Stephanie S. Faubion, author of the Mayo Clinic’s The Menopause Solution, is the director of the Women’s Health Clinic at the Mayo Clinic where she has practiced for more than 10 years. She says that for her patients, sometimes perimenopause is shrouded in mystery.

“We get the talk when we’re in 5th grade when we’re about to start our periods, but nobody gives us the talk when we’re about to stop our periods,” she explains. “And this is a problem because women are blindsided by some of the symptoms. I have patients who come to the Mayo Clinic thinking that they’re dying because they’re gaining weight, losing hair, are irritable and anxious, and have acne for the first time since they were a teenager. They think something is horribly wrong because we as women haven’t been educated about the perimenopausal stage of life.”

A number of Gen-X women grew up as feminists and are used to kicking ass and taking names. It’s tough to admit that we don’t know everything. (I know.) Now that we’re grown-ass ladies, though, we’re starting to realize that we still have things to learn — about our own bodies.

We get the talk when we’re in 5th grade when we’re about to start our periods, but nobody gives us the talk when we’re about to stop our periods.

– Stephanie S. Faubion, author of the Mayo Clinic’s The Menopause Solution

If you Google the “average age for perimenopause,” you’ll likely find it starts “sometimes in your 40s.” But wait a minute, sometimes you’re a late bloomer and you won’t start experiencing symptoms until your 50s. Or maybe you like to get a head start on things so you may even begin dealing with perimenopause in your 30s. So, essentially, women have to be on the lookout for vague perimenopausal symptoms for three decades of their lives.

So, let’s start with the basics.

So, is it perimenopause or a thyroid disorder?

When I went to my doctor and told her about some of my perimenopausal symptoms, she immediately ordered a thyroid test. Often, because they are so similar, symptoms of perimenopause can point to hypothyroidism, which occurs when the thyroid no longer produces enough crucial hormones to keep the body functioning properly. To make matters more complicated, perimenopause can also contribute to an underactive thyroid. Common symptoms of both perimenopause and hypothyroidism include fatigue, forgetfulness, mood swings, weight gain, irregular menstrual cycles, and cold intolerance.

If left untreated, hypothyroidism can lead to high cholesterol, osteoporosis, heart disease, and depression. However, there is a test for this and if you experience any of these symptoms, talk with your doctor.

In a nutshell, no, there is not a definitive hormone test for perimenopause — yet, anyway. There is no hormone test to diagnose perimenopause because hormonal cycles are so erratic and unpredictable during this stage. Further muddying the waters, perimenopause symptoms are so variable and mimic so many other possible things, it can be hard for doctors to pinpoint.

Jill Clements, 44, had a baby after 40 and now she says she can’t tell the difference between what may be perimenopausal symptoms from postpartum symptoms.

“Are the mood swings, breast tenderness, and anxiety the result of me having a baby or of me going into perimenopause? At my age, it’s hard to tell,” she says.

Surprisingly, sometimes doctors aren’t prepared to help women recognize the start of this life phase, and women aren’t really taught how to recognize it themselves, either.

Amy Cuevas Schroeder, founder of The Midst, was 42 when she started experiencing perimenopause symptoms. Like Jill, she had trouble distinguishing whether her symptoms were related to perimenopause or were postpartum as she had delivered twins a couple of years before. After researching her symptoms — anxiety, mood swings, midsection weight gain — she felt strongly that she was experiencing perimenopause. However, because her period was not yet irregular and she was still in her early 40s, both her general doctor and her gynecologist dismissed her claims.

“I felt like I wasn’t being listened to and my concerns were just written off really quickly even though I kept experiencing symptoms,” she says. “I had all the tell-tale signs of perimenopause, so I continued to do online research and talk to friends who were experiencing the same thing. What I found was that there were a lot of women going through the same thing I was going through, so I knew I was not alone.”