34 Symptoms of Perimenopause Every Woman Should Know

Do you remember, back in the day, your mother, aunties, and grandmother whispering to each other behind closed doors about "The Change of Life"? A generation or so ago, menopause was a secret between women of a certain age. Perimenopause wasn’t even a term yet.

Today, we know so much more about perimenopause and menopause and how to manage the symptoms. Women in their 40s and 50s are taking control of their health and well-being and aren’t afraid to speak out to get answers.

What is perimenopause?

Menopause is our body’s natural end to menstruation. It’s a point in time when you haven’t had a period for the last 12 months. Since "peri" is Greek for "near" or "around," perimenopause is the time your body takes to transition to menopause.

Harvard Health Publishing of Harvard Medical School reports the average woman’s perimenopause lasts three to four years. Since women’s bodies are diverse and unique, your perimenopause stage could last for a few months or years, but it starts with irregular periods. In fact, there is an array of symptoms women can experience.

Here are 34 symptoms caused by perimenopause every woman should know.

1. Irregular periods

As previously mentioned, irregular periods are the first sign of perimenopause. Your periods could last shorter or longer than normal and be heavier or lighter. Or you may experience the regular signs of PMS like sore breasts, irritability, bloating, etc., but not have a period that month.

2. Hot flashes

Sometimes called hot flushes, you’ll know when you’re having a hot flash. Your body feels like it’s burning up from the inside out. Your face and neck might turn red, and you may sweat. Up to 79 percent of women experience hot flashes, perhaps the most common symptom many will experience.

3. Vaginal dryness

During perimenopause, your vagina’s natural lubrication falters thanks to thinning walls and flagging hormones. When your body slows in producing estrogen, your vagina can become dry, sometimes making sex uncomfortable and even painful.

4. Night sweats

Another common symptom is night sweats. Some women have hot flashes in the middle of the night that disrupts their sleep schedule. And sometimes the night sweats are so severe, you might need to get up and change the sheets. It’s one of the most prevalent causes of sleeping difficulties for perimenopausal women.

5. Mood swings

One minute you’re happy and the next you’re Mr. Hyde, snarling at everyone. Mood swings can strike quickly during perimenopause. In fact, about 23 percent of women will experience mood swings, sometimes severe, as well as anxiety and depression.

6. Changes in sex drive

Some, but not all, women experience a drop in their sex drive during perimenopause, while others find their sex drive increasing. Since each woman is unique, sex drive changes differ substantially. Exercising and eating healthy can help you regulate how you feel about your body if you feel self-conscious about your changing body.

7. Weight gain

Gaining weight during perimenopause doesn’t help you feel confident about your sexuality and your body image. Some women gain weight around their middles thanks to hormonal changes. It’s important to eat healthy and exercise to avoid significant weight gain.

8. Bloating

Perimenopausal bloating is like PMS symptoms, but usually persists after your period ends or when you don’t have a period. This could be an early sign that your body is approaching or around menopause.

9. Tender breasts

Just like with bloating, your breasts could be sore during perimenopause. Your breasts will feel like when you’re on your period or are pregnant.

10. Headaches

Women who experience headaches during their period can get headaches during perimenopause as well. Your fluctuating hormones affect your brain chemicals, causing headaches. If your hormones are steady, however, you’re less likely to experience headaches. Once you hit menopause, though, your hormones start fluctuating, causing more headaches.

11. Joint pain

If you thought you were just getting old, perimenopause could cause your joint pain. Without getting too technical, your body’s estrogen works to strengthen your bones and reduce inflammation around them. As this important hormone decreases, your joints can become inflamed and painful.

12. Electric shocks

You may feel sensations throughout your body that women describe as an electric shock. Again, with hormone levels changing, this sensation can happen at any time. Many women report feeling these electric shocks right before a hot flash.

13. Digestive problems

If you’re experiencing excessive nausea, abdominal cramps, bloating, and flatulence, it could be a symptom of perimenopause. Hormones are at work here, mainly when your cortisol level raises. Cortisol is the stress hormone, and estrogen usually maintains your cortisol at healthy levels. Once your estrogen levels fluctuate, your cortisol spikes, making you feel stressed and causing digestive problems.

14. Burning tongue

Reduced levels of estrogen can dry out your mouth, causing your tongue to feel like it’s burning. Just like reduced lubrication in your vagina, the mucous membranes in your mouth are affected by your level of estrogen. When your estrogen levels drop, your saliva can dry up, leaving you with a burning tongue.

15. Gum issues

Up to 60 percent of women experience dental health issues during perimenopause, caused by hormone changes in their bodies. Just as our dental health suffers as we age, it’s important to stay up to date with your dentist during and after perimenopause.

16. Skin issues

Many women suffer from dry, itchy skin thanks to perimenopause. Your estrogen level affects the level of collagen your body produces. We’ve all heard how important collagen is for younger looking skin. A drop in collagen results in dry, itchy skin.

17. Anxiety

Fluctuating hormones can cause unexplained anxiety or a general feeling of unease in some women. As your hormone levels rise and fall, they affect your emotions. You might feel nervous, but can’t explain why and can’t find a viable reason for the feeling.

