3 Stages Of Perimenopause- What Every Women Needs To Know
If you've ever wondered “Is this perimenopause?”—you're not alone.
One of the most common things I hear from women in their late 30s to late 40s is confusion. The mood swings, poor sleep, irregular periods, fatigue—it’s not “just getting older,” and it’s certainly not “all in your head.”
Recently, I was listening to the brilliant Dr. Carrie Jones on her Hello Hormones podcast, where she breaks down the three stages of perimenopause. Her insights align so closely with what I teach in my coaching sessions, I had to share it with you—along with my own guidance on how to support your body through each phase.
Stage 1: Early Perimenopause – Subtle but Significant
This stage often sneaks up on us. You might not realise it’s hormonal at first. Cycles can shift by 7 days or more—periods coming a little early or late, moods changing, sleep starting to feel more fragile.
What You Might Notice:
Poor sleep (waking up at 3am for no reason)
Feeling more anxious or emotionally sensitive
Brain fog, irritability, itchy skin, or even phantom smells
Increased sensitivity to alcohol and caffeine
What’s Happening Hormone-Wise:
Progesterone begins to decline (even if oestrogen is still in normal range)
Oestrogen starts fluctuating—but doesn’t fully drop yet
FSH (follicle stimulating hormone) might start creeping up
How to Support Yourself:
Prioritise restorative sleep and regular movement
Keep your blood sugar stable (goodbye sugar crashes!)
Start tracking your cycle and mood to identify patterns
Support your nervous system with calming routines—meditation, magnesium, breathwork
This is the perfect time to build the foundations that will serve you well through the rest of your perimenopause journey.
Stage 2: Mid Perimenopause – The Hormonal Rollercoaster
This is when things start to feel more intense. Periods may go missing for 60+ days, symptoms become more obvious, and those hormonal ups and downs feel like a rollercoaster you didn’t queue for.
What You Might Notice:
Hot flushes, night sweats, joint pain
Heightened anxiety or low mood
Vaginal dryness or changes in libido
Weight changes or bloating that feels unexplained
Fatigue that rest doesn’t fix
Behind the Scenes:
Oestrogen becomes very unpredictable—high one day, crashing the next
Progesterone stays low, FSH levels rise higher
You may skip ovulation some months
What Helps:
This is when you might want to explore testing and personalised support
Focus even more on blood sugar balance and gut health
Gentle, regular movement (think walking, yoga, strength—not punishment workouts)
Seek support: from your GP, a women’s health specialist, or a qualified coach (hi, I’m here!)
You're not “losing it.” Your body is simply doing what it's meant to—but without the right tools, it can feel overwhelming.
Stage 3: Late Perimenopause – The Final Countdown
If your period has been missing for 6–11 months, you may be entering the final stage before menopause. Hormones are at their most erratic or depleted, and this stage can be the most physically and emotionally intense.
Symptoms Can Include:
Worsened hot flushes or night sweats
Increased forgetfulness or mental fatigue
Deep emotional sensitivity or low motivation
Ongoing sleep disruption and lower resilience to stress
Hormone Profile:
Oestrogen and progesterone are both low
FSH remains high (often above 20 mIU/mL)
Your body is transitioning to a new hormonal baseline
What to Focus On:
If you haven’t already, this is the time for comprehensive hormone and health testing
Nutritional support is vital—calcium, vitamin D, magnesium, protein, healthy fats
Prioritise strength training and bone health
Consider HRT or other therapies if symptoms are impacting your quality of life
This stage is temporary, but it’s powerful. With the right approach, you can feel empowered—not defeated—by it.
Why Knowing Your Stage Matters
Understanding where you are on your perimenopause journey is incredibly validating. It helps you make better choices, seek appropriate support, and stop second-guessing yourself. Most importantly, it reminds you—you’re not alone, and you’re not broken.
Ready to Take the Guesswork Out?
If this blog spoke to you, I’d love to support you further. At Inga Connelly Health, I offer personalised 1:1 coaching to help you navigate perimenopause with clarity, confidence, and calm.
You’re not here to survive perimenopause—you’re here to thrive through it.
Let’s work together to make that your reality.
