You’re 38, 42, maybe 46. Your periods are changing. You’re not sleeping the way you used to. You snap at your family over nothing and then feel terrible about it. You’re gaining weight around your belly even though nothing in your diet has changed.

You go to the doctor. They run some tests. Everything comes back “normal.”

So what is happening?

There’s a very good chance the answer is perimenopause — and there’s an equally good chance no one has told you about it.

What Perimenopause Actually Is

Perimenopause is the transition phase before menopause. It’s the years — sometimes 4 to 10 years — during which your ovaries gradually produce less oestrogen and progesterone.

Menopause itself is a single moment: 12 consecutive months without a period. Everything before that point is perimenopause.

This transition can begin as early as your mid-30s, though it most commonly starts between 40 and 44. By the time most women realise what’s happening, they’ve already been in perimenopause for years.

Why Indian Women Are Often the Last to Know

In India, perimenopause is almost entirely invisible. There is barely a word for it in most Indian languages. Women are expected to simply endure whatever they experience — the sleeplessness, the mood changes, the body shifts — in silence.

Doctors, including gynaecologists, frequently dismiss these symptoms. “It’s just stress.” “You’re too young for menopause.” “Try yoga.”

Meanwhile, a woman spends years blaming herself — for her anger, her forgetfulness, her weight gain, her low libido — never knowing that these are recognised, treatable hormonal symptoms.

What’s Happening in Your Body

As oestrogen levels decline and fluctuate, nearly every system in your body is affected:

Your brain — Oestrogen regulates serotonin, dopamine, and norepinephrine. When oestrogen drops, mood, memory, and sleep all suffer. This is why brain fog, anxiety, and low mood are so common.

Your metabolism — Lower oestrogen changes where your body stores fat, shifting it toward the abdomen. Insulin sensitivity also decreases, making weight management harder.

Your sleep — Progesterone has a natural sedative effect. As it declines, sleep becomes lighter and more fragmented. Night sweats further disrupt rest.

Your periods — Cycles may become shorter, longer, heavier, lighter, or erratic as ovulation becomes less predictable.

Your bones — Oestrogen protects bone density. During perimenopause, bone loss can accelerate significantly.

The Symptoms No One Prepares You For

The symptoms most associated with menopause — hot flashes — are actually just one of many. Many perimenopausal women experience symptoms that seem completely unrelated to their reproductive system:

  • Sudden anxiety or panic attacks (with no prior history)
  • Heart palpitations
  • Joint pain and stiffness
  • Skin changes — dryness, itching, adult acne
  • Hair thinning
  • Extreme fatigue that sleep doesn’t fix
  • Loss of confidence or sense of self
  • Changes in memory and word recall

If you’ve been experiencing any of these and have been told everything is fine — you are not imagining it.

When Should You Talk to Someone?

If your symptoms are affecting your sleep, your relationships, your work, or your sense of wellbeing — that is reason enough. You don’t need to wait until things become unbearable.

The women who fare best during this transition are those who seek information and support early — not those who push through alone.

At The Second Spring, you can ask anything about perimenopause — privately, without judgement, any time. Start a conversation →