40 Perimenopause Symptoms You Should Know

Perimenopause symptoms are what you might commonly experience as you go through the pretty insane build-up to the Big M.

But hang on a sec, what is perimenopause anyway? This article was reviewed and fact-checked by Dr. Fionnuala Barton.

Dr. Fionnuala Barton is a GP, Women's Health Doctor, and registered member of the British Menopause Society.

She is passionate about optimizing physical and emotional wellness for women at all stages of life and has a particular interest in early recognition and management of perimenopausal and menopausal symptoms, POI, PMS, and PMDD.

Dr. Barton is the founder of The Menopause Medic, an independent women's hormone health clinic that aims to provide empathetic, holistic, personalized, proactive, evidence-based women's hormone health consultations.

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The peri in perimenopause means “around”. Perimenopause, then, is the time around (or more specifically, leading up to) menopause.

It’s just so different for everyone. Some people have debilitating symptoms, some people have frustrating ones (temperature control, please!) and some people have no symptoms at all.

The more you know about what you can expect, the less confusing the experience might be. (Look, it’s still going to be confusing, but we do what we can.)

So here goes.

In this article: 📝

How do you know if you are pre or perimenopausal?

What is the average age for perimenopause?

As the opening act for menopause, perimenopause typically happens about five to eight years ahead of menopause—but can arrive on the scene even earlier.

Menopause is officially diagnosed 12 months after your last period.

In the United States, the average age for this to happen is 51.

Most women hit it somewhere between 45 and 55, but it can happen earlier.

If it does, it’s referred to as early menopause and may have some associated health risks.

Listen up—if you’re worried about any of this, check in with your doctor. There’s no reason to struggle through it alone.

Symptoms of perimenopause

So what are the signs of perimenopause? The crazy thing is, while we only ever hear of about like five or six of them, this list is long.

1. You’ve become a bit of a clown. We thought we’d kick off with a ridiculous one. Why not? If you find yourself a little more clumsy than normal, yes, this is indeed a symptom. Growing old gracelessly? Yeah, we can get behind that. Seems way more fun.
2. You’re blowing hot and cold. Hot flashes. Chills. These are the popular kinds of perimenopause symptoms.
3. You lose bone density. Meaning you’re a bit more fragile than normal. And may be prone to osteoporosis.
4. Your periods appear to be having a bit of an identity crisis. They’re all over the place in terms of frequency and length. Perimenopause bleeding can be seriously wild. And:
5. You’re gushing. (Blood, that is.) Yup, it’s not uncommon to experience heavy period flow over this time. (If you’re worried, reach out to your doctor.)
6. You may be more prone to yeast infections and:
7. Your vagina might be feeling dry and irritated. And yes, this can make sex painful and like the last thing you want to do. (It goes without saying, you should only do it when you want to do it.)
8. You wake up drenched. Yup, night sweats. The worst.
9. You smell different. Sometimes in the groin area. Sometimes just anywhere on your body.
10. Your body is literally cramping your style. Muscle cramps. Like everywhere. Legs. Back. Arms. Neck. Everywhere. This could be to do with calcium intake or hormone changes.
11. The whole thing is a bit of a headache. A really bad one. That arrives often. Headaches and migraines can be debilitating. Your doctor may prescribe triptans to help you out in this department.
12. You can’t be bothered. This may be a symptom of having taken way too much nonsense for way too long. Or it’s perimenopause. If you’re feeling lethargic, yup, this could be the reason.
13. You’re utterly wiped. Just so darn tired. But again, this could be all sorts of things—like the insatiable demands of home and work life.
14. But you can’t actually sleep. Thoughts race as you hit the pillow. Why can’t you just sleeeeeeep? And then:
15. You fall asleep only to wake yourself up again just moments later. The idea of a long stretch of sleep just doesn’t seem to be a thing anymore. Could be stress. Could be perimenopause. Could be a combo deal.
16. You just can’t seem to remember your dreams. This is a really weird one—particularly if you’re used to recalling dreams in great detail. You somehow suddenly don’t seem to have access to that faculty.
17. You can’t seem to remember things as well as you used to. If you’re worried about your memory, it’s a good idea to chat with your healthcare provider to make sure all is well.
18. So many pee problems. You want to pee all the time. You pee when you sneeze, jump, fart, laugh. Urgh. Come ooooooooon.
19. Hangriness is not a joke. When you need food, you need food. Those blood sugar crashes are more severe than ever.
20. You’ve got some weird cravings. At some weird times. Salty things. Sugary things. Things you haven’t even thought of eating in years. And at the most bizarre time. Yes, it appears the midnight snack is back in fashion.
21. You’re bloated. You’re retaining water as if you were on a long trip through the desert. Body, is this really necessary?
22. Your body is expanding. You have full license to feel whatever you want to feel about this—just try to throw out any shoulds when it comes to how you look. There are so many ways to be beautiful.
23. Balance is a challenge. You may feel lightheaded and dizzy at times. And:
24. You experience ringing or itching in your ears.
25. You’ve done some redecorating around your eyes. Dark circles. Mmm. Look at them shine.
26. Your hair is literally falling out. And not just on your head. But don’t worry. It seems to be appearing in other places to make up for it—boobs, back, chin.
27. Your teenage pimples are making a comeback. Who doesn’t love an acne reboot?
28. You thought it couldn’t get worse until… If you’re living with any chronic illnesses or pre-existing conditions, the hormone craziness that’s happening right now can set them in full swing. Be very, very kind to yourself.
29. You may be grieving. If (for any reasons that are totally your own) you didn’t have children, you may be feeling a sense of grief over this time. We just don’t talk about this enough. It’s real and it hurts. You’re allowed to be feeling what you’re feeling. Counseling can help a lot.
30. Your boobs feel like someone let out the air. Or:
31. Your boobs feel swollen. Either way:
32. They might feel tender or sore.
33. Your heart is aflutter. Palpitations one moment and racing another. This can be pretty scary—particularly if it’s a new experience for you. Your risk of heart disease is higher as you get older so check in with your doctor if you’re at all concerned. (There are no stupid questions when it comes to your health.)
34. Your extremities feel cold or tingling. This can be a symptom of a bunch of things, from diabetes to deficiencies in vitamins and minerals—so best to check in with your doctor about this one too.
35. You’re constipated and/or:
36. You have diarrhea. Sheesh, intestines. Could you pick a lane?
37. You’re all dried out. Skin, hair, everything.
38. It feels like bugs are crawling on your skin. Yeah, this is a pretty weird one. Sci-fi, much?
39. Your eyes are dry and itchy.
40. Your teeth hurt.
    We often shove these symptoms into the Little Room of Menopause Symptoms, lock the door and throw away the key. The reality is, they could be the result of something else. A full check-up can really help determine what’s what.

And then, please, please, please, can we just start talking about this more?

Okay. We’re rooting for you. All the best. 💕