I remember the time we were first told about menstruation and using sanitary napkins in school. The instructors listed excuses women often told their children in daily life to hide their periods and avoid talking about them. At the time, it didn’t mean much to me, but as I grew older, I found myself slipping into the same habits, using those excuses without really knowing why I needed to hide my menstrual cycle at all.

Menstruation has a stigma to it, and this makes it challenging to acknowledge or express the pain that it’s associated with. And while menstruation is still somewhat discussed, perimenopause and menopause are hardly even mentioned.

Perimenopause marks the transition into menopause and brings changes to a woman’s menstrual cycle, hormonal balance, and overall bodily functions. These can include joint pain, weight gain, sleep disruptions, and hot flashes, to name a few. 

Perimenopause, already an under-discussed concept, becomes even more elusive in the Indian context, where bodily changes are often explained away with convenient reasoning or simply laughed off.

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Symptoms

Physical and Vasomotor

• Hot Flashes
• Vaginal dryness
• Irregular periods
• Joint pain
• Weight gain

Cognitive and Emotional

• Brain fog
• Mood swings
• Sleep Disruption

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Challenges in recognition and diagnosis

Even after recognising the symptoms that signal the onset of perimenopause, it remains highly challenging to clinically identify and diagnose this transitional phase in women. One of the primary reasons is the wide variability of symptoms from one woman to another. The intensity of these symptoms can differ significantly, influenced by factors such as diet, mental health, physical activity, and, importantly, age. While perimenopausal symptoms typically begin to appear between the ages of 40 and 45, a recent study conducted by Flo in February, 2025 revealed that women as young as 30–35 have also reported experiencing these symptoms, an age range not usually associated with perimenopause.

What makes diagnosis even more difficult is the subjective nature of many symptoms, such as sleep disturbances and brain fog, which can easily overlap with other conditions. Adding to the complexity is the lack of a single, standardised test for diagnosing perimenopause. Blood tests, often used to assess hormonal levels, are not always reliable, as hormone levels fluctuate frequently, sometimes even multiple times within a single day.

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Treatment approaches

Since perimenopause is not a disease but a natural phase in a woman’s life, there aren’t many medical procedures aimed at curing its symptoms. However, there are a few effective treatment options available that can help ease the effects of perimenopause, among which hormone therapy is considered the most effective.

Hormone Replacement Therapy

Hormone therapy involves artificially supplementing estrogen and progesterone in the body to help manage the effects of perimenopause, which are largely caused by declining estrogen levels. According to NHS UK, hormone therapy can help relieve symptoms such as disrupted sleep, hot flashes, mood swings, and vaginal dryness.

These hormones can be administered in various forms, including tablets, patches, gels, and sprays. Hormone Replacement Therapy (HRT) may also lower the risk of developing certain hormone-related conditions in the future. However, HRT is not without its risks, it has been associated with an increased likelihood of strokes, uterine cancer, and blood clots.

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Lifestyle changes

A majority of perimenopausal symptoms can be managed through a healthy lifestyle, alongside proper medical care. Regular exercise and consistent physical activity, combined with balanced dietary practices, can help regulate body weight, boost mood, and improve sleep, all of which contribute to easing the effects of perimenopause on the body.

Additionally, practising stress-reduction techniques such as yoga and meditation can help lower stress levels, stabilise mood swings, and promote overall relaxation, something especially important during the perimenopausal period. 

Related Story: 10 Ways To Ease Menopause Symptoms

Emerging policies, tech and support

Apps and tools

In recent times, several online platforms, especially mobile apps, have emerged to help women navigate perimenopause and menopause more easily. These apps often include menstrual trackers, educational content for a better understanding of the female body, expert advice, and community support for women going through similar experiences.

Elda Health and Mirror are two India-based apps specifically designed with the Indian context in mind. They focus on the holistic well-being of Indian women, offering tools and assessments tailored to their unique needs. Their culturally relevant advice, along with multilingual support, makes them especially accessible and relatable.

Mirror has also partnered with the National Health Mission in Karnataka to raise awareness about menopause and provide rural women with the support and resources needed to cope with menopausal symptoms and challenges.

Online communities and forums

Online communities and forums have recently emerged as safe spaces for women navigating perimenopause. This phase is not just a biological transition but also an emotional journey, where many women often find themselves feeling isolated and confused due to the lack of open conversation around the topic. Platforms like the Elda Health Community in India, MenoClarity Community in the UK, and several other online forums have stepped in to fill this gap, creating supportive, enriching environments where women can speak freely about their experiences, ask questions, share stories, and find comfort and solidarity in one another.

Perimenopause is a natural phase in a woman’s life, yet it is seldom recognised and often misunderstood. Marked by a shift in hormonal balance, it brings changes such as irregular menstrual cycles, disrupted sleep, vaginal dryness, mood swings, and hot flashes, among others. Despite the fact that nearly half of the world’s population experiences this transition, it remains a topic rarely discussed, leaving many women uninformed about this vital stage of their lives.

With the rise of technology, increasing numbers of women are becoming more aware of perimenopause, finding support through online communities, expert-backed apps, and educational tools. Yet a significant portion of the population, particularly in rural India and even within urban areas where menstruation remains taboo, continues to be excluded from this growing awareness.

The key lies in breaking the silence: in reaching out, asking questions, and seeking help. It means embracing this transitional phase by embracing your body, understanding it better, and treating it with the care, love, and respect it deserves.