If you’ve been having hot flashes, brain fog, or cycle changes—and your doctor has shrugged it off because “you’re too young for menopause”—you’re not imagining things. You might be in perimenopause, the phase leading up to menopause that can start years before your periods stop for good.
Yes, even in your 30s. Definitely in your 40s.
What Is Perimenopause, Really?
Perimenopause is the hormonal transition before menopause. It’s when estrogen and progesterone start fluctuating—sometimes wildly—and your body begins adjusting to the eventual end of ovulation.
While menopause is marked by 12 consecutive months without a period, perimenopause can last 4 to 10 years, or more (yep, years). And it’s often the most symptomatic phase of the whole hormonal transition.
Common Symptoms in Your 30s and 40s
Symptoms during early perimenopause are often subtle—or easily dismissed as stress, parenting, or “just getting older.” But the hormonal shifts are real, and they can cause:
- Irregular periods (heavier, lighter, longer, shorter)
- Hot flashes and night sweats
- Brain fog or trouble concentrating
- Mood swings, anxiety, or irritability
- Sleep disturbances
- Fatigue
- Vaginal dryness or pain with sex
- Decreased libido
- Weight gain or changes in body composition
If you’re nodding along to several of these, it’s worth having a conversation with a menopause-trained provider.
Why You’re Being Told “You’re Too Young”
Sadly, many clinicians are not trained in recognizing perimenopause—especially in women under 45. Hormone levels can still fall within “normal” ranges, even while fluctuating enough to cause major symptoms. And standard lab tests often miss the bigger picture.
It’s frustrating, invalidating, and leaves far too many women suffering silently—or being prescribed antidepressants or birth control without a full understanding of what’s happening hormonally.
What You Can Do About It
If you suspect you’re in perimenopause, trust your gut. You know your body. Start tracking your symptoms, your cycle (or lack of one), and anything that feels “off.” Bring this to a doctor who actually specializes in menopause care.
Treatment can include:
- Hormone therapy tailored to perimenopausal needs (yes, it’s safe!)
- Non-hormonal options for mood, sleep, and hot flashes
- Lifestyle support for nutrition, stress, and movement
- Validation (sometimes, that alone is powerful)
The Bottom Line
You are not too young for perimenopause. And you’re definitely not too young to feel heard, supported, and treated with expertise. If your body is changing and you’re feeling off, don’t let outdated assumptions keep you from getting the care you deserve.
This isn’t in your head. It’s in your hormones—and help is out there.
👉 Hot flashes in your 30s? Yep, that’s a thing. If your doctor says you’re “too young,” it might be time to talk to someone who actually gets it.
Need support or want to learn more about treatment options? Schedule a free 15-minute call to see how we can work together.
Dr. Aoife O’Sullivan is a family physician, board certified by the American Board of Family Physicians and a menopause specialist, certified by the North American Menopause Society, dedicated to empowering women through their midlife health journeys. She is the founder of Portland Menopause Doc, co-founder of the Portland Menopause Collective, podcaster on The Dusty Muffins, and an expert speaker, frequent podcast guest and active contributor to midlife women’s health research.
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