#Perimenopause

A recently reported side effect of menopause—an acute and sometimes unbearable heightening of the sense of smell—has cast light on an under-recognised health issue affecting women globally, including in Thailand. While hot flashes, mood swings, and sleep problems are well-documented hallmarks of menopause, women are coming forward with distressing accounts of ordinary smells becoming intolerable, wreaking havoc on daily life and relationships. Medical professionals admit that the problem is little understood, and concrete solutions remain elusive, leaving many women without adequate support.

A recent story has captivated fitness enthusiasts and health professionals alike: a 51-year-old woman, after years of struggling with hormonal changes and chronic health issues, has reached her peak physical condition through a dramatic shift in her exercise routine. By replacing exhausting cardio with focused strength training, she not only managed her perimenopause symptoms but also achieved new levels of strength and wellness—challenging outdated ideas about aging and female fitness. Her journey, covered by Business Insider in June 2025, is now echoed by a surge of medical research supporting the benefits of weightlifting and muscle-building workouts for women in their 40s and 50s worldwide—including Thailand.

Perimenopause, often misunderstood as a sudden transition late in a woman’s life, can begin as early as one’s 30s, introducing a myriad of surprising symptoms. This transitional phase, preceding menopause, is gaining attention for the range of unexpected experiences it presents to women. It’s vital for Thai women to understand these developments to accurately interpret their health changes and seek appropriate care.

For many Thai women, the notion of menopause has always been associated with an abrupt cessation of menstruation typically happening in their 50s, but recent insights highlight that perimenopause can commence much earlier. Dr. Natalia Llarena, an OBGYN specializing in reproductive endocrinology, emphasizes that perimenopause can start before the age of 40 and persist for several years. Importantly, it carries distinctive symptoms like irregular menstrual cycles, hot flashes, and mood swings which are frequently overlooked.

Women have long prepared themselves for menopause, often perceived as a defining milestone occurring in the 50s. Yet, the journey begins much earlier, sometimes as early as the 30s, with perimenopause marking the onset of significant physiological changes. This precursor phase, laden with unexpected and easily overlooked symptoms, underlines the need for a comprehensive understanding and dialogue.

Perimenopause, the transitional stage leading up to menopause, can start in the 30s or 40s and last from months to several years. Contrary to some misconceptions, perimenopause is not a swift process but a complex period characterized by a wide array of symptoms. Dr. Natalia Llarena, an esteemed OBGYN and reproductive endocrinologist, emphasizes that the signs of perimenopause are commonly dismissed due to their subtlety and variability, with many women uninformed about their significance until they manifest more severely.