1. Constant Fatigue and Low Energy
The most commonly reported symptom, according to Donsky, is overwhelming exhaustion. Many women describe feeling drained no matter how much they sleep. Hormonal fluctuations—particularly declining progesterone—can disrupt sleep quality and leave you feeling depleted throughout the day.
2. Anxiety and Stress Levels That Feel Out of Control
If your stress tolerance suddenly feels nonexistent, hormones may be to blame. Estrogen plays a role in regulating mood and serotonin, and as levels fluctuate, anxiety can spike seemingly out of nowhere.
3. Zero Patience
Short tempers, irritability, and feeling easily overwhelmed are common during perimenopause. Women often report snapping at loved ones or feeling frustrated by things that never used to bother them.
4. Headaches or Migraines
New headaches—or migraines that are becoming more intense or frequent—can be another red flag. Hormonal shifts, especially estrogen dips, are known migraine triggers.
5. Feeling More Emotional or Weepy Than Usual
Unexpected crying spells or heightened emotional sensitivity are frequently reported. Many women say they don’t recognize their emotional reactions, which can feel unsettling without understanding the hormonal connection.
6. Changes in Sleep Patterns
Trouble falling asleep, staying asleep, or waking up too early is one of the most overlooked signs of perimenopause. Even without night sweats, hormonal changes can interfere with deep, restorative sleep.
7. Brain Fog and Difficulty Concentrating
Many women notice memory lapses, trouble focusing, or feeling mentally “foggy.” Estrogen supports cognitive function, and fluctuating levels can temporarily affect clarity and recall.
Donsky emphasizes that perimenopause looks different for everyone—and that women are often dismissed or told their symptoms are “just stress.” Her research aims to change that narrative.
“You’re not crazy and you’re not alone,” she stresses, noting that education and awareness are key to feeling empowered during this stage of life.
If you’re experiencing several of these symptoms, experts recommend tracking changes, advocating for yourself at medical appointments, and seeking providers knowledgeable about hormonal health. Lifestyle changes, nutrition support, and stress management can also make a meaningful difference.
Perimenopause isn’t something to “power through” in silence. Understanding the signs is the first step toward getting the support your body needs.