Renae Smith was 38 when she first felt something start to shift within her.

They were small, subtle changes that didn't quite make sense at first. "It wasn't one big moment," she told Mamamia. "It was lots of small things that didn't quite add up."

A glass of wine would suddenly trigger a migraine. Her cycle, once reliably 28 days, shortened and stretched in ways that felt unfamiliar. Her skin changed. Her hair changed. Her sleep changed.

"I've always been quite in tune with my body… and the best way I can describe it is that I just didn't feel the same."

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"I just wanted to manage the symptoms."

Now 43, the symptoms are harder to ignore. The migraines come four or five times a month and can be severe enough to stop her functioning. Sleep is disrupted by insomnia and restless legs. Her temperature regulation feels unpredictable. There's joint pain, dizziness, and a low-level emotional shift she doesn't quite recognise as her own.

"I can feel myself getting irrationally angry or on edge… because it's so out of character."

Like many women arriving at this stage, Renae didn't initially set out to overhaul her life.

"I just wanted to manage the symptoms in a way that felt sustainable," she said.

But managing it has proved far less straightforward than she expected. Not because there aren't options, but because there are so many.

Over the past few years, Renae tried a whole host of different treatment options. She's spent thousands of dollars.

Much of that was driven by what she was seeing and hearing around her. "You're constantly exposed to people saying 'this worked for me'… and it makes you more likely to try things," she said.

The problem, she explains, is that it's hard to tell what's grounded in evidence and what's simply being sold well.

Some things have helped slightly. But other treatments she's still not entirely sure on. Overall, the experience has felt uncertain.

"You try something, feel hopeful, and then realise it hasn't really made a difference."

There was a moment when the effort began to outweigh the outcome. "There was a point where I was doing everything 'right'… and still waking up with migraines or feeling off," she said.

Renae's steadfast determination is being driven by a growing awareness around perimenopause, which is proving both a blessing and a curse for women approaching it.

"Something long and unpredictable."

"What's driving it is hearing that perimenopause can last for years. That's quite overwhelming. It makes you feel like you're at the start of something long and unpredictable," she said.

Women are talking about it more openly than ever before. Symptoms that were once dismissed or endured quietly are now named, shared and validated. For many women, that visibility has been long overdue.

But according to clinical and health psychologist Narelle Dickinson, that increased awareness can come with its own challenges.

"The increased awareness of perimenopause… has resulted in many more women naming symptoms that were previously dismissed," she explained. "Unfortunately, awareness can sometimes tip into hypervigilance."

In practice, that can look like a heightened sensitivity to every shift in the body.

Mood changes, sleep disruption, weight fluctuations, or concentration issues might quickly be funnelled into a single explanation. Perimenopause. At the same time, the explosion of content around this life stage has created a parallel marketplace. Social media feeds filled with advice, personal experiences, symptom checklists and product recommendations.

The global menopause market is already worth around AUD $27 billion, according to market research firm Grand View Research, and is expected to grow to more than AUD $37 billion by 2030.

Narelle says that while there is strong evidence supporting some treatments, and psychological approaches for mood and sleep, these are often presented alongside wellness products with far less evidence, in almost identical ways.

"The problem is that evidence-based care and wellness marketing are often presented with the same level of confidence," she said.

For the person trying to make sense of their symptoms, it can feel like everything is equally valid, and therefore everything is worth trying.

Over time, that creates a subtle but powerful shift in how perimenopause is experienced. It stops being something to move through, and becomes something to solve.

Narelle describes this as the pressure to "fix" perimenopause, a mindset that can carry its own psychological weight.

"The urgency to 'fix'… can create a sense that your body is failing," she said.

"If I feel tired, emotional or uncomfortable, I must not have found the right product yet."

Renae relates to the cycle of hope that comes with starting something new, followed by disappointment when it doesn't deliver.

"It's more frustration around spending money and effort without getting a result," she said.

At the same time, she's trying to manage the real symptoms of perimenopause, while balancing full-time work and a toddler.

"There's no real space to stop and recover," she explained.

"Perimenopause may be part of the picture, but it should not become the only explanation."

While her sex drive has also shifted, Renae believes this is a response to other symptoms rather than a symptom itself.

Narelle says this is common and cautions against ticking off a check-list to diagnose perimenopause.

"A 30-second video or post cannot account for the complexity of what women are experiencing. Symptoms may be hormonal, but they may also be influenced by stress, mental health, physical health conditions, or life circumstances," she said.

"Perimenopause may be part of the picture, but it should not become the only explanation."

Listen: In this episode of Well, the hosts track the journey from the 'magic and mayhem' of puberty to the 'window of chaos' that is perimenopause, exploring how these changing hormones reshape us at every life stage. Post continues below.

Which is why proper medical assessment is critical, although doing so brings its own set of challenges. When Renae sought help through a GP, she felt dismissed and unsupported, eventually deciding to manage things on her own.

That experience of not feeling heard is one many women recognise. It also helps explain why the wellness space has become so influential. When traditional pathways feel difficult to access or navigate, people look elsewhere.

"Anything that makes big promises… or suggests one protocol works for everyone is a red flag," Narelle said.

Her advice is not to reject all treatments or supports, but to approach them with more caution instead of urgency. A balanced approach, she says, is one that allows for curiosity without tipping into panic.

For Renae, what has made the biggest difference isn't something she's paid for, but support.

"I am lucky I have a husband I can talk about it all with," she said. "He actually says things like 'I feel so sorry you're going through this'.

"Just having someone see me… is a huge help."

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Feature Image: Supplied.