You’re in your early or mid 40s. Your periods are still coming — maybe a little differently than before. But something has shifted. Sleep is worse. Your mood feels less steady. You’re gaining weight around the middle despite nothing changing. Brain fog has become a regular companion. You feel, in some hard-to-describe way, like you’re not quite yourself.
If this sounds familiar, research suggests you may be in the early stages of perimenopause — and you are very likely not being told that.
As a CNM Qualified Naturopathic Health Coach in Dubai, KHDA approved and trained at the College of Naturopathic Medicine, I want to share what studies have found about this life stage — because the gap between what research shows and what most women are told is significant.
What Research Says About When Perimenopause Begins
The word “menopause” tends to make women think of their 50s. But research has consistently found that the transition leading up to menopause — called perimenopause — begins much earlier than most women expect.
A study published in the journal Menopause found that hormonal changes associated with perimenopause begin, on average, in the early-to-mid 40s — and for some women, in their late 30s. Research has shown that this early phase is characterised not by hot flushes (those tend to come later) but by more subtle shifts: changes in sleep quality, mood fluctuations, changes to the menstrual cycle, increased anxiety, and weight gain — particularly around the middle.
The Stages of Reproductive Aging Workshop (STRAW), a major international research collaboration, developed criteria for the stages of hormonal transition in women. Their research identified that the transition can span 7 to 14 years — meaning that by the time a woman reaches actual menopause, she may have been in transition for over a decade.
The Symptoms Research Links to Early Perimenopause
Research has identified a wide range of symptoms associated with the hormonal shifts of perimenopause — many of which women commonly attribute to stress, ageing, or lifestyle:
Sleep disruption. Studies have found that changes in the hormone progesterone — which supports sleep — are among the earliest hormonal shifts of perimenopause. Research published in the journal Sleep found that women in perimenopause reported significantly worse sleep quality than pre-menopausal women, including more difficulty falling and staying asleep.
Mood changes. Research has found increased rates of anxiety and low mood during perimenopause, linked to fluctuating hormone levels and their effects on mood-regulating brain chemistry. A study published in Archives of General Psychiatry found that women were two to four times more likely to experience a depressive episode during perimenopause than at earlier stages of reproductive life.
Brain fog. Studies from the University of Rochester found that women in perimenopause showed measurable differences in verbal memory and processing speed during the transition — and importantly, research found that these changes were temporary for most women, resolving after the transition.
Irregular periods. Research identifies changes to the menstrual cycle as one of the most consistent early signs of perimenopause — cycles becoming shorter, longer, heavier, lighter, or simply less predictable than they have been before.
Weight changes. Research has found that hormonal shifts in perimenopause are associated with increased fat storage around the abdomen, even without dietary changes.
Why This Stage Is So Often Unrecognised
Research suggests perimenopause goes unrecognised in many women — regardless of where they live — for a few consistent reasons:
Symptoms are attributed to other things. Research shows the fatigue, mood shifts, and sleep disruption of early perimenopause closely resemble general life demands. Studies suggest many women spend years managing these symptoms without realising a hormonal transition is contributing — because periods are still regular and nothing obviously fits the “menopause” picture yet.
Healthcare doesn’t always look for it. Research on perimenopause recognition in primary care settings has consistently found it is under-investigated — particularly in the early stages. Studies suggest that without specific testing for hormone levels, the early transition is frequently missed.
Cultural factors. For many women from South Asian, Middle Eastern, and other backgrounds, menopause is not discussed openly. Research on awareness of perimenopause in these communities has found significant knowledge gaps — meaning women are navigating these changes without context or language for what is happening.
What Research Suggests Supports the Transition
There is no approach that stops perimenopause — research is clear that it is a natural life stage, not a condition. But studies have identified several factors that meaningfully affect how it is experienced:
Strength training. Research has found that women who maintain regular resistance training during perimenopause show less abdominal weight gain, better bone health, and improved mood compared to those who do not. Studies suggest it is one of the highest-impact lifestyle choices for this life stage.
Stress reduction. Research has found that women with higher stress levels during perimenopause report more severe symptoms — suggesting the combination of hormonal change and sustained lifestyle pressure compounds the experience. Studies consistently show that building genuine rest into your week measurably affects symptom severity.
Sleep prioritisation. Given what research shows about progesterone and sleep, protecting sleep quality is particularly important at this stage. Studies suggest a consistent bedtime, a cool dark room, and reducing screens before bed all support sleep during this transition.
A whole-food diet with adequate protein. Research links higher protein intake and lower ultra-processed food consumption with better symptom management during perimenopause — supporting muscle maintenance, blood sugar stability, and mood.
For more on hormonal health support, visit the Hormonal Health page.
One thing you can do today:
Write down three symptoms you’ve been putting down to stress or age over the past year. Research suggests that tracking symptoms — even briefly — helps both you and any practitioner you work with to see patterns that point to what’s actually happening.
If you’d like support with this:
I work with women in Dubai and across the GCC as a CNM Qualified Naturopathic Health Coach. If you’re in your 40s and something feels off — but you’re not sure what — understanding where you are in your hormonal transition can be genuinely clarifying. Learn more about working with me →
This article is for educational purposes only and does not constitute medical advice. If you have concerns about your hormonal health, please speak with your GP or a qualified medical professional.
To explore more about women’s hormonal health and what a naturopathic approach looks like in practice, visit the Women’s Hormonal Health resource page.
