Stay up to date with our latest news...
Stay up to date with our latest news...
Written by
Stacy Miller
As women, we undergo many hormonal transitions throughout our lifetimes. From our first menstrual cycle to menopause and beyond, there are many stages our bodies go through. One change that doesn’t get as much attention as it should is perimenopause. Perimenopause means “near menopause,” when the ovaries begin producing less estrogen, causing a range of symptoms. Typically, natural perimenopause occurs after age 45, but early perimenopause can begin between ages 40 and 45. Knowing how to identify common signs will make it easier to recognize perimenopause and take steps to alleviate symptoms. So, what are the 34 symptoms of perimenopause? Keep reading to find out.
Perimenopause is a natural stage in a woman’s life when the ovaries become less responsive to brain signals, leading to significant fluctuations in estrogen and progesterone levels, which drop right before the final period. This hormonal decline leads to a range of symptoms. Natural perimenopause starts after age 45 and can last up to 10 years. Some women may experience early perimenopause between the ages of 40 and 45, but these changes are commonly tied to other conditions like thyroid dysfunction or pituitary issues.
It is important to note that having perimenopause symptoms from ages 35 to 40 is not a natural start of perimenopause but rather a condition called premature ovarian insufficiency. After 12 consecutive months without menstruating, a woman is no longer in perimenopause and has entered postmenopause. The list of perimenopause symptoms and menopause symptoms is very similar, because menopause is defined as 12 months after the final period and is the third stage of perimenopause.
Going through a transition like perimenopause can be scary, especially if you don’t know what to expect. One of the best ways to monitor the changes in your body is by tracking your perimenopause symptoms. Observing when you experience symptoms, including the time of the month, your physical activity levels, your diet, and more, can give you greater insights into how your body works. It also makes it easier for your doctor to determine the best course of treatment if necessary.
Since perimenopause is the natural transition to postmenopause, it’s important to keep track of your menstrual cycles so you can know when you’ve entered postmenopause. Of course, if you don’t know what perimenopause symptoms are, it will be difficult to track them. That’s why we’ve made this complete list of perimenopause symptoms, so you can know what to look out for throughout this transition. Fortunately, the chances are low that you’ll experience every symptom, but having this comprehensive list on hand is a valuable resource.
A common question we often get when discussing hormonal transitions is, “How many symptoms of menopause are there?” It’s understandable that you’d want to be prepared for this next stage when entering perimenopause. Fortunately (or unfortunately, depending on how you look at it), the menopause symptoms list is the same as perimenopause. So, when discussing the full list of perimenopause symptoms, you can count them as 34 menopause symptoms as well.
As we mentioned earlier, around age 45, a woman’s ovaries become less responsive to brain’s stimuli, which leads to changes in estrogen and progesterone production. The fluctuations can cause changes in your menstrual cycle, leading to irregular periods. These changes include:
You may also notice a longer time between periods as late perimenopause progresses, leading up to menopause.
One of the most common of the 34 signs of late perimenopause and menopause is hot flashes. A hot flash is when you suddenly become sweaty, flushed, and hot, typically in the chest, neck, and face. Since they can occur at any time, many women choose to dress in layers or keep a small fan on them so they can quickly cool off when hot flashes strike.
Mood swings aren’t fun for you or those around you, but they are a common symptom of early perimenopause. One minute, you may feel happy, and the next you’re angry or sad. Changes in your mood can directly impact your mental health, especially if these fluctuations become severe. You should seek medical advice from a professional if mood swings begin impacting your daily life.
When hot flashes happen at night, they’re called night sweats. Similar to their daytime counterparts, night sweats are believed to be caused by decreasing estrogen levels impacting the hypothalamus, the part of the brain responsible for regulating body temperature.
One of the 34 symptoms of menopause and late perimenopause is vaginal dryness. The lack of natural lubrication is due to decreased blood circulation in the vagina. Vaginal dryness can cause pain or discomfort during sex or bleeding, causing a decreased libido.
