Perimenopause: Why am I crying, tired and wide awake at 3 AM?

By Joan Oyiela | 3 hours from now | 3 Min read

For many women, the body rarely announces perimenopause with clarity. Instead, it arrives in fragments: a restless night here, an emotional outburst there, a skipped period, a sudden wave of anxiety, or a fatigue that sleep cannot fix. Slowly, the familiar version of self begins to feel unfamiliar, yet most women do not recognise it at first.

Psychologist Dr Leah Ngari says perimenopause is one of the most misunderstood stages in a woman’s life. She explains it as the transitional phase before menopause, when the ovaries gradually reduce hormone production, especially oestrogen and progesterone. This fluctuation, she says, is what triggers both physical and emotional changes that many women often misinterpret.

“Women often assume they are stressed, depressed, or simply exhausted from life demands,” Dr Ngari explains. “But in many cases, the body is actually entering a hormonal transition that can begin in the late 30s or 40s.”

Unlike menopause, which is confirmed after 12 consecutive months without a menstrual period, perimenopause is unpredictable. Periods may become irregular, heavier or lighter and symptoms may come and go without warning. This inconsistency is what makes it even more confusing for many women.

Common symptoms include mood swings, hot flushes, brain fog, sleep disturbances, weight changes, fatigue and reduced libido. Beyond the physical signs, Dr Ngari says the emotional impact can be just as significant.

“Some women experience anxiety, irritability, or low moods that they have never felt before,” she says. “It is important to understand that these are hormone-driven changes, not personal weakness.”

Despite its prevalence, perimenopause remains largely unspoken in many households, leaving women to navigate it alone and often in silence.

For 42-year-old Mercy Achieng, a teacher and mother of three, the changes crept in so gradually that she did not connect the dots at first.

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“I started forgetting small things like where I placed my phone or simple instructions I had just been given,” she recalls. “Then my sleep changed completely. I would wake up at 3 a.m. and just lie there. During the day, I was always tired but restless at the same time.”

Mercy says what worried her most were the emotional shifts.

“I became very sensitive. I would cry easily or get irritated over things that normally would not bother me. At some point, I thought I was losing control of myself,” she says.

For 39-year-old Caren Wanjiru, an entrepreneur running a small retail business in Nairobi CBD, the first sign was a change in her menstrual cycle.

“My periods became unpredictable. Sometimes they were very heavy, other times they would skip entirely,” she says. “Then came the hot flushes. I would suddenly feel intense heat in my body, especially at night. It was uncomfortable and scary.”

Caren initially attributed her symptoms to stress and workload.

“I run a business, so I thought I was just overworking myself,” she explains. “But when I started experiencing anxiety and constant fatigue, I knew something deeper was going on.”

Like many women, she had never associated her symptoms with perimenopause.

“In our environment, nobody really talks about it. You hear about menopause as something for older women,” she says. “So when I was told this is perimenopause, I was surprised and honestly, a bit unprepared.”

Experts say this lack of awareness often delays diagnosis and emotional acceptance. Women may spend months or even years trying to treat symptoms individually, such as insomnia, anxiety and weight gain, without realising they are all connected to hormonal changes.

Dr Ngari emphasises that awareness is key. She encourages women to track their cycles, pay attention to emotional and physical changes, and seek medical guidance when symptoms feel unusual or persistent.