The 35 Symptoms of Perimenopause

by Magnolia on March 10, 2016

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Update: This post was originally written in 2010.  It has been edited and updated to reflect the current position and opinions of The Perimenopause Blog in 2016

When I was in the midst of the worst of my perimenopause symptoms, I was convinced that I was going crazy. Yes, I had hot flashes, night sweats, irregular periods and those gawdawful mood-swings. But without question, the most compelling emotion I experienced during that time was the feeling that I was finally going nuts. In fact, it was my anxiety and emotional turmoil that drove me to begin blogging about perimenopause in the first place.

Like most women, I needed to talk through my anxiety and emotional angst so that I could sort through the feelings and make some sense out of what was happening to me. Perhaps that is what has brought you here as well. Maybe you’re feeling crazy too, vulnerable, not yourself, and hanging on by a very thin thread. So, before I go any further, let me say very plainly – I understand, and you are not going crazy.

It’s difficult to explain to others what perimenopause feels like. It’s especially difficult to explain to husbands who can’t begin to understand or even remotely connect to the female experience. Not only is this frustrating but it can add to the feelings of isolation and vulnerability.

The symptoms of perimenopause are long and varied. You may have many or you may have a few. But there is no typical perimenopausal experience, though most women seem to have hot flashes, night sweats, irregular periods and mood-swings. In fact, these four symptoms are usually what signals to women that they are in perimenopause.

As of right now, most experts, health care providers and those devoted to understanding and helping women in perimenopause agree there are at least 35 symptoms of perimenopause. It’s not necessarily a comprehensive list but it’s certainly a good starting point.

35 Symptoms of Perimenopause

  • Hot flashes, flushes, night sweats and/or cold flashes, clammy feeling
  • Irregular heart beat
  • Irritability
  • Mood swings, sudden tears
  • Trouble sleeping through the night (with or without night sweats)
  • Irregular periods; shorter, lighter periods; heavier periods, flooding; phantom periods, shorter cycles, longer cycles
  • Loss of libido
  • Dry vagina
  • Crashing fatigue
  • Anxiety, feeling ill at ease
  • Feelings of dread, apprehension, doom
  • Difficulty concentrating, disorientation, mental confusion
  • Disturbing memory lapses
  • Incontinence, especially upon sneezing, laughing; urge incontinence
  • Itchy, crawly skin
  • Aching, sore joints, muscles and tendons
  • Increased tension in muscles
  • Breast tenderness
  • Headache change: increase or decrease
  • Gastrointestinal distress, indigestion, flatulence, gas pain, nausea
  • Sudden bouts of bloat
  • Depression
  • Exacerbation of existing conditions
  • Increase in allergies
  • Weight gain
  • Hair loss or thinning, head, pubic, or whole body; increase in facial hair
  • Dizziness, vertigo, light-headedness, episodes of loss of balance
  • Changes in body odor
  • Electric shock sensation under the skin and in the head
  • Tingling in the extremities
  • Gum problems, increased bleeding
  • Burning tongue, burning roof of mouth, bad taste in mouth, change in breath odor
  • Osteoporosis (after several years)
  • Changes in fingernails: softer, crack or break easier
  • Tinnitus: ringing in ears, bells, ‘whooshing,’ buzzing etc.

What Treatment Options are Available?

Many women choose hormone therapy to help with the symptoms.  I was not one of them during my own years of perimenopause, and frankly, it’s a decision that I’ve come to regret. Like a lot of women, I was concerned that if I used hormones it would cause more problems than it would help. So I made the decision to white knuckle my way through it.  But I’ve learned a lot since then and if I could back and rethink that choice I would.

I am currently 5 years post-menopause and have been using both the Vivelle Dot Patch (a bioidentical estradiol) and Prometrium ( a bioidentical progesterone).  Though it should be said that symptoms during actual menopause are quite different the symptoms of perimenopause.  And that distinction is important.

If you decide you would like to use hormone therapy be sure and do your research on the difference between synthetic hormones and bioidentical hormones.  I will tell you right now that there are medical professionals who will tell you that bioidentical hormones are nothing more than a marketing scam.  But, I beg to differ.


Here is a link to a PDF file put out by Harvard School of Medicine which outlines the difference between synthetic hormones and bioidentical hormones.  It’s a great reference sheet to have and to take with you when you see your physician.

Do Your Own Research and Educate Yourself

It’s very important that you take the time to do your own research and decide for yourself how you feel about hormone therapy.  If, after you’ve done your research you still do not feel that hormone therapy is the best option for you, there are plenty of other ways to approach perimenopause as well.  The point is, we do have options and there is no reason to suffer with perimenopause when we don’t have to.


