The 34 Symptoms Of Perimenopause

33 perimenopause signs

The 34 symptoms of perimenopause? Thirty-four and counting!

Indeed, if you’re reading you’re probably searching for information on the hormonal changes of menopause. It’s a sad fact that many of us are starved of good information and knowledge. So, let us enlighten you. 😀


Many women believe that the age of 40-45 is too early for menopause. And in a lot of cases this is true, but it’s the peri part of the equation that comes into play here. Early to mid-40s is the average time for symptoms of perimenopause to begin*.

Meet peri

Once we hit this age (and in some cases our late 30s) many women can begin to experience the hormonal symptoms of perimenopause.

🔆 Although one caveat here is that many of the signs can also be precursors to pregnancy so please rule that out first.

Peri moves slowly

Unfortunately, a lot of women don’t have a clue that 1. change is happening and 2. its perimenopause.

What is perimenopause?

Perimenopause is the first stage of menopause. It occurs during the lead up (menopause is the cessation of fertility and periods) and can last around six to 13 years.

During these years sex hormones such as estrogen and progesterone may fluctuate wildly contributing to the characteristic symptoms of perimenopause.


Changes to your periods

Typically our menstrual cycles change during peri; becoming irregular, shorter or longer, or heavier or lighter.

The 34 most common symptoms of perimenopause:

1. Allergies

The hormones and the immune system are closely related so it’s not uncommon to experience an increase in allergies.

2. Anxiety

Anxiety is a feeling of constant worry and concern out of all proportion to normal feelings of everyday life.

3. Bloating

Perimenopausal women often experience an increase in bloating. It can feel similar to PMS, that distended tummy and often (sorry) an increased incidence of burping or farting.

4. Breast tenderness

Many of us have experienced the feeling of tender breasts during menstruation and/or pregnancy. This is also a common sign of perimenopause and so is an increase in breast size.

5. Body odour changes

Although this sign is often a surprise, decreasing estrogen levels can alter the pH level of the vagina.

6. Brain Fog

Difficulty concentrating, memory lapses (where have I put my keys?) and mental blocks can be a result of what is – quite literally – a feeling as if your brain is foggy.

7. Burning mouth syndrome

Some perimenopausal women experience a sensation of ‘burning’ on the tongue, roof of the mouth or inside the lip area.

8. Depression

What’s more, feelings of sadness and hopelessness often accompany fluctuating hormones.

9. Digestive issues

As mentioned under bloating, signs of gas along with cramping, and sometimes nausea can go hand in hand with perimenopause.

10. Dizziness

Furthermore, perimenopausal women can experience loss of balance, vertigo, a feeling of spinning and/or dizzy spells.

11. Electric shock sensations

While it might sound unusual, some women have said they feel an electric shock sensation under their skin.

12. Fatigue

Feelings of extreme exhaustion or a complete loss of energy are one of the common signs of perimenopause.

13. Feelings of Dread

Often located in the pit of the stomach, we feel dread for no apparent reason.

14. Formication

Some perimenopausal women report feeling like they have bugs crawling on their arms and legs.

15. Hot Flushes

Probably the most infamous sign of peri and recognisable by the heating up of the body/face and red flushing of the skin.

16. Hair changes

An extremely frustrating symptom, thinning hair on the head and other parts of the body along with an increase in facial hair is common.

17. Headaches/Migraines

Hormonal headaches and migraines really are a ‘thing’. And even if you’ve never experienced them during your period they can rear their heads (pardon the pun) or become more frequent in peri.

18. Incontinence

This one is seldom discussed but is very real. Bladder leakage and control are one of those ‘shhh’ signs. You could choose a pelvic floor trainer such as Elvie to help. Or, pelvic floor exercises are also extremely helpful.

19. Insomnia

Along with sleep disruption and night sweats insomnia can become an issue during perimenopause.

20. Irregular heartbeat

This one gives new meaning to the phrase ‘be still my beating heart’, but it’s quite a common perimenopausal sign. If it occurs breathe deeply in and out for a few breaths.

