If you’re in your 40s and suddenly dealing with joint pain, exhaustion that sleep doesn’t fix, or symptoms you can’t quite explain, this one is for you.

As a GP with a special interest in women’s health and rheumatology, I see this pattern constantly: women in perimenopause coming in with joint pain, brain fog, fatigue and dry eyes — and being told it’s just their age or just stress.

Here’s what’s actually happening in your body.

Oestrogen does far more than you think

Oestrogen isn’t only a reproductive hormone. It’s also a powerful anti-inflammatory, and it actively helps regulate your immune system.

During perimenopause, oestrogen levels start to fluctuate and fall. When that happens, the immune system can become dysregulated — meaning it can start to overreact, or even turn on the body’s own tissues.

Why autoimmune conditions surface now

This is why autoimmune conditions so often first appear, or significantly flare, during the perimenopause transition, including:

• Rheumatoid arthritis
• Lupus
• Sjögren’s disease
• Hashimoto’s thyroiditis

In fact, 80% of all autoimmune disease patients are women — and the timing is not a coincidence.

The problem: the symptoms overlap

Joint pain, fatigue, brain fog, hair loss — these get attributed to menopause, when in reality they could be pointing to an underlying autoimmune condition.

And the cost of that overlap is real. Women wait an average of four to seven years for an autoimmune diagnosis. That’s four to seven years of being dismissed.

Please advocate for yourself

So if you’re in perimenopause and something doesn’t feel right, advocate for yourself. You’re not imagining it. Your body is communicating something — and you deserve to be heard.

Follow me @thesoulfulgp for more evidence-based women’s health content. And if this resonated with you, share it with someone who needs to hear it.