. 

This leaves out so much of what women are and what we deal with. It ignores the critical, wide-ranging roles hormones play in our body’s functioning and our states of mind. 

Truth: You may undergo a series of changing symptoms for years before your period ends or even really changes significantly. 

Is this perimenopause?

We deserve answers, options and insights into our own bodies. Here’s a start: 

Perimenopause is more than hot flashes and periods. 

When you study the menopause and perimenopause thinking out there (and we do), you’ll see stats about how many years perimenopause lasts, what the duration is, etc. Although 34 perimenopausal symptoms are now acknowledged, there’s only one that seems to count.

“Changes in your menstrual period are the first sign of perimenopause” is the widely accepted definition. It shows up in different forms over and over.

Why? It’s reductive, inaccurate and keeps women from balancing their hormones and living better lives through their 40s. 

Perimenopause is a full body experience. 

We know that perimenopause affects the entire body. The endocrine system—and most notably, progesterone and estrogen produced by it—is linked to so many processes in our bodies, from cognition to metabolism to inflammation and more. 

So when the hormone levels start declining, becoming erratic and changing from the ratios and  cycles we’re used to, of course things are going to change. We’re going to feel differently. 

And in far more ways than the wild periods or hot flashes that we call “menopause” in American culture.

Welcome to the Shift.

Because we live in arguably the most ageist country on earth, with ever-more blatant misogyny, it’s no surprise that women want to avoid thinking about menopause or identifying with perimenopause as long as possible. 

And since many OB/GYNs are not well trained in perimenopause, they often don’t identify early stages or clear signs, either. 

So we’re calling this early phase The Shift. The time when most things menstrual are going per usual, but many other things may start to change.

The Shift: Focus, mood, aches, appearance 

Wile’s own quiz has validated what we long suspected: Many women are plagued by issues of sleep, mood and more, way before their periods are changing in significant ways. . 

And let’s be real: the occasional spotting or slightly changing flow is easy to overlook and explain away. 

A group of researchers has also noted this gap between when women start experiencing changes and when the medical community generally recognizes perimenopause.

They dove into past data on women that are recognized medically as Late Reproductive Age (LRA). LRA includes the final stages of fertility, right before the onset of meaningful changes in their menstrual cycles or hot flashes, which define perimenopause as the medical industry has recognized it.  

The group also did their own survey of women between 35 and 55, with a granular look at what they were experiencing. It found many women whose periods were pretty unchanged experienced issues otherwise identified as perimenopausal symptoms. The results were published in the medical journal Menopause.

Here are some highlights validating The Shift. While even more symptoms were experienced, we’re highlighting only those that occurred for at least 30% of the women at least 1+ times per month or more.  

Here's what women in The Shift are feeling:

"I can't sleep, stressed or not. Wake up tired." 

common sleep issues in perimenopause

"My brain's all over the place. I'm forgetting things and it takes me forever to complete projects that used to be easy. Is this 40?! Help!" 

mood supplements for perimenopause

"My fuse is so short lately. It comes out of nowhere."

"I swear I feel my hair coming out when I wash it. Terrified."

"Sometimes I suddenly have to pee. Like, NOW."

body changes perimenopause

"It's not that I don't want to. I just don't want to tonight."

These are all perimenopausal symptoms. “Regular” period or not. 

Why Is This Happening? Progesterone Levels Start to Decrease by 30 

Progesterone levels begin declining in your late 20s, and decrease more rapidly after age 30.

By your late 30s, your regular production is already lower. Progesterone is the driver of sleep, calm and much more. Lower progesterone drives a drop in the number and quality of follicles in the body, and follicles produce estrogen. While your estrogen levels may spike, drop—or both—they’re in higher ratios than earlier in your 30s, and that drives more changes. 

Before your period hits big changes, its timing or length or flow may adjust a bit. Maybe there’s some spotting. PMS may be a bit more pronounced than it has been. But yet, none of it may be noticeable enough to really feel “perimenopausal” yet. That may be years away. 

Since it’s been little studied, your doctor really can’t tell you for sure. 

So welcome to the shift. Now what? 

Now is the time to take control of hormonal balance, stress and mood. 

1 - Earlier = better. 

The sooner you get ahead of symptoms, the more manageable they will be—and likely, the easier your entire perimenopausal journey will be. 

Wile Perimenopause Support can be taken at the very start of The Shift to help manage today and tomorrow, targeting the most common issues of the 40s and 50s.  

2 - Care for the focus, mood and stress components. They affect everything else. 

Know they can be both hormonal and situational. We created our Women's Stress as a mood supplement and more, helping focus and resilience, too. Add our arsenal of tinctures and drinks to address those issues in a healthy way in the here and now. 

3 - Recognize it's complex. 

We call cortisol “the other female hormone” because life and work stress are so high for women in this life phase. The reported changes in mood, sleep, headaches could be stress related, too.  

And worse: Ongoing stress can actually reduce progesterone production even more, exacerbating perimenopausal symptoms. These realities led us to incorporate adaptogens in every Wile product.

4 - Stay in tune. 

One reason we like natural medicine for perimenopause (The Shift included) is that it doesn't completely cover up or break your awareness of what’s going on in your body. With the Pill, your period is artificially changed. Other medications come with side effects that may increase weight gain and further kill libido. 

We believe in working with your hormones to feel better while still maintaining a connection to your body. 

Find what you really need. Our quiz can help you navigate and understand where you may be and what can help. 

Do you see yourself in The Shift? Or has a friend talked about some of these issues and been unsure what’s happening? Share with friends, with your doctor and continue to advocate for your own health and well-being at every age. As women, we need to! 


Coslov, Nina MBA1; Richardson, Marcie K. MD, FACOG2; Woods, Nancy Fugate PhD, RN, FAN3 Symptom experience during the late reproductive stage and the menopausal transition: observations from the Women Living Better survey, Menopause 28(9):p 1012-1025, September 2021. 

Woods NF, Mitchell ES, Coslov N, Richardson MK. Transitioning to the menopausal transition: a scoping review of research on the late reproductive stage in reproductive aging. Menopause. 2021 Jan 15;28(4):447-466. doi: 10.1097/GME.0000000000001707. PMID: 33470754.


Harvard Health Publishing, “Perimenopause: Rocky Road to Menopause”, August 9, 2022

Photo credit: Eric Ward, Unsplash


This article is intended for informational purposes and is not intended to replace a one-on-one medical consultation with a professional. Wile, Inc researches and shares information and advice from our own research and advisors. We encourage every woman to research, ask questions and speak to a trusted health care professional to make her own best decisions.
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