Could It Be Perimenopause? Why So Many Women Miss the Signs

Written By Tracey Kiernan

If you had asked me to describe perimenopause before I started specializing in this work, I probably would have listed hot flashes, irregular periods, and maybe some sleep issues.

Most women would.

And that's part of the problem.

Many women spend years searching for answers to symptoms that never seem to fit neatly into a diagnosis. They wonder if they're anxious, depressed, burned out, losing motivation, becoming forgetful, or somehow just not coping as well as they used to.

Meanwhile, perimenopause isn't even on the radar.

The reality is that perimenopause can begin years before menopause itself, often in your late 30s or 40s. Symptoms can show up long before periods become irregular, making it difficult to connect the dots.

Women often tell me:

"I thought I was just stressed."

"I thought I needed a vacation."

"I thought I was losing my mind."

The challenge is that many symptoms overlap with mental health concerns:

  • Anxiety

  • Irritability

  • Brain fog

  • Mood changes

  • Increased sensitivity to stress

  • Difficulty concentrating

  • Sleep disruption

  • Loss of motivation

When these changes happen gradually, it's easy to normalize them.

But normalizing suffering doesn't make it any easier to live with.

Understanding that perimenopause may be part of the picture doesn't mean every symptom is hormonal. It simply provides an important lens through which to understand what's happening.

Many women experience tremendous relief when they realize there is an explanation for what they've been feeling.

If you're questioning whether this might be happening to you, you may also relate to Why You Feel Like You're Losing Yourself in Perimenopause and Perimenopause Anxiety: Why It Feels So Intense.

Because sometimes the first step isn't finding a solution.

It's finally having the right explanation.

Tracey Kiernan

About the Author

Hi, I'm Tracey, a therapist (AMFT) specializing in working with high-achieving women and couples navigating anxiety, relationship challenges, and major life transitions, including perimenopause.

My clients are often used to holding it all together, yet feel internally overwhelmed, disconnected, or stuck in patterns that no longer serve them. I offer integrative, results-oriented therapy that goes beyond insight—focusing on meaningful, lasting change in how clients think, feel, and show up in their lives and relationships.

I also provide workshops and consultations on the emotional, relational, and identity shifts that come with perimenopause, supporting both individuals and couples, and the therapists who work with them, in understanding and navigating this often-overlooked transition.

If you want to talk about therapy that is both supportive and effective, or just want to talk about all things perimenopause, I invite you to connect.

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