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Understanding Perimenopause: A Guide to Its 34 Common Symptoms

Perimenopause marks a significant transitional period in a woman’s life, preceding the full onset of menopause. This phase can begin several years before menopause, when the ovaries gradually produce less oestrogen. Perimenopause varies widely among women, with most beginning to experience it in their 40s, but it can start as early as the mid-30s. Understanding the symptoms can help manage this natural process more effectively. Here, we delve into the what are the 34 symptoms of perimenopause, providing insights and suggestions for relief.

34 symptoms of perimenopause

1. Irregular Periods

The most noticeable sign of perimenopause is the change in menstrual cycle regularity. Periods may become unpredictable, and the flow can vary.

2. Hot Flashes

Sudden waves of heat that spread through the upper body are common. They can last from a few seconds to several minutes and may be followed by chills.

3. Night Sweats

Hot flashes during sleep can lead to excessive sweating, which disrupts sleep quality.

4. Sleep Problems

Many women experience insomnia or disrupted sleep patterns due to night sweats or hormonal changes.

5. Mood Swings

Fluctuating hormones can cause significant mood changes, leading to feelings of irritability, anxiety, or depression. It is one of the most common 34 symptoms of perimenopause.

6. Vaginal Dryness

Decreased estrogen levels can reduce vaginal lubrication, causing dryness and discomfort, particularly during intercourse.

7. Decreased Libido

Hormonal changes often lead to a reduced interest in sex.

8. Breast Tenderness

Breasts may feel tender or sore during the perimenopausal transition.

9. Weight Gain

Metabolic changes can make it easier to gain weight, especially around the abdomen.

10. Urinary Urgency

A need to urinate more frequently or urgently is common, and some women may experience urinary incontinence.

11. Dry Skin, Eyes, or Mouth

Lower estrogen levels can affect the moisture levels in various body parts, leading to dryness.

12. Fatigue

Many women feel unusually tired during perimenopause, which may be exacerbated by sleep disturbances.

13. Memory Lapses

Short-term memory problems and difficulties concentrating are often reported.

14. Hair Loss or Thinning

Hormonal fluctuations can lead to hair thinning or loss.

15. Increased Heart Rate

Some women experience heart palpitations or an increased heart rate during perimenopause.

16. Headaches

New or worsening headaches, including migraines, can occur.

17. Joint and Muscle Pain

Aches and pains in the joints and muscles are commonly reported symptoms.

18. Digestive Problems

Changes in hormone levels can affect digestion, potentially leading to stomach upset, bloating, or changes in bowel habits.

19. Electric Shock Sensation

A feeling of electric shocks, often preceding hot flashes, may occur, particularly in the head and neck areas.

20. Gum Problems

Increased susceptibility to gum disease, bleeding gums, or a burning sensation in the mouth can develop due to hormonal changes.

21. Tingling Extremities

Numbness or tingling sensations in the hands, feet, arms, and legs are possible.

22. Itchy Skin

Changing hormone levels can lead to itchy skin.

23. Body Odor Changes

Some women notice a change in their body odor during perimenopause.

24. Irritability

Fluctuations in hormone levels can cause significant irritability.

25. Anxiety

Many women report new or worsened feelings of anxiety during this transitional period.

26. Depression

Perimenopause can trigger depression or depressive symptoms in some women.

27. Panic Disorder

Instances of panic attacks or panic disorder may increase during perimenopause.

28. Stress Incontinence

Laughing, sneezing, or coughing can cause small amounts of urine to leak, known as stress incontinence.

29. Bloating

Hormonal fluctuations can cause feelings of bloating.

30. Changes in Fingernails

Fingernails may become brittle or split more easily.

31. Allergies

Some women develop new allergies or find that existing allergies worsen.

32. Osteoporosis

Decreased estrogen levels can lead to a decrease in bone density, increasing the risk of osteoporosis.

33. Irregular Heartbeat

Women may experience irregular heartbeats or arrhythmias.

34. Changes in Body Fat Distribution

Fat may begin to redistribute itself, particularly accumulating around the abdomen.

Managing Symptoms

  • Lifestyle Adjustments

  • Exercise Regularly: Regular physical activity can help manage weight, improve mood, and enhance overall health. Activities like yoga and Pilates can also reduce stress and promote relaxation.
  • Maintain a Healthy Diet: Eating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can help stabilise your energy levels and mood. Foods high in calcium and vitamin D are essential for bone health, while those rich in phytoestrogens, like soy products, may help balance hormones.
  • Stay Hydrated: Drink plenty of water to combat dry skin and vaginal dryness. Staying hydrated also helps with bloating and digestive issues.

2. Symptom-Specific Treatments

  • Hot Flashes and Night Sweats: Dress in layers and use breathable fabrics like cotton. Keep your bedroom cool at night, and consider using a fan or cooling gel pillow. Avoid triggers like spicy foods, caffeine, and alcohol.
  • Sleep Disturbances: Establish a calming bedtime routine to enhance your sleep. This might include reading, meditation, or a warm bath. Avoiding screens before bed and keeping a consistent sleep schedule can also improve sleep quality.
  • Mood Swings and Emotional Health: Engage in activities that reduce stress, such as meditation, deep breathing exercises, or mindfulness. Connecting with friends and family can also provide emotional support.

3. Natural and Alternative Remedies

  • Herbal Supplements: Some women find relief with herbal supplements such as black cohosh, red clover, or evening primrose oil. However, it’s important to consult with a healthcare provider before starting any supplement, as they can have side effects and interact with medications.
  • Acupuncture and Massage Therapy: These therapies can help reduce stress and alleviate symptoms like pain and mood swings.

4. Medical Interventions

  • Hormone Replacement Therapy (HRT): HRT can be effective in treating many perimenopausal symptoms, including hot flashes, night sweats, mood swings, and vaginal dryness. Discuss the benefits and risks with your healthcare provider to determine if HRT is appropriate for you.
  • Antidepressants: For severe mood swings or depressive symptoms, antidepressants may be prescribed. These can help stabilise mood and improve overall emotional well-being.


Perimenopause is a significant phase in a woman’s life, marked by a range of symptoms that can affect physical health, emotional well-being, and quality of life. Knowing the 34 symptoms of perimenopause and various ways to manage them can empower women to navigate this transition more effectively. By seeking support from healthcare providers and maintaining a healthy lifestyle, many of the challenges of perimenopause can be mitigated.

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