We all know about the hot flashes and mood swings. But what if there’s more going on – things no one warned you about? Changes that don’t show up in blood tests but still leave you feeling off? You might just be experiencing one of the many things that happen in perimenopause. Here’s the truth: perimenopause isn’t a one-day switch. It’s a phase – one that often begins in your early 40s and can last anywhere from 4 to 10 years. And while the experience is unique for every woman, the symptoms can sneak up on you. So quietly, in fact, that you might think you’re just not coping well anymore. But this isn’t about personal failure. It’s biology.

Let’s talk about the things that happen in perimenopause that no one mentions, until you’re knee-deep in them – Googling symptoms at 3 a.m.

1. You Wake Up Tired – Even After a Full Night’s Sleep

One of the earliest things that happen in perimenopause is that sleep becomes weird. You might go to bed at 10, sleep eight hours, and still wake up feeling like you’ve run a marathon. That’s because your hormones, especially estrogen and progesterone, impact melatonin and sleep cycles. You may fall asleep just fine, but then wake around 2a.m. or 3a.m. – alert and restless.

Try this: Step outside within an hour of waking to get natural light. Eat protein by 9 a.m. and swap your afternoon coffee for tulsi or herbal chai. Small changes can support better sleep rhythms.

2. You Start Forgetting Words (and Worry You’re Losing It)

Brain fog is one of those scary things that happen in perimenopause. You forget why you walked into a room. You fumble for names or common words. It’s unsettling, but it’s not early-onset dementia. Estrogen plays a big role in memory and cognition, and when it fluctuates, so does your mental clarity.

Support your brain: Get more omega-3 fats like flaxseeds or walnuts, drink plenty of water, and prioritize brain-heavy tasks in the morning when you’re most focused.

3. You Feel Bloated – Even With a Healthy Diet

Feeling puffy or sluggish even when you’re eating clean? Blame progesterone. It helps relax your digestive tract, and when levels drop, digestion can slow down. Add fluctuating cortisol and you’ve got a recipe for bloat, even from foods you’ve always tolerated well.

Try this: Chew slowly, eat in a relaxed setting, and take a 10-minute walk after meals. Herbs like ajwain, fennel, or ginger water between meals can help reduce discomfort.

4. Your Cravings Return – Strong

If you thought cravings were a thing of your 20s, think again. One of the more frustrating things that happen in perimenopause is the resurgence of intense sugar or carb cravings. That’s because estrogen helps with insulin sensitivity. When it dips, blood sugar swings get worse, and cravings kick in.

Balance your meals: Always include protein and healthy fats with your carbs. Eat within 30-60 minutes of waking and aim for steady meals every 4-5 hours. Cinnamon, fenugreek, or diluted apple cider vinegar before meals may help with blood sugar control.

5. You Feel Anxious – Out of Nowhere

You used to be calm and grounded. Now, your heart races before a meeting or your chest tightens without warning. This isn’t “just stress.” Anxiety is one of those sneaky things that happen in perimenopause, caused by hormone shifts that lower your calming neurotransmitters (like GABA) and make you more sensitive to adrenaline and cortisol.

Soothe your system: Try 4-4-6 or 4-7-8 breath work before meals or at bedtime. Eat magnesium-rich foods like leafy greens and pumpkin seeds. And spend time outdoors when possible.

6. Your Period Becomes a Total Mystery

Some months, your period barely shows up. Others, it’s heavy enough to cancel plans. You might skip a month, or have two in one. Irregular ovulation causes this hormonal chaos, throwing off both estrogen and progesterone timing. It’s one of the more obvious but often misunderstood things that happen in perimenopause.

Get curious: Track your cycle with an app or journal. Patterns will help you plan and manage symptoms better. Herbal teas like shatavari or chamomile, along with seed cycling, may gently support regulation.

7. You’re Drained by Social Interaction

Small talk feels harder. WhatsApp groups are suddenly overwhelming. Noise, bright lights, even casual social time feels like a chore. That’s not you becoming a hermit. It’s nervous system fatigue – a lesser-known thing that happens in perimenopause when estrogen dips and your resilience to sensory input lowers.

Build in quiet time: After social activities, take 10 minutes to lie down, journal, or just sit quietly. Dim the lights in the evening and use noise-cancelling tools when needed.

8. You Care Less About Pleasing Everyone

Here’s one shift that feels surprisingly liberating. As hormones change, many women report that they stop obsessing about being liked, and start caring more about what actually feels good. You may question relationships, work boundaries, or long-held habits.

Honour it: This isn’t moodiness – it’s clarity. Journal, go for solo walks, talk to a therapist if you feel called. This shift deserves space and respect.

9. Your Body Doesn’t Bounce Back the Way It Used To

In your 30s, a few days of clean eating could undo a month of stress. In perimenopause? Not so much. One of the real things that happen in perimenopause is slower recovery – whether it’s from sugar, stress, or skipped workouts. Your body now needs consistency over intensity.

Go steady: Focus on sustainable habits – blood sugar-balancing meals, strength training 2–3 times a week, early dinners, and quality sleep. This isn’t about perfection, it’s about rhythm.

10. You React to Things You Used to Tolerate

Perfumes, spicy foods, certain sunscreens, suddenly they make you itchy, headachy, or just uncomfortable. It’s not in your head. Perimenopause impacts your histamine response and gut integrity, making you more reactive to everyday things.

Give your body a break: Simplify your skincare, reduce processed foods, and minimize exposure to known irritants. Your body is asking for a cleaner, calmer environment – inside and out.

It’s Not the End – It’s a Reset

Perimenopause can feel like an unraveling – of your body, your emotions, your energy. But it can also be a rebirth. A call to slow down, listen, and respond to your body’s new rhythm. The things that happen in perimenopause aren’t failures. They’re signals. Your body is evolving, and it’s asking you to evolve with it. So start where you are. Notice what’s changing. Support yourself with rhythm, nourishment, and rest.

You’re not overreacting. You’re not alone. And you’re not done. This is your next chapter – and you get to write it with more wisdom, clarity, and care than ever before.