What are 34 symptoms of perimenopause?

While in this article we look at 34 menopause symptoms, there are more and our symptom checker (here) gives you an overview of 40 symptoms of the menopause.

When you read through these symptoms, you will see that they are not specific just to the menopause transition. It is sensible to speak to a doctor or other healthcare professional to rule out other causes before putting the symptoms down to the menopause. Always seek help if symptoms are severe and impacting your quality of life. Some ‘red flag’ symptoms are called out along the way. If you click on the links below, you will find more detailed information about why the symptoms occur and what you can do about them.

1. Hot Flushes

Hot flushes are sudden feelings of intense heat that spread over the body, often accompanied by redness and sweating. They can vary in timing, frequency and severity – from a sensation of warm ‘glow’ to a feeling of a raging furnace inside your body. They can occur day and night and are commonly triggered by decreasing oestrogen levels. Severe hot flushes can be linked to increased risks of cardiovascular disease.

2. Night Sweats

Night sweats are episodes of excessive sweating during sleep, related to a decrease in oestrogen. They can disrupt sleep significantly, sometimes necessitating changes of bedding or clothing. Some women also have sweats in the daytime, which can cause anxiety and embarrassment, which can result in worsening sweats.

3. Sleep Disturbances

Perimenopause can bring about various sleep issues, including trouble falling asleep, waking up frequently, and early morning awakenings, often exacerbated by night sweats, increased nighttime urination, stress and anxiety.

4. Brain Fog

Cognitive difficulties such as poor concentration, memory lapses, and trouble multitasking can occur, impacting daily functioning and work performance. This can in turn decrease confidence and self-esteem. Other symptoms of the menopause can worsen brain fog, such as poor sleep and hot flushes and  night sweats.

5. Vaginal Dryness

Lower oestrogen levels can lead to vaginal dryness, causing discomfort during intercourse Other vaginal and vulval symptoms experienced include itching, painful intercourse and altered and loss of sensation.

6. Bloating

Changes to the digestive system during perimenopause can result in bloating. This may be accompanied by constipation, but not always. Dietary adjustments can help manage this symptom. You should always see a doctor to discuss persistent bloating or any persistent change in bowel habits.

7. Hair Loss

Hormonal changes can cause thinning hair on the scalp, increased facial hair, and more brittle, fragile hair. There are other reasons for hair loss during the menopause transition that may need investigating, such as low iron (which may result from heavy periods in the perimenopause).

8. Weight Gain

Weight gain during perimenopause is often due to hormonal shifts and a slower metabolism, with fat accumulating more in the abdominal area. Loss of muscle mass can also contribute.

9. Mood Swings and Irritability

Sudden changes in mood, including anger, sadness, or frustration, are common and often linked to hormonal change, stress and poor sleep. There may also be additional life pressures at this time that can also contribute.

10. Anxiety and Panic Attacks

Anxiety symptoms can include restlessness, difficulty concentrating, and physical symptoms like rapid heartbeat and chest pain, driven by hormonal impacts on stress regulation. Symptoms can be anything from very mild to severe. Please always seek help through your GP, 111 or 999 in an emergency.

11. Breast Pain

Breast tenderness, especially during certain phases of the menstrual cycle and menopause as a result of hormone changes, is common. While usually benign, persistent pain should be evaluated by a healthcare provider.

12. Digestive Issues

Symptoms like flatulence, nausea, and abdominal discomfort can arise from hormonal influences on the digestive system. Always speak to a doctor if you have persistent changes in your bowel habit – don’t always just put symptoms down to the menopause.

13. Irregular Periods

Menstrual cycles and bleeding patterns can change and may become unpredictable in terms of frequency and flow, signaling the approach of menopause. Seek advice if you have a change to very heavy flow, spotting in between periods or bleeding after sex.

14. Decreased Libido

Reduced sexual desire and lower libido may result from hormonal changes affecting arousal and pleasure, potentially leading to a diminished interest in sexual activity. Other symptoms can also impact libido, such as low mood. Vaginal symptoms can also impact libido.

