How Do I Know I’m in Perimenopause? When Your Social Feed Hits a Little Too Close to Home
- Marie Powell
- Nov 9
- 4 min read
It’s 2 a.m. You’re scrolling again because sleep won’t stick. Suddenly your feed is full of hot flashes, brain fog, mood swings—and you think: Wait… is this me?
As a nurse practitioner who works with women and people with ovaries every day, I see this all the time. Social media is scarily good at spotting patterns. But an algorithm isn’t a diagnosis. Let’s turn the scroll into clarity—with simple, evidence-based steps to figure out what’s really going on.
What Perimenopause Actually Is
Perimenopause is the transition into menopause. Estrogen begins to fluctuate, cycles get irregular, and symptoms show up in waves. It can last a few months to several years (about 4 years on average, but can last up to 12 years!). Menopause = 12 months after your last period (one day on the calendar, identified after the fact).
Clinically, we use STRAW+10 stages:
Early perimenopause: your cycle varies by 7+ days from your usual.
Late perimenopause: you start skipping periods (gaps of 60+ days).
Most people enter perimenopause in their 40s (some earlier), with menopause around age ~51 (average age in Canada).
The Algorithm Wake-Up Call (helpful… and confusing)
Why did your feed change? You searched, watched, or lingered on content about sleep, weight, mood, or midlife health. Platforms connect the dots and serve more of it.
Good: it normalizes the conversation.
Risk: it can nudge you into self-diagnosing without context.
Bottom line: social media can raise your hand; a clinical assessment plus your symptom pattern gives the answer.
The 5-Minute Self-Check (save this)
1) Age + Period Pattern
35–55? Start here.
Have your cycles been 7+ days off your normal?
Any 60-day gaps between periods?
2) Common Symptoms (Are you experiencing any of these?)
Vasomotor: hot flashes, night sweats
Sleep: trouble falling or staying asleep
Cognition: “brain fog,” word-finding, distractibility
Mood: irritability, anxiety, low mood
Body: joint aches, headaches/migraines, breast tenderness, weight gain around the middle
Genitourinary: vaginal dryness, pain with sex, urinary urgency/frequency, lower libido
3) Timing
PMS shows right before your period and stops when bleeding starts.
Perimenopause symptoms can pop up any time, feel less predictable, and may hang around.
If you’re in the age range + you’ve noticed cycle changes + you have multiple ongoing symptoms, perimenopause is very likely.
“Should I get blood work?” (the honest answer)
FSH and other hormones bounce around during perimenopause. A single test can look “normal” on Tuesday and “high” on Friday. For most people over 45 with typical symptoms, blood tests aren’t needed to make the diagnosis. They can help if you’re under 45, have an unclear picture, or we need to rule out other causes. Clinical history + cycle changes usually tell the story best.
Green Flags vs. Red Flags
Green flags (common, treatable):
Hot flashes/night sweats, sleep issues, brain fog, mood shifts, vaginal dryness, weight gain.
Red flags (book care promptly):
Heavy or unusual bleeding, or bleeding after 12 months without a period
Severe mood symptoms or thoughts of self-harm
Night sweats with fever/weight loss, or rapid heartbeat at rest
Symptoms of thyroid or other medical conditions
What Actually Helps (evidence-based options)
Hot flashes / night sweats
Hormone therapy (HT) is the most effective for vasomotor symptoms when appropriate for your health profile.
If periods are ongoing, combined hormonal contraception or an IUD + estrogen can stabilize things.
Non-hormonal options: certain antidepressants, gabapentin, and practical lifestyle supports.
Genitourinary symptoms (GSM)
Vaginal estrogen (low-dose, local), lubricants, moisturizers; other prescription options if needed.
Mood / brain fog
HT (when started within the right window), therapy, targeted antidepressants when indicated, plus stress and sleep strategies.
Everyone benefits from
Movement (strength + aerobic), sleep hygiene, protein-forward nutrition, vitamin D and calcium as indicated, and real social support.
How to Prepare for a Helpful Appointment
Track for 30 days: Use a simple app or notebook: cycles, symptoms, sleep, triggers, and how it affects daily life.
Bring questions!
“Based on my age, cycle changes, and symptoms, does this look like perimenopause?”
“What treatments fit my health history?”
“Do I need any tests?”
“How will we follow up and adjust?”
Choose the right clinician - Look for menopause training and an evidence-based approach. (Tip: The Menopause Society has a directory of certified practitioners.)
If TikTok Is Nudging You… Trust your body first.
Yes, the algorithm might be onto something. Use it as a nudge to notice patterns, not to panic. Then get expert confirmation so you can feel better faster—and with a plan you trust.
Key takeaways
Perimenopause is a clinical diagnosis—age, cycle changes, and consistent symptoms matter more than one lab result.
Early signs often show up in your calendar (7+ day shifts) before your labs.
Symptoms are real, common, and treatable.
You’re not too young at 40, and you’re not “imagining it.”
Effective options exist—from hormone therapy to non-hormonal meds and lifestyle supports.
Tracking helps you and your provider make smart, tailored decisions.
Ready for clarity and a plan?
If you’re in NL, NS, ON or AB, book a menopause consult with our clinic to talk about your symptoms. You deserve science-backed options and time to ask every question.