Perimenopause is a natural part of life but its symptoms can often creep up on you. Typically, in your mid to late 40s, levels of oestrogen and progesterone start to fall and this can affect your body in many ways. Oestrogen receptors are all over the body (not just in the uterus and ovaries) which is why the range of perimenopause symptoms (around 45 of them!) can be so vast.

Understanding the key symptoms of perimenopause is the best way to help you prepare and manage them effectively. (Read here: Is There A Test For Perimenopause?)

Here are the top 10 most common symptoms of perimenopause you need to know about—and a few surprising ones you might not expect. 

The 10 Common Symptoms of Perimenopause

1. Irregular Periods 

During perimenopause, your periods may become unpredictable. They might be heavier or lighter than usual and may arrive more or less frequently. Eventually, they stop altogether as you transition into menopause. 

2. Hot Flushes/flashes 

Hot flushes are sudden waves of heat that can make you feel flushed and sweaty. They can feel very uncomfortable. They’re one of the most common symptoms of perimenopause and can happen during the day or night. Often only you can tell you are having a hot flash but sometimes they can cause redness and intense sweating as your body tries to cool itself down.

3. Night Sweats

Night sweats are hot flushes that happen while you sleep, often waking you up and leaving you damp with sweat and uncomfortable. They can disrupt your sleep (as you may have to get up to change clothing or bedding) and leave you feeling tired the next day. 

4. Trouble Sleeping 

Perimenopause often brings sleep issues. You might struggle to fall asleep, wake frequently during the night, or feel unrefreshed even after a full night’s sleep.  The next day you feel tired and have that jet-lagged feeling.

5. Mood Swings

Changes in hormone levels can affect your emotions. You might feel irritable, sad, anxious or rage for no apparent reason. Some women also experience heightened stress or a lack of motivation.  It’s really important to spot these symptoms early and take action so that anxiety and low mood don’t progress into bigger problems.

6. Brain Fog

Perimenopause can impact your ability to focus and remember things. Many women describe this as “brain fog,” where everyday tasks or words feel harder to recall.  Short term memory gets worse and some women feel so bad that they worry they’re slipping into dementia.

7. Changes in Libido

You may notice a lower interest in intimacy during perimenopause. This is often linked to falling sex hormones which drive libido and can be accompanied by vaginal dryness or discomfort during sex.  This can put a strain on partner relationships.

8. Weight Gain

Weight gain, especially around the belly, is common during perimenopause. Hormonal changes can slow your metabolism, making it easier to gain weight even with the same diet and exercise routine. 

9. Joint Pain and Stiffness

Aching joints and stiffness are symptoms that many don’t realize are connected to perimenopause. Lower levels of oestrogen can affect your bone and joint health, leading to these issues. 

10. Hair and Skin Changes

You might notice your hair becoming thinner or your skin feeling drier. Hormonal shifts can affect how your body produces collagen and other substances that keep hair and skin healthy. 

Surprising Symptoms You Might Not Expect

Perimenopause doesn’t just bring hot flashes and mood swings. Here are some lesser-known symptoms that might take you by surprise: 

Heart Palpitations:

Feeling like your heart is racing or skipping beats can be linked to hormonal fluctuations. Always consult a doctor if this happens. 

Tinnitus:

Some women report a ringing or buzzing in their ears during perimenopause. 

Burning Mouth Syndrome:

A tingling or burning sensation in the mouth can be another unexpected sign of changing hormones. 

Dry Eyes:

Hormonal changes can reduce tear production, making your eyes feel dry or irritated. 

Electric Shock Sensations:

Sudden, brief jolts of a buzzing or tingling sensation can occur, often linked to changes in your nervous system. 

Digestive Changes:

Bloating, constipation, or changes in gut health can be tied to perimenopause. Always consult your doctor if you notice persistent changes to your bowels.

Increased Allergies:

Hormonal shifts can make some women more sensitive to allergens. 

Body Odour Changes:

Your natural scent may change due to fluctuations in hormones. 

Tingling Extremities:

Numbness or tingling in your hands and feet may occur, though it’s less common. 

Why It’s Important to Know These Symptoms 

Perimenopause symptoms can sneak up on you (they did me) and may come and go throughout the month. Tracking your cycle and symptoms, such as mood, sleep, and physical changes, can help you spot patterns and identify what might be happening. For some women, perimenopause starts much earlier than they expect.

Other Factors to Consider  

A. Early Perimenopause 

For some women, perimenopause can begin earlier due to factors like IVF, chemotherapy, or certain ethnic backgrounds. Black, Latina, and Indigenous women are more likely to enter perimenopause earlier than the average. 

B. Premature Ovarian Insufficiency (POI) 

1 in 20 women suffer from premature ovarian insufficiency (POI), which can bring a very premature perimenopause.  If symptoms start before age 40, it could be due to POI. This condition causes the ovaries to stop functioning earlier than usual, leading to perimenopause symptoms. Speak with a doctor if you suspect this. 

C. The Role of Hormones in Your Health 

Oestrogen and progesterone don’t just regulate your periods—they also impact your sleep, brain, bones and many other organs of the body. Understanding their huge role can help you manage symptoms effectively. 

How to Manage Perimenopause Symptoms

• Track Symptoms: Use an app or journal to log changes in your cycle, mood, and energy. 
• Stay Active: Regular exercise can ease stress, improve sleep, and maintain bone health. 
• Eat Well: A balanced diet with plenty of protein, calcium and vitamin D supports your overall health. 
• Talk About It: Sharing your experiences with friends or a healthcare provider can help normalise this stage of life.  Find a support group – online or IRL.
• Explore Treatment Options: If symptoms are causing your problems consult your doctor about options like hormone replacement therapy (HRT), non-hormone medications and look at complimentary therapies and lifestyle changes too.  

Take Charge of Your Perimenopause Journey 

Perimenopause is a natural transition, but its symptoms don’t have to take over your life. By understanding these common and lesser-known signs and taking proactive steps to manage them, you can feel more in control and better prepared for what’s ahead. 

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