21. Irregular menstrual cycle

As we mentioned above, menstrual irregularity is often the first sign of perimenopause, and some ladies may experience heavy bleeding during their period.

22. Irritability

There are many comedic memes out there about this one, but all laughter aside it’s a common fact that perimenopausal women often become very irritable. Breathe deep.

23. Itchy skin

It’s not talked about often, probably because people don’t associate it with hormone imbalance, but itchy skin can definitely be a side effect of those pesky fluctuating hormones.

24. Joint pain

Unfortunately, many women put this down to overexercise or exercise and don’t connect the dots that it’s a common sign of perimenopause.

25. Loss of libido

Not feeling ‘in the mood’ is common during peri. Annoying? Definitely. Probably more so for your other half!

26. Mood swings

Tears, joy, irritability, rage – the pendulum can swing back and forth with perimenopausal women.

27. Muscle tension

A feeling of increased muscle tension or pain may not be due to your workout but a result of hormonal fluctuation.

28. Night sweats

Many women complain about this sign, which wakes them in the middle of the night contributing to fatigue.

29. Oral problems

Some people experience increased problems with bleeding gums and tooth loss in perimenopause.

30. Paresthesia

It’s an unusual word, isn’t it? It refers to ‘tingling extremities’ because it’s a sensation often felt in the hands, arms, feet, and legs. It can feel like numbness or ‘pins and needles’

31. Vaginal dryness

Because estrogen levels drop during menopause, a lessening of the vaginal ‘mucosa’ leads to vaginal dryness.

32. Weakened fingernails

The hormonal fluctuations associated with peri can limit the body’s ability to produce keratin, resulting in brittle fingernails and toenails.

33. Weight gain

One of the biggest bugbears of women at this age is weight gain. It’s due to both hormonal and metabolic changes, but it can be rectified through lifestyle changes.

34. Osteoporosis

This becomes a serious risk for women at menopause. Osteoporosis (meaning porous bone) is a skeletal disease characterised by weakened bones and increased risk of bone fractures. The prevalence of osteoporosis is on the increase and affects more than half of women over 60. We lose bone mass two to four times faster after menopause – 10 percent of it in the first five years of post-menopause.

For more detailed symptom information click here.

*It’s important to remember that every woman’s body is different so we are talking average statistics here.

We hope this helps you wade through the, often confusing, changes of this life stage. Having been there, we know what a rollercoaster perimenopause can be. Don’t hesitate to reach out here if you have any questions.


Disclaimer: This article should never take the place of medical advice. Perimenopausal signs could also be indicative of some other conditions such as pregnancy and various disorders so please see your GP to rule them out.


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This is the time when menstruation is well and truly over, the ovaries have stopped producing high levels of sex hormones and for many ladies, perimenopause symptoms subside.

Estrogen has protective qualities and the diminished levels mean organs such as your brain, heart and bones become more vulnerable. It’s also a key lubricant so your lips may become drier, your joints less supple and your vagina might be drier. In addition, your thyroid, digestion, insulin, cortisol and weight may alter.

At this juncture, a woman might experience an increase in the signs of reduced estrogen but she should have a decrease of perimenopause symptoms. That said, some women will experience symptoms like hot flushes for years or even the rest of their lives.


Peri = ‘near’

Most females begin to experience the symptoms of perimenopause in their mid-forties. Your progesterone levels decline from your mid-30s but it’s generally from around 40 that the rest of your sex hormones begin to follow suit. 

Perimenopause is a different experience for every woman and some women may barely notice it. The first indicators are usually changes to the monthly cycle. This means that for some ladies, this can be accompanied by things like sore breasts, mood swings, weight gain around the belly, and fatigue as time goes on.

For those with symptoms it can be a challenging time physically, mentally and emotionally.

Importantly, perimenopause lasts – on average – four to 10 years. The transition is usually a gradual process and many women enter perimenopause without realising.