What are the first signs of perimenopause?

On Eps. 279, 300 and 324, Dr. Jolene Brighten explains why progesterone is her focus. It's only made after ovulation, and in her view it's the first hormone to decline. Progesterone helps calm the brain and supports deep, unbroken sleep, so when it drops she says to watch the two to five days before your period. Signs include snapping at your partner over small things, night waking, or waking at 4 or 5 when you normally wake at 6. She adds that in early perimenopause there's still a lot that can be done, and that chronic stress is a big factor.

On Ep. 207, Hatty McCafferty notes that doctors usually ask about your cycle first, but cycle changes are rarely what women notice first. Sleep disruption often comes first, frequently waking between 1 and 3 a.m. Other early signs she lists: drier skin, unexpected breakouts, digestive changes with foods you used to tolerate, shifts in your circadian rhythm and fatigue. These changes are subtle and easy to blame on stress or travel, so she suggests tracking your cycle and symptoms, even in a free app.

If your body is changing while your habits haven't, that's information, not failure. Write down what you're noticing and take it to your doctor. Janet describes pushing for more in-depth blood work after being told everything was fine.