What are the first signs of perimenopause starting?

The earliest signs are often subtle changes to your menstrual cycle: periods arriving earlier or later than usual, shifts in flow, or increased irregularity. Alongside this, many women notice sleep disruption, particularly waking in the night or difficulty staying asleep, as well as changes in mood, energy levels, or an unfamiliar kind of fatigue that doesn't resolve with rest. These symptoms can appear years before periods become noticeably irregular, and they're easy to attribute to stress or a busy life. If several of them are happening at once, a hormone panel can help clarify what's driving them.