What early, non-obvious signs can indicate perimenopause even before periods become irregular?

Many women are surprised to learn that perimenopause can start with subtle, non-obvious symptoms even before periods become irregular. Here at Alloy, we see that some of the earliest signs can include:

Sleep disturbances, such as waking up at 4 a.m. and being unable to fall back asleep, even if you’re not experiencing hot flashes yet.
New or increased anxiety, or feeling more “on edge” than usual.
Mood changes, including feeling blue or more irritable, even without classic mood swings.
Itchy skin, dry eyes, or even itchy ears—these are less recognized but common early symptoms.
Hair thinning or increased hair shedding.
Brain fog, memory lapses, or trouble concentrating.

These symptoms are often dismissed or attributed to other causes, especially if your menstrual cycles are still regular. Hormone levels can fluctuate wildly during perimenopause, so blood tests are not always reliable for diagnosis at this stage.

For a deeper dive into these early signs, check out the “First Signs of Perimenopause” chapter in our YouTube video: Are YOU in perimenopause? It’s not always easy to tell!, where real experiences with early symptoms like anxiety and sleep issues are discussed.

If you’re experiencing these symptoms and want to explore relief options, Alloy offers a range of solutions, including low-dose birth control pills for cycle regulation and symptom relief, as well as estradiol vaginal cream for vaginal dryness and related issues.

You can also take our personalized assessment to connect with a menopause-trained doctor and find the best treatment plan for your unique symptoms. At Alloy, we’re here to help you feel like yourself again, even in the earliest stages of perimenopause.

This answer was created using the following resources: