Dr Punam Krishan reveals the perimenopause symptom she sees 'every day' but often goes undiagnosed

Instead, Dr Punam Krishan says that many of her patients mistake perimenopause for exhaustion, stress, or anger, leaving them to feel like they're failing, or even "going crazy".

Speaking in a video on Instagram, the GP and Strictly Come Dancing Star says perimenopause is a famously difficult time for women, not just because of the symptoms themselves, but also not knowing what perimenopause feels like. It can look different for everyone.

“You might still have regular periods. It can feel like anxiety, low mood or even pure rage, totally out of the blue. Sleep might fall apart, you’re wide awake at 3 am, your brain’s all foggy. You’re wired but exhausted, your joints are achy, your fatigue feels deep-boned. And the sad thing is that it gets dismissed as stress, burnout or even depression.

“So many women get disregarded, and that makes me both sad and just really mad, as I know it doesn’t have to be this way,” she says.

The doctor, who also regularly appears on the BBC’s Morning Live programme, wants to raise awareness of how early some perimenopause symptoms can begin and to encourage women to seek advice and support.

“You’re not making it up, you’re not going crazy,” she says. “Perimenopause doesn’t just mean hot flushes or missed periods. It can sneak up years before menopause actually begins, and the worst bit is that hardly anybody warns you.”

For most, perimenopause begins in your late 30s or early 40s, with the average age for menopause (when periods have stopped for a year) in the UK being 51, according to the British Menopause Society.

We go through a "massive internal shake up" in these years, but the "body isn't broken", the doctor says.

"Hormones are shifting, and that affects everything: your energy, memory, your relationships and confidence. So, if this is you, you're not going crazy, you're not failing, you're not just tired and stressed. Perimenopause is real and powerful. It's a transition to a new phase. It's a whole new sense of identity."

Hormonal Replacement Therapy (HRT) and similar options won't be suitable for everyone, but there are many HRT alternatives available and various other ways to optimise our menopause transition.

"You deserve to feel like yourself again," the doctor says.

Why don't we recognise the symptoms of perimenopause?

Earlier this year, the women’s health app Flo found that there can be a five to 10-year gap between psychological and physical symptoms of perimenopause, where we might be expecting to see them all at once.

Data from over 4,400 women aged 30 and above in the US showed that the symptoms associated with mental health or mood, such as anxiety, irritability, and depression, were highest in women aged 41 to 45 and lowest in those aged 56 and older.

The study, which was published in the npj Women’s Health Journal, found that physical symptoms of perimenopause, such as hot flushes, sleep issues, excessive sweating, vaginal dryness, and low libido were more common in the those 51 to 55.

Everyone will experience menopause differently, and some will find it has a bigger impact on quality of life, relationships, and mental health than others will, so speak to your doctor if you're concerned.

What can help perimenopause symptoms?

• Exercise: Regular exercise can help relieve stress and improve sleep.
• Stop smoking: Smoking has been shown to increase the risk of early menopause and trigger hot flashes. It's also linked to an increased risk of heart disease and some types of cancer, which also naturally increase with age.
• Cut down on alcohol: Alcohol has also been linked to more severe menopause symptoms, like hot flashes and sleep disturbances.
• Find a relaxation technique that works for you: You can't meditate your way through perimenopause, but some relaxation techniques like yoga can help ease short-term anxiety and stress.