Based upon doctoral research conducted in Accra and Kumasi, Ghana, this chapter looks at the everyday hidden geographies of the perimenopause through women's use of water and sanitation during this particular reproductive stage. By examining how limited water and sanitation infrastructure in patriarchal Ghana dictates perimenopausal women's movements through space, it builds upon discussion by Laws who explored how patriarchal social structures limit women's spatial mobility. Thechapter explores the hidden geographies of perimenopausal women as demonstrated through WASH use in Ghana. Examining the needs of perimenopausal women explores hidden knowledge that is not recorded in the literature. The studies showed women have three particular hidden hygiene needs that have been present throughout their adult life, but change dramatically as they enter the perimenopause: menstrual hygiene management, bathing and laundry. The chapter presents some preliminary findings on this, with scope for deeper exploration in the future into the geographies of the perimenopause, through WASH and beyond.