5 Perimenopause Myths To Stop Believing Right Now (From An OB/GYN) 

Perimenopause is one of the least understood yet most impactful transitions in a woman’s life. Many women begin experiencing symptoms in their late 30s or early 40s, but because they still have regular periods, their concerns are often dismissed—even by healthcare providers. 

Reality: Hormonal changes can start years before your cycles shift.

One of the biggest misconceptions is that perimenopause1 only begins when menstrual cycles become unpredictable. In truth, estrogen and progesterone fluctuations can start as early as the late 30s, even while cycles remain regular.

Symptoms such as mood swings, increased anxiety, fatigue, and brain fog may appear first, but because periods are unchanged, women—and even their doctors—fail to connect these symptoms to perimenopause. 

Reality: Many women never experience hot flashes at all.

While hot flashes2 and night sweats are well-known menopause symptoms, they are not always the first indicators of perimenopause. In fact, many women never develop them.

Some of the earliest signs of perimenopause include:

✔ Mood swings and increased irritability

✔ Unexplained fatigue and joint pain

✔ Insomnia and restless sleep

✔ Changes in libido and vaginal dryness

Reality: It can last anywhere from 4 to 10 years.

Many women are surprised to learn that perimenopause is not a short phase—it can last a decade or more. Hormone levels fluctuate unpredictably, which is why symptoms may come and go, vary in intensity, or change over time.

Reality: Hormonal fluctuations directly impact brain function, mood, and energy.

Women experiencing sudden anxiety, depression, or brain fog are often told it’s just stress. But hormonal changes directly affect brain chemistry, influencing serotonin and dopamine—the body’s “feel-good” neurotransmitters.

This is why perimenopausal women frequently report:

✔ Increased anxiety or panic attacks

✔ Mood swings or depression

✔ Difficulty concentrating or memory lapses (“brain fog”)

Reality: Proactive management can dramatically improve quality of life.

Many women believe perimenopause is something they must endure, but that’s far from the truth. Effective strategies can minimize symptoms and improve well-being during this transition:

✔ Track your symptoms – Keeping a journal can help identify patterns and advocate for care.

✔ Nutrition & exercise – A diet rich in healthy fats, protein, and phytoestrogens can support hormone balance, while strength training helps maintain muscle mass and metabolism.

✔ Stress management – Chronic stress worsens hormonal imbalances, making practices like meditation, deep breathing, and therapy valuable.

✔ Hormone therapy & supplements – Bioidentical hormone therapy (HRT), adaptogens, and targeted supplements can alleviate symptoms and support long-term health.

Perimenopause is not a disease—it’s a natural life transition. However, the lack of education around it leaves many women feeling dismissed and unsupported.

By debunking these myths and educating women on what to expect, we can empower them to take control of their health, seek the right care, and optimize their well-being during this critical stage of life.

If you suspect you’re experiencing perimenopausal changes, don’t wait for irregular periods—advocate for yourself, get informed, and seek guidance from a specialist who understands this transition.