Breast tenderness, or mastalgia, is another possible symptom of perimenopause or menopause caused by hormonal fluctuations. The hormonal changes can cause fluid to build in the breast tissue, causing tenderness. You may also notice changes to their shape and fullness. Once menopause is over, the discomfort should subside.
With perimenopause 34 symptoms may seem like a lot, but it’s important to remember you most likely won’t experience them all at once. Headaches, however, are common. As your estrogen levels drop, you become more prone to migraines and headaches, similar to what you can feel during a period.
Since perimenopause and menopause are the results of decreasing sex hormones like estrogen, it’s no surprise that they can impact your libido. One hormone you may not realize is also affected is testosterone. While women have lower testosterone levels than men, it’s still a crucial hormone for sexual arousal. If these levels drop, you could be less interested in having sex.
One of the lesser-known symptoms of perimenopause and menopause is a burning mouth. It can feel like numbing, heat, tingling, tenderness, or burning around or in your mouth. Since the mucus hormones in your mouth also have receptors tied to sex hormones, when your estrogen levels drop, it can cause burning, discomfort, or pain.
When your estrogen levels decrease, it causes thinning of the vaginal tissue, leading to irritation and dryness in the vagina, which makes it more susceptible to urinary tract infections. If you experience 3+ UTIs in a year or 2+ in 6 months, they’re considered recurrent, and you should speak with your doctor to discuss prevention and treatment.
Just like in puberty, hormonal changes during perimenopause can cause acne flare-ups. Because your skin is often thinner and drier as you age, you should avoid using products that cause further dryness. Topical retinoids, such as retinol, are commonly helpful to reduce comedons and inflammation.
Similar to a burning mouth, the sex hormone receptors in your mucus glands can cause changes to your sense of taste during menopause. Dry mouth is also common, which can cause cavities and gum disease, so it’s important to have regular visits with your dentist during perimenopause.
Another interesting way your sex hormones impact your health is their connection to your gut microbiome. Changes to your gut flora composition during perimenopause may impact how your body reacts to different foods, which can cause bloating, stomach upset, and more. What is a bit unexpected is that changes in reproductive hormones do not seem to impact digestion, but how you perceive and deal with stress does.
Another common symptom of early perimenopause is fatigue. There are numerous possible causes of feeling tired during this life transition, including poor sleep quality, stress, and normal hormonal fluctuations.
Hormonal changes can impact skin hydration and collagen production, which can cause your skin to feel dry and itchy. While this uncomfortable sensation can be anywhere, it’s often most prevalent in your vulva.
Estrogen is a multi-functional hormone, with two of its roles being keeping your joints lubricated and decreasing inflammation. Since it also helps regulate fluid levels, you may find your joints become more achy during menopause. Menopausal arthritis is another possibility during this stage.
During perimenopause, you may notice changes in your sleep patterns. Some women find they wake up earlier, have trouble falling asleep, or sleep lighter during the night.
Similar to joint pain, you could experience muscle aches or tension as your hormones fluctuate. Light stretching and staying active can help keep your muscles loose and pain-free.
Another interesting perimenopause symptom is electrical shock sensations throughout your body or paresthesia. While the reasoning behind these feelings is unclear, it’s believed to be caused by how your nervous system responds to hormonal fluctuations during this period of time.
Ovarian hormone changes can cause hair loss during perimenopause as your hair follicles shrink, causing your hair to shed more easily and grow slower. Proper nutrition can help with hair thinning, however, for some women medications could be required.
Difficulty concentrating and brain fog can make it harder to focus due to dropping estrogen levels. Typically these issues tend to happen during the early perimenopause stage.
Along the same lines as trouble concentrating are lapses in memory. Also, due to lowered estrogen levels paired with sleep issues, you may find your memory isn’t as sharp as it was before.
Frequent urination or stress incontinence is when you feel a suffer or frequent urge to urinate. It’s also called an overactive bladder and is due to hormonal fluctuations that cause a weakening of the pelvic and bladder muscles.