15. Urinary Incontinence

Weakened pelvic floor muscles due to low estrogen levels can lead to stress incontinence or overactive bladder symptoms. Some experience more urinary tract infections, and the bladder may sometimes feel as if there is an infection with no bacterial growth.

16. Bone Loss

Decreasing oestrogen levels accelerate bone loss, increasing the risk of osteoporosis and fractures.

17. Skin and Hair Changes

Dry, itchy skin changes, hormonal acne, and changes in hair texture are common, with hair thinning or increased facial hair growth.

18. Heavy Periods

An imbalance between oestrogen and progesterone can cause a thickened uterine lining, leading to heavier and longer periods. Always speak to a doctor if there is a significant change in bleeding, if there is bleeding in between periods or if there is bleeding after sex.

19. Muscle and Joint Pain

Loss of muscle mass and cartilage degradation can lead to joint pain and muscle aches, often exacerbated by reduced oestrogen levels.

20. Infertility

As ovulation becomes less frequent, fertility declines. Contraception is still necessary until menopause is confirmed. If you aren’t certain where you are in the menopause transition because you are not bleeding due to progesterone contraception, you may be advised to continue to use contraception till you are 55 years old. Discuss when to stop using contraception with a doctor.

21. Low Energy and fatigue

Fluctuating hormones, sleep disturbances, lifestyle changes and metabolic changes can all contribute to fatigue and loss of energy.

22. Nail Changes

Nails may become more brittle and prone to breakage, reflecting broader changes in skin and hair health.

23. Lower libido

Loss of libido can occur as a result of vaginal symptoms and painful or uncomfortable sex. It may occur as a direct effect of a change in hormone levels, or as an indirect effect of fatigue, mood changes, loss of motivation and relationship issues.

24. Dizziness

Hormonal changes can affect blood pressure and glucose levels, causing dizzy spells or light-headedness.

25. Bacterial Vaginosis

Lower estrogen levels can alter vaginal flora, increasing susceptibility to bacterial vaginosis, which may require medical antibiotic treatment.

26. Formication and changes to skin sensation

There can be changes in skin sensation, such as a feeling of electric shocks, or sensation of crawling skin, known as formication, as a result of hormonal changes. They can be distressing symptoms during perimenopause.

27. Urinary Tract Infections (UTIs) and bladder symptoms

Reduced oestrogen impacts the urinary tract’s health, making bladder infections more common due to a less protective vaginal environment.

28. Painful Periods

At times, in the perimenopause, changes in hormone levels can lead to higher levels of prostaglandins, causing more intense menstrual cramps.

29. Gum and Dental Issues

Hormonal changes can affect oral health, leading to gum disease, increased sensitivity, and a higher risk of tooth decay.

30. Tinnitus

Hormonal change can result in tinnitus, which is the perception or hallucination of noise when no external sound is perceptible. Tinnitus can take many forms, such as buzzing, ringing, roaring, whistling, clicking – it’s whatever the person describes it to be and is unique to them.

31. Irregular Heartbeat

Palpitations and arrhythmias may occur due to hormonal effects on heart rate regulation, warranting medical evaluation if persistent.

32. Burning Mouth Syndrome

A burning sensation in the mouth, often described as tingling or numbness, can be an uncomfortable symptom of perimenopause.

33. Changes to the immune system

Perimenopause may increase susceptibility to autoimmune diseases, potentially exacerbating conditions like thyroid disorders and rheumatoid arthritis. Some women suffer from allergies for the first time during the menopause transition. This is an area where more research is needed.

34. Headaches

Hormonal changes can trigger or worsen headaches, including migraines, particularly during certain phases of the menstrual cycle and in the perimenopause.

Conclusion

Perimenopause presents a variety of symptoms due to hormonal changes. Awareness and understanding of these symptoms are essential for effective management, and seeking medical advice helps ensure other conditions are ruled out.

If you’d like to find out more, take a look at our symptom checker here.

Click on a symptom (listed in alphabetical order ) to highlight the affected area on the body diagram and reveal a short explanation. Click each ‘read more about the symptom and treatment’ link to go to individual symptoms pages where you will find more detail about the symptom, how many women experience it (and for how long) and how to treat it.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.