Perimenopause in Your 40s: Symptoms Indian Women Often Miss

The Transition Before Menopause

Menopause is a single point — 12 months after your last period. Perimenopause is the transition leading up to it, often beginning in the 40s (sometimes late 30s) and lasting several years. During this time hormones fluctuate, and the symptoms can be confusing because they are easy to attribute to stress or ageing rather than a recognised phase.

Dr. Sanjana L helps women across HSR Layout and Attibele name what is happening and manage it well, as part of menopause management.

Symptoms That Are Often Missed

• Irregular periods — cycles becoming shorter, longer, heavier or lighter
• Hot flushes and night sweats — sometimes mild at first
• Sleep problems — difficulty falling or staying asleep
• Mood changes — irritability, anxiety or low mood
• Brain fog — trouble concentrating or remembering
• Vaginal dryness or discomfort
• Changes in libido
• Joint aches and fatigue

Because these creep in gradually, many women do not connect them to perimenopause and simply put up with them.

Why It Is Worth Addressing

Perimenopause is also a time when longer-term health matters more — bone health, heart health and emotional wellbeing all deserve attention. Recognising the phase lets you take supportive steps rather than struggling silently.

What Helps

• Lifestyle — regular exercise (including weight-bearing for bones), a calcium- and protein-rich diet, good sleep and stress management
• Symptom-specific care — for heavy or erratic bleeding, hot flushes, or vaginal dryness
• Hormone therapy — for suitable women, HRT can be very effective; the risks and benefits are discussed individually
• Bone and heart health checks — as advised for your age

Frequently Asked Questions

When does perimenopause start?

Often in the 40s, sometimes the late 30s, and it can last several years before periods stop completely at menopause.

Are irregular periods a sign of perimenopause?

They can be. In your 40s, cycles becoming shorter, longer, heavier or lighter is a common early sign, though other causes should also be checked.

Do I need treatment for perimenopause?

Not everyone does. Where symptoms affect your quality of life, lifestyle measures, symptom-specific care or hormone therapy can help significantly.

Is HRT safe?

For many suitable women, hormone therapy is safe and effective. The decision is individual, based on your health and symptoms, and is discussed with your doctor.

Consult Dr. Sanjana L

Dr. Sanjana L (MBBS, MS — OBG, Gold Medalist) helps women navigate perimenopause with clear information and personalised care. Learn more about Dr. Sanjana, see her HSR Layout and Attibele clinics, or book an appointment.