There's a lot of noise around perimenopause, but don't jump to conclusions. Symptoms can be complex and may not always be hormonal.

Perimenopause starts around age 46 or 47 with irregular periods and hot flashes. There’s no straightforward test for it, as hormone levels fluctuate wildly during this time.

Hormone replacement therapy (HRT) might help some women manage symptoms like fatigue, but its effects on perimenopausal women are not the same as they are in menopause. Supplements also lack strong evidence to support their efficacy and can be misleading.

The key is to seek advice from a doctor who can rule out other causes of your symptoms. Perimenopause isn't the only reason for feeling unwell, especially with all else you might juggle in your 40s.