Perimenopause 101: Signs, Symptoms, and Why Black and Brown Women Are Often Overlooked

TL;DR: Too Long; Didn’t Read – 
Perimenopause can begin as early as your late 30s, and for many Black and Latine women, it often starts sooner and brings more intense symptoms. From anxiety and brain fog to joint pain and low libido, this phase of hormonal change is often misunderstood or ignored by healthcare providers. In this blog post, you’ll learn what perimenopause really is, how to recognize the early signs, and what support options are available. To help you navigate this transition with clarity and confidence, I’ve created a free companion guide for the journey from perimenopause to menopause. You are not broken. You are not alone. This is a powerful shift, and support is available.

In 2020, I turned 44. I was excited. My birthday is on 4/4, and something about turning 44 on 4/4 in a year that added up to 4 felt meaningful. I thought it was going to be a powerful year, and it was, just not in the way I imagined.

That was the year the world shut down. I celebrated my birthday at home during the pandemic, not realizing I was also stepping into a whole new chapter of my life. One I wasn’t prepared for. One I didn’t have the language for yet.

At first, I chalked the overwhelming symptoms I was experiencing up to the stress of the pandemic. The weight gain, anxiety, and waves of sadness all made sense. After all, the world was in crisis. I was working from home, eating way too much bread (remember, the flour shortage?!), and pairing most meals with a glass of red wine like it was my new coping ritual.

(What I understand now is the stress of the pandemic probably made my symptoms worse, but weren’t the sole cause.)

But even after the world reopened, something still felt off. I was tired all the time. My joints ached. My ears were itchy. My thoughts felt slow and cloudy. I didn’t feel like myself anymore. I remember wondering if maybe this was it. Maybe 44 was the peak, and everything else was just downhill.

It wasn’t until almost two years later that I came across a post online listing symptoms of perimenopause. And I was stunned. It was all there! Every single thing I had been experiencing. That was the moment I realized, oh, I’m knee-deep in perimenopause!

And then I got furious.

How could I not have known? I’m a woman over 40. I’m an AASECT-certified sex therapist. I support Black and Brown women to have healthier sexuality for a living. But all I ever associated with perimenopause were hot flashes and low libido. I had no idea that our bodies have hundreds of estrogen receptors, from our brains to our joints to our skin, which means hormonal changes can show up everywhere.

I was shocked that I hadn’t been prepared for this stage of life. But I also knew I wasn’t alone. What I have learned since then is that the majority of people assigned female at birth, especially Black and Brown people, don’t get the education, support, or care they need to navigate this transition with confidence and ease.

That’s why I’m talking about it now. Because we deserve better. We deserve to know what’s happening in our bodies. We deserve to feel seen, informed, and supported. Not dismissed. Not made to feel like we’re making our symptoms up.

This isn’t the end. It’s a powerful shift. And with the right support, it can be a season of clarity, reclamation, and real connection.

For individuals assigned female at birth, perimenopause, the years when hormone levels begin to decline, can start as early as the late 30s or early 40s. For Black and Latine women, symptoms may begin even sooner and often go unrecognized or dismissed.

During this time, the body starts adjusting to lower levels of estrogen and progesterone. That shift can bring on a wide range of physical, emotional, and cognitive changes. In many ways, this phase is the mirror image of puberty. Only now, instead of hormones ramping up, they’re winding down.

Perimenopause can last anywhere from 4 to 10 years. And while it’s a natural transition, many of us go through it without the information, support, or language to understand what’s really happening.

Perimenopause can come with a wide range of symptoms that affect the body, mind, and emotions. Some people barely notice the shift. Others feel like they’ve been hit by a wave they didn’t see coming.

Here are some commonly reported symptoms:

• Irregular or missed periods

• Hot flashes

• Night sweats

• Brain fog or memory issues

• Mood swings

• Increased anxiety or depression

• Fatigue

• Low libido

• Vaginal dryness or discomfort during sex

• Sleep disturbances or insomnia

• Weight gain, especially around the midsection

• Breast tenderness

• Joint and muscle pain

• Headaches or migraines

• Hair thinning or hair loss

• Dry skin

• Heart palpitations

• Changes in body odor

• Itchy skin or ears

• Increased sensitivity to alcohol

• Feelings of overwhelm or disconnection

Not everyone will experience all of these symptoms. Some may come and go, while others may linger. And for many, the intensity can vary from manageable to completely disruptive.

It’s also important to acknowledge that there’s still so much we don’t know. Perimenopause remains under-researched, especially when it comes to the experiences of Black, Brown, and Indigenous women. There’s been a long-standing gap in medical research around women’s sexual health and aging.

The result? Many doctors are ill-prepared to recognize or treat perimenopausal symptoms. Too often, patients are dismissed, misdiagnosed, or told that nothing is wrong.

You’re not imagining it. You’re not overreacting. And you’re definitely not alone.

Black and Latine women are among the least prepared for this transition. Not because we aren’t strong or capable, but because we haven’t been given the outreach, education, or resources we need. The lack of culturally relevant information makes this season even harder to navigate.

And it’s not just about hot flashes. During this time, we are more vulnerable to cognitive changes, heart disease, and other serious health risks. Studies show that Black and Latine women tend to experience symptoms earlier, and those symptoms are often more intense.

This is not simply a matter of biology. It is the result of systemic racism in healthcare, the impact of chronic racial stress, and years of being dismissed or misdiagnosed. Our concerns are more likely to be overlooked. Our pain is more likely to be minimized. And many of the providers we see are not trained to offer culturally competent care.

So we keep going. We minimize. We normalize the suffering. But doing so in silence takes a toll.

You deserve to know what is happening in your body. You deserve care that listens to you and honors your experience. And you deserve to move through this season feeling informed, supported, and empowered.

This time can be incredibly confusing. It’s not uncommon to feel like a stranger in your own body or to feel less desirable. You might not be able to put your finger on it, but you just don’t feel like yourself.

And as natural as this phase of life may be, I want you to know that you do not have to suffer.

Finding the right support can be challenging, but it’s worth advocating for. Medical interventions like hormone replacement therapy may not be right for everyone. Still, there are nutritional, emotional, and lifestyle changes that can help you feel more vibrant and grounded during this time.

What’s most important to remember is this: this is not the end. You are not broken. You are not less than. You are not past your prime.

Perimenopause is a portal. It can connect you with the version of yourself you were always meant to become.

This phase of life asks us to slow down and reassess what we’re giving our energy to and what we’re nurturing. Our bodies begin to demand the care and attention they’ve long been denied, often because we’ve been too busy caring for everyone else.

Now is the time to turn some of that care inward. You deserve that. You always have.

To support you through this transition, I’ve created A Companion Guide for the Journey from Perimenopause to Menopause. It’s completely free and designed to help you feel more informed and less alone as you move through this season.