Perimenopause usually starts in the mid-40s, but it can begin in the late 30s, and a survey reported in November 2026 suggests that the women who reach it earliest are the most likely to be told they've got it wrong. Among women aged 40 and under, almost half said they had been told they were too young. If your sleep, mood or periods have shifted and nobody can tell you why, the findings, and what the doctors who commented on them suggest you do, are worth knowing.
Perimenopause is the run-up to menopause: the years when hormone levels rise and fall unpredictably before periods stop altogether. It rarely announces itself.
What the survey found
ThisIsMenopause, an online community for people going through perimenopause and menopause, surveyed 1,000 women aged 35 to 59 who were in perimenopause or menopause. The results were reported by Health.com.
72% said a doctor, friend or family member pushed back when they suggested their symptoms might be perimenopause. Many were told they were too young, or that what they were feeling was simply getting older. Across the whole group, 24% were told outright that they were too young for perimenopause; among those aged 40 and under, that rose to 47%.
The women themselves were often slow to make the link too. 82% first put their symptoms down to something else, about a third took at least six months to connect them to perimenopause, and some took more than two years.
That delay makes more sense once you look at which symptoms tend to come first. Hot flushes are the best-known sign, but many women don't have them early on. Poor sleep, anxiety, irritability, irregular periods, brain fog and aching joints are more common in the early stages, and every one of them is easy to blame on stress, burnout, low mood or age. Mindy Goldman, a gynaecologist and clinical professor emeritus at the University of California, San Francisco, told Health.com: "We do see it happening in the 30s."
Why it's so easy to miss
There is no lab test for perimenopause. Hormone levels swing so widely that a single blood test can't confirm it, so doctors recognise it from age, symptoms and medical history. A woman in her late 30s who still has regular periods may not have perimenopause on her doctor's list at all, and the doctors quoted in the piece point out that menopause gets limited space in medical training. In the US, fewer than a third of residency programmes for obstetricians and gynaecologists offer dedicated menopause training.
The survey has limits worth keeping in mind. It was run by a menopause community among its own audience, one of the doctors quoted sits on that community's medical advisory committee, and the full methods haven't been published. People who have joined a menopause community may also be more likely to have struggled to get answers. So the numbers are a signal rather than a national picture, and the experts in the piece are US doctors describing the US system. The pattern they describe, of vague symptoms being explained away one by one, will still sound familiar to plenty of women in the UK.
What actually helps
The advice from the doctors quoted is practical. Don't wait until a routine check-up comes round: book an appointment specifically to talk about your symptoms. Before you go, keep a detailed log for about a month, noting things like night sweats, days when anxiety was bad and any changes to your cycle.
A log works because it turns a vague sense that something is off into a pattern a clinician can work with. "I haven't felt right for a while" is easy to put down to stress. Waking at 4am three nights a week, anxiety that peaks in the days before your period, and a cycle that has shortened by several days are much harder to dismiss. It is worth adding how you slept, how your mood was and how your energy held up through the day, because signs that are easy to explain away one day at a time can look quite different once a month of them is written down.
If you still feel you aren't being listened to, it's reasonable to ask to see someone else, ideally a clinician who specialises in menopause or midlife women's health.
Being in your 30s makes perimenopause less likely, but it can still happen, and a month of honest notes can be what moves the conversation from "you're too young" to "let's look at this properly".
Read more: Nearly a quarter of women in perimenopause were told they were too young, survey finds, Health.com
If your periods have changed or your sleep or mood has been off for a while, see your doctor.
Wear a sensor, log your breakfast, and your coach will tell you by lunchtime whether it worked.
This article is general information, not medical advice. If you're worried about your blood sugar, talk to your GP.
