The guide every woman 35+ needs right now.

You’ve been foggy, cranky, exhausted, and your cycle’s gone rogue. You catch yourself thinking: “Is this just stress (again)? Or am I entering perimenopause and nobody told me?” You’re not alone;  many women in midlife ask the same question. And the truth is: it’s messy. The symptoms overlap. But there are clues to help you tell them apart.

Let’s decode your body, once and for all.

What’s perimenopause anyway?

Perimenopause is the biological transition before menopause, when your ovaries gradually produce less oestrogen and your menstrual cycles begin shifting¹. While most people think of menopause as the “end,” perimenopause is the lead-up; often, the most symptomatic part.

The transition brings hormonal fluctuations that trigger symptoms like hot flushes, night sweats, mood swings, fatigue, cognitive fog, and more². These aren’t “just stress”;  they’re chemical shifts in your brain and body.

Stress: the silent amplifier.

Chronic stress mimics many perimenopausal symptoms: irritability, low energy, poor sleep, brain fog, and anxiety³. Add to that the fact that women in their 40s and 50s are often navigating careers, parenting, caregiving, and financial pressure, and you’ve got a perfect storm.

Stress doesn’t cause perimenopause, but it can magnify every symptom⁴. The hormone chaos of peri plus life stress = double trouble.

Biggest giveaway? Hot flushes + menstrual irregularities. Stress doesn’t usually touch those.

What the Aussie + NZ Research Says

1. Mood swings, anxiety, and depression increase sharply during perimenopause, even for women with no prior history⁵.
   

2. Hot flushes are the strongest diagnostic clue and don’t occur with stress alone⁶.
   

3. Brain fog and memory issues are real and often linked to hormonal fluctuation, not just ageing or burnout⁷.
   

4. Menopausal depression can present uniquely;  more irritability, paranoia, anger, and mental “flatness”⁸.
   

5. Women in early perimenopause report higher stress and psychological distress than postmenopausal women, even when age is factored out⁹.
   

6. Sleep disruption is common and often triggered by night sweats;  not just stress-induced insomnia¹⁰.
   

7. Burnout overlaps with perimenopause symptoms, but lacks vasomotor signs or menstrual disruption¹¹.
   

When You Should Suspect Perimenopause

• Periods are changing (shorter, longer, heavier, MIA)
  

• You’re having hot flushes or night sweats
  

• You feel mentally off, emotional, or angry for no clear reason
  

• Sleep is tanking, but your life stress hasn’t increased
  

• Libido or vaginal comfort has dropped off
  

If you tick 2–3 of the above, you’re likely not “just stressed.” It’s probably perimenopause showing up;  loud and hormonal.

What To Do About It

1. Track your symptoms

Start journaling: cycle, mood, sleep, energy, flushes. Patterns help identify hormonal clues vs. stress spikes.

2. Talk to a perimenopause-aware GP

Request a GP familiar with perimenopause diagnostics. Not all are. Ask directly or search the Australasian Menopause Society directory.

3. Consider testing.

Hormone levels can fluctuate wildly, so tests aren’t always clear-cut, but they may help if you’re under 45¹².

4. Lifestyle medicine

This works for both stress and perimenopause:

• Move your body (especially strength training)
  

• Improve sleep hygiene
  

• Eat hormone-supportive foods (leafy greens, phytoestrogens, protein)

• Ditch or dial back alcohol and caffeine
  

• Prioritise joy, support, and rest
  

5. Explore relief options.

Menopausal Hormone Therapy (MHT) helps many, but isn’t for everyone. Non-hormonal support, like natural blends, acupuncture, and CBT, can also reduce symptom severity¹³.

This is where Hey Sister! comes in. Our natural formulations are designed to work with your body, giving it a nudge of support while you handle the real stuff. Think of it as relief you can trust, no side-eye required.

A Little Real Talk

This isn’t just about hormones or stress;  it’s about feeling in control of your own body. It’s about being taken seriously when you say, “Something’s not right.” Whether you’re in perimenopause, deep in stress, or somewhere in the hormonal Bermuda Triangle, you're not imagining it. And you’re definitely not alone.

FAQs

Q: At what age does perimenopause usually start?
Typically between ages 40–45, but it can begin earlier (late 30s) or later, depending on genetics, lifestyle, and health factors¹.

Q: Can perimenopause happen without missed periods?
Yes. You might still bleed monthly, but if your cycle is shorter, longer, heavier, or fluctuates significantly, plus symptoms like hot flushes or mood swings, perimenopause is still likely².

Q: Is there a hormone test for perimenopause?
Yes, but it’s not always reliable. Hormones like FSH and oestradiol fluctuate daily. Tests are more useful for women under 45 with irregular cycles³.

Q: Can stress mimic perimenopause?
Absolutely. Stress can cause fatigue, anxiety, mood swings, sleep disruption, and brain fog;  all common in perimenopause too⁴. The difference? Stress doesn’t trigger hot flushes, night sweats, or menstrual changes.

Q: What’s the treatment for perimenopausal symptoms?
Treatment depends on symptom severity. Options include lifestyle shifts, natural remedies, non-hormonal therapies, and MHT (menopausal hormone therapy)⁵. Always chat with a trained GP.

Q: Is menopause depression different from clinical depression?
Yes. It often presents with mood swings, anger, irritability, or emotional numbness;  triggered by hormonal fluctuations, not just external stressors⁶.

References

1. Australasian Menopause Society. (2024). Perimenopause or Menopausal Transition – Information Sheet. https://www.menopause.org.au/hp/information-sheets/perimenopause
   The Guardian. (2025). Ignoring hot flushes is wrong: study challenges assumptions about perimenopause symptoms.
   https://www.theguardian.com/society/2025/jul/26/ignoring-hot-flushes-is-wrong-study-challenges-assumptions-about-perimenopause-symptoms

2. Stats NZ. (2024). New Zealanders' mental wellbeing declines. https://www.stats.govt.nz/news/new-zealanders-mental-wellbeing-declines/

3. Beyond Blue. (2024). Mental health and menopause. https://www.beyondblue.org.au/

4. Australasian Menopause Society. (2024). Menopause and mental health – Information Sheet. https://www.menopause.org.au/hp/information-sheets

5. Australasian Menopause Society. (2024). Non-hormonal treatments for menopausal symptoms – Information Sheet. https://www.menopause.org.au/hp/information-sheets

6. Australasian Menopause Society. (2024). Oestrogen and cognition in the perimenopause and menopause – Information Sheet. https://www.menopause.org.au/hp/information-sheets

7. Kulkarni, J. (2018). Perimenopausal depression – an under-recognised entity. Australian Prescriber, 41(6), 183-185. https://australianprescriber.tg.org.au/articles/perimenopausal-depression-an-under-recognised-entity.html

8. Mu, E., Kulkarni, J., Szoeke, C., & Mellor, D. (2024). Stress, depression, and anxiety: psychological complaints across menopausal stages. Frontiers in Psychiatry, 15, 1323743. https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1323743/full

9. Australasian Menopause Society. (2024). Menopause and sleep – Information Sheet. https://www.menopause.org.au/hp/information-sheets

10. Jean Hailes for Women's Health. (2024). Perimenopause fact sheet. https://www.jeanhailes.org.au/resources/perimenopause-fact-sheet

11. Australasian Menopause Society. (2024). Testing guidelines for women under 45. https://www.menopause.org.au/hp/information-sheets/perimenopause