18. Tingling in extremities

You know that tingling sensation in your hands and feet when they’ve fallen asleep? Some women experience the same sensation because of perimenopause. It can feel like a burning or numbness. Again, the culprit is your estrogen levels, which can affect your central nervous system. Your central nervous system relays mixed signals to your hands and feet as a result.

19. Sleep issues

If night sweats and hot flashes aren’t enough to disrupt your sleep schedule, you can experience insomnia. Up to 60 percent of women in some stage of menopause experience sleep disturbances that affect their quality of life. It’s unclear if hormone levels cause insomnia or if it’s part of the aging process.

20. Cognitive difficulties

Some women during perimenopause experience difficulties concentrating during daily activities. A drop in your estrogen levels can affect how the brain uses energy to focus. If you’ve ever wondered why you came into the kitchen, it could be a symptom of perimenopause.

21. Dizziness

If you’ve ever experienced a sudden, unexplainable bout of dizziness, it could result from your estrogen levels dropping. While dizziness can be a symptom of many causes, when combined with other symptoms listed here, it likely leads to perimenopause.

22. Fatigue

Feeling exhausted today has become a way of life for many women, but an unexplained fatigue can be a common symptom of perimenopause. A healthy diet and regular exercise can help you fight fatigue, but it’s time to see your doctor if your fatigue is severe and affects your quality of life.

23. Hair changes

Sometimes it’s hard to tell what are age-related changes in your body and what are due to perimenopause. With hair, perimenopause speeds up the effects of aging on your hair. Particularly, you’ll see a difference in volume and see some thinning. You’ll lose hair faster and regrow it slower.

24. Memory lapse

It’s common for women to experience temporary forgetfulness during perimenopause. As with memory lapses as we age, it’s important to strengthen your cognitive abilities with brain exercises like crossword puzzles, math problems, and more.

25. Brittle nails

If your nails become brittle and break easily, it could be a perimenopause symptom. Estrogen, the likely culprit, is essential for keeping your nails strong. When this hormone level drops, your nails weaken and become brittle, easily split and cracked.

26. Muscle strain

You may be more susceptible to muscle strain during perimenopause. Stress, anxiety, and nervousness can cause your muscles to tighten, making it easier to strain one or more. Yoga and meditation can help keep your muscles from tightening and getting strained.

27. Bladder issues

We all know about incontinence as we grow old, but did you know perimenopause can cause stress incontinence? If you’ve even sneezed and peed a little, or lifted a heavy box off the ground and leaked, you’ve experienced stress incontinence.

28. Body odor

Your body’s natural scent can change during perimenopause. Sometimes it’s due to hot flashes prompting excessive sweating, which can lead to body odor. Other times, it’s a result of the fluctuating hormones coursing through your body.

29. Irritability

Like with a lot of symptoms, any sudden, unexplained irritability might result from perimenopause. Blame those erratic hormones that can alter your mood in a moment. If you haven’t, try yoga, meditation, exercise, or a relaxing activity to combat irritability when it crops up.

30. Allergies

Did you know you can develop allergies at any point in life? And perimenopause can lead you to develop new allergies. Since your hormones are linked to your immune system, it’s easier to develop allergies during perimenopause because of fluctuating hormones.

31. Heart palpitations

Perimenopause can cause changes to your heart beat, such as palpitations. Similar to the tingling sensations you might feel in your hands and feet, your estrogen levels affect how neurons fire in your central nervous system, causing your heart to skip a beat.

32. Depression

You are experiencing so many physical and emotional sensations and changes during perimenopause. Women are twice as likely as men to develop depression, and it’s worse during major life changes such as menopause, postpartum, puberty, and even during your monthly period.

33. Panic attacks

While not a common symptom of perimenopause, panic attacks can occur thanks to the level of emotions you’re experiencing. Similar to depression, anxiety, and irritability, your hormones are creating a roller coaster of emotional and physical distress in your body that can contribute to a panic attack.

34. Osteoporosis

Last, but certainly not least, is osteoporosis, a condition that leads to weak bones prone to fracturing. Every woman knows about osteoporosis, but did you know your estrogen is significant to maintaining healthy, strong bones? It’s one of the reasons women decide to pursue hormone therapy around menopause.

What can you do?

Know that you’re not alone. Millions of women experience perimenopause every year and live to laugh about it. However, you have options.

First, take an inventory of your symptoms. If you have several on this list, and if they’re adversely affecting your quality of life, it’s time to see your doctor. He or she can help you discover the right treatment to ease your symptoms. Sometimes that’s natural remedies and sometimes it means prescription medication. Get informed so you understand what’s happening to your body and the treatments available to you.

Second, make sure you know the basics, like you can still get pregnant during perimenopause. Also, your periods can be long or short, heavy or light, and your cycle will definitely be irregular. Finally, don’t ignore spotting between your monthly periods, regardless of their irregularity.

Final thoughts

No worries—you’re not likely to experience all 34 symptoms of perimenopause. But just being aware of the symptoms can help you get ahead of the curve in managing their effect on your life. We don’t need to struggle in silence anymore around menopause and its various symptoms. And as more research is performed and the evidence grows, medical advances can mean the difference between living your best life in your 40s, 50s, and later… and just surviving.