You may blame work for tiredness, stress for bad sleep, an overbooked calendar for mood swings and 'just hormones' for irregular periods at 35. But sometimes these changes can be signs of something else.
The 40s are typically when perimenopause is thought to occur. Hormonal changes, though, can begin earlier, and younger women may miss menopause-related symptoms simply because they are considered “too young” for them.
The first clue is often menstruation. Your period may be shorter or longer, heavier or lighter, or you may not get a period at all. Other symptoms may include hot flushes, night sweats, disturbed sleep, anxiety, low mood, brain fog, headaches, joint aches and changes in sexual health. Changes in periods tend to be one of the first symptoms of perimenopause, says the NHS.
But symptoms don't necessarily mean a woman in her 30s is going into perimenopause. Symptoms can be produced by thyroid disorders, anaemia, polycystic ovary syndrome, stress, nutritional deficiencies and other hormonal conditions.
One condition that deserves special attention is primary ovarian insufficiency (POI), also called premature ovarian insufficiency, a decline in ovarian function that occurs before age 40.
According to the American College of Obstetricians and Gynaecologists (ACOG), POI occurs in approximately 1 per cent of women and may be characterised by irregular or absent periods, infertility and symptoms associated with low oestrogen. This is important because early loss of ovarian function is more than just periods or fertility. Persistent low oestrogen may impact the health of bones and the cardiovascular system. ACOG says women with POI are at higher risk for bone loss and fractures, among other longer-term health consequences.
There is also increasing evidence that symptoms of the menopausal transition can be more severe than previously assumed. A 2025 study of 5,509 women aged 40 to 69 and published in The Lancet Diabetes & Endocrinology found that 37.3 per cent of women in late perimenopause had moderate to severe hot flushes or night sweats.
The message for women in their 30s is not to panic at every missed period or sleepless night. It is important to look for patterns. If periods have changed consistently, or symptoms are interfering with daily life, or if there are concerns about fertility, it is worthwhile having a consultation with a gynaecologist. Depending on your age and symptoms, the doctor may look for other causes and consider whether you have early ovarian dysfunction.
Perimenopause is not a diagnosis you can self-diagnose using a social media checklist. But age should not be a reason to dismiss ongoing symptoms. Sometimes the first step in understanding why is to hear what the body is saying and how it is changing.
(The author is a consultant gynaecologist, infertility specialist, vaginal & laparoscopic surgeon at HOSMAT Hospitals, Bengaluru)
The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.