If you have sudden or unexpected panic attacks, it could signal a panic disorder. Hormonal changes can be to blame, or even the anxiety of having a panic attack.
Many women find it harder to maintain their weight during perimenopause and menopause due to a slowing metabolism. Dropping estrogen is again the culprit, often paired with a decrease in physical activity. Mood swings may also play a role by impacting your eating habits.
Some women may find their nails become more brittle during perimenopause due to insufficient keratin production. As a response, they can break and crack more easily.
Heart disease is a leading cause of death worldwide, so experiencing palpitations or an irregular heartbeat can be frightening. Some women may have these symptoms during menopause, and it’s important to talk with your doctor to ensure they aren’t caused by an underlying issue.
Dizziness is another common symptom of perimenopause, but the reason behind it is still unclear. One study found a link between anxiety and dizziness during these life stages.
Estrogen plays a key role in maintaining bone density, which is why you should be aware of developing osteoporosis during menopause and postmenopause. This condition causes fragility in the bones, causing them to break more easily.
You may be surprised to learn that during perimenopause your allergic reactions can exacerbate. During perimenopause under influence of spiking estrogen levels, as they tend to fluctuate significantly during late perimenopause, asthma and allergic rhinitis can get worse.
This symptom can cause panic attacks and may feel worse at night. Fortunately, it should even out once your hormone levels stabilize.
The changes in hormone behavior and levels that come with perimenopause can cause a depressed mood in some women. Add in poor sleep and anxiety, and maintaining your mental health can become a challenge. Speaking to your doctor and therapist can be very helpful in developing a coping strategy.
Tinnitus is commonly known as a ringing in the ears, but it can also sound like buzzing, roaring, squealing, hissing, clicking, humming, or whistling. It’s believed that hormone changes can be to blame since there’s no external causes.
Irritability is very common during early and late perimenopause stages. Journaling, taking walks outdoors, and meditation can make it easier to control irritation.
Answering the question of “What are the 34 symptoms of menopause and perimenopause?” is a great first step, but you also want to know how to treat them.
If your symptoms interfere with your daily life or become severe, you should consult with your doctor. You don’t have to suffer alone; they can help you create a treatment plan to help you feel better.
Understanding how your body works through every stage of life can take the fear out of perimenopause. Hormona is proud to offer our award-winning hormone tracker, the revolutionary app that provides insights and tools to help you understand your body and feel your best.
According to STRAW + 10, there are three stages of perimenopause: early, late, and menopause. Each stage is determined by specified bleeding criteria and hormone behavior.
The first signs that perimenopause is starting are often heavier and irregular periods, mood swings, depressed mood, sleep disturbances, forgetfulness, issues with concentration.
During perimenopause, you should avoid smoking and excessive alcohol since they can worsen your symptoms.
In this context, red flags could include unusual or concerning symptoms that may signal that you’re entering perimenopause or that you need to consult a healthcare provider. Red flags for perimenopause are weight gain, irregular periods, brain fog, vaginal dryness, headaches, joint pain, and urinary issues.
On average, women begin perimenopause after age 45. Early menopause is characterized as starting between the ages of 40 and 45, while premature ovarian insufficiency occurs from 35 to 40 and is not a natural start of perimenopause.
-
Dr Singh is the Medical Director of the Indiana Sleep Center. His research and clinical practice focuses on the myriad of sleep.
What does spotting before your period look like? Spotting is a few drops of blood on your underwear that are not enough to soak a pad. It’s typically brown, light pink, or red and may only be noticeable on a
Postpartum hormonal changes: What are they? Postpartum hormonal changes occur when your body experiences shifting hormone levels after birth. After your baby is born, the doctor removes the afterbirth or placenta, which sends signals to your body that you’re no
What is ovulation fatigue? As women, we can get numerous symptoms throughout our menstrual cycles. One question we’re asked is, “Why do you get tired during ovulation?” For some, the answer could be ovulation fatigue. Ovulation fatigue is when you
Hormona© 2025, All Rights Reserved
