Perimenopause
Perimenopause can begin as early as your early thirties, years before periods become noticeably irregular, and its overlap with age-related fertility decline makes it easy to misread one for the other. By your mid-thirties, this transition can already be having a bigger impact on fertility than most people realise, often while cycles still look broadly regular. Shifts in sleep, mood, PMS severity and cycle length can all show up early, and hormone testing, AMH, FSH and oestradiol, can help clarify where you are, though these fluctuate more through this transition than a single test can always capture.
As a fertility nutritionist working with a functional medicine approach, I support women through perimenopause with testing and a nutrition and lifestyle plan built around hormone regulation, blood sugar, sleep and stress, whether you're managing symptoms, still trying to conceive, or both. I've supported many couples in their late thirties and forties through this transition and on to a healthy pregnancy, and getting a clear picture of what's happening hormonally is often the first step.