Question 1

What is perimenopause?

Accepted Answer

Perimenopause is the 5–10 year transition phase before menopause during which hormones become increasingly irregular. It can begin in your mid-30s and causes symptoms like hair loss, weight changes, sleep disruption, and mood shifts.

Question 2

When does perimenopause start?

Accepted Answer

Perimenopause typically begins in your early-to-mid 40s, but can start as early as your mid-30s. There is no single test to confirm it — it is diagnosed based on patterns of symptoms and hormonal changes over time.

Question 3

Can perimenopause cause hair loss?

Accepted Answer

Yes. Declining estrogen shortens the hair growth phase (Ohnemus et al. 2006), while changes in SHBG and thyroid function compound the effect. Hair loss in perimenopause is usually reversible once the underlying pattern is identified.

Question 4

Why are my labs normal but I feel terrible?

Accepted Answer

Standard lab ranges are population-based — they compare you to a statistical average, not to your own baseline. A value that's "normal" for the general population may represent a significant decline from your personal optimal level.

Question 5

How is perimenopause different from menopause?

Accepted Answer

Menopause is the point when your period has stopped for 12 consecutive months. Perimenopause is the transitional phase before that — the years during which hormonal changes are already causing symptoms, even when periods are still present.