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{ 12 comments… read them below or add one }

Joanne April 10, 2016 at 5:34 pm

Hi I am 43 in 3 weeks this site is great read the symptoms on peri menopause and I am sure it is what’s happening to me my periods are just all over nothing much then heavy the anxiety is through the roof it’s making going to work hard I can have a panic attack just waiting for the bus if it is late I carnt sleep all of a sudden I will get hot and feel like I am in my own bubble I am getting facial hair my mood swings are really bad I live with my husband and two sons so have no females even though there great my muscles ache a lot I itch quite a lot especially on a night time my list just goes on could I be in per menopause


Kim April 11, 2016 at 11:56 pm

I’m almost 44. I’ve had four kids, peri-partum cardiomyopathy in 2004, and have had Mirena for about 3 years now. I’m a pack-a-day smoker. I’ve tried very hard to quit 2 different times over the past year, and went off the chain with anxiety, to the point where even the doctor told me to give it some time before I try again. Feel like I’m going crazy. Due for bloodwork here shortly, and trying to find a new OB/GYN.

My list includes: Cold flashes, clammy feeling (and I’ve usually been one that was always warm). Irritability, mood swings, sudden tears, trouble sleeping through the night, irregular periods – almost constant bleeding, sometimes heavy, sometimes light, crashing fatigue (constantly), anxiety, feelings of dread, apprehension, doom (I’ve been diagnosed with Generalized Anxiety Disorder in the past, so this isn’t totally unusual for me, but it’s been a good while since I’ve had this intense anxiety), difficulty concentrating, disorientation, mental confusion – including getting dizzy/vertigo when sitting up or trying to stand up, incontinence, especially upon sneezing, laughing (um… yeah), aching, sore joints, muscles and tendons, breast tenderness, headache change: increase or decrease (migraines that I’ve dealt with since I was a teen decreased for 6 months, are now back with a vengeance), gastrointestinal distress, flatulence, nausea, Sudden bouts of bloat (gained 15 pounds last month with no changes in activity or eating, lost 10 just as quickly), depression (diagnosed back in 2003, haven’t really struggled with it since… but it’s back, also with a vengeance), dizziness, vertigo, light-headedness, episodes of loss of balance (yes!), tingling in the extremities (doc said it could be beginnings of carpal tunnel), gum problems, increased bleeding, tinnitus: ringing in ears, bells, ‘whooshing,’ buzzing etc. (have had all of these since I was a teen as well, but the volume seems to have increased). I also have shortness of breath, which causes severe anxiety attacks.


Leigh S. April 12, 2016 at 1:37 am

Anyone have a sore scalp?


Judy S. April 15, 2016 at 6:33 pm

When I first started with perimenopause symptoms about 10 years ago, I had tingling and tightness sensation in my scalp. Was not sure what was causing this until I read the symptoms for perimenopause. It still happens every now and then but glad I know what is causing it.


Leigh S. April 17, 2016 at 4:07 pm

Hi Judy,

This started about a week ago. It is only on the right side, slightly above my ear. I guess it might feel a little tingly but when I touch my scalp it feels sore. I thought maybe I hit my head but don’t remember doing that. It is the strangest thing. Recently started on new medication so thought maybe it was that. Or this new probiotic that I started. I tend to feel like I have a dull headache on that side as well. It is always something. So aggravating.


Treena May 1, 2016 at 3:37 am

Make sure it is not shingles, I have had that recently and it sounds a bit like it, only mine was on my legs


Olga C. April 12, 2016 at 1:56 am

Tender and tight, somewhat sore…


Leigh S. April 16, 2016 at 12:06 am

Hi Olga,

How long have you had it? Are you also having headaches?


Denise April 17, 2016 at 3:51 am

Anyone’s anxiety stay with them all day in the chest? It feels like a spasm that won’t release. Just don’t know anymore. I am on Lisinipril and read some blogs on this medication and isome of people’s side effect kind of mimics some symptoms of perimenapause. Anxiety joint pain etc. Have doctors on the 26th I love you hink I will have him change my bp meds to see if any of these symtoms go away . I sick of feeling like I have some fatal disease it’s exhausting!!


Jay April 21, 2016 at 3:41 pm

I’m just coming out of one of the most horrendous anxiety crashes in my life due to this. I didn’t know what the hell was going on. Checked my menstrual calendar and log and Monday last week I ovulated, I literally couldn’t stop crying and felt so sad but no reason. I’ve had hot flushes for a while but each time I started my period again they’d go away, this time the hot flushes have started earlier and the anxiety has been so bad I wanted to die. The anxiety hangs around my stomach and back all day long at the moment, and down my arms. I just thought it was my depression again but it’s like everything came crashing round my ears. I hadn’t slept well for ages either. Now looking back, looks like I’ve had this a fair few years, just battled through it with green tea (which I think is vile) and holding on to hopes. I’m now taking Menopace plus and hoping it will work. I don’t remember my mum going through this, and I certainly didn’t expect it to be as bad as this! What the hell!!


Treena May 1, 2016 at 3:32 am

Hi ladies

Does anyone on here have or had a Mirena, I am interested to hear anyone’s experience with side effects and how they are similar to symptoms of Perimenopause, I have had one for 7 months and am not sure weather it is that or peri that is making me feel horrible

Thanks Treena 48 years old from Austrlaia


Stephanie May 2, 2016 at 12:42 am

I am a 43 year young athlete that in the past year could give a hoot about anything other than sleeping, and not sweating like an idiot in the freezer section of the grocery store. Three weeks late and no, not preggers. This last year I’ve been all over the place with my cycle, and this is the longest I’ve gone without having it. But, lucky me, I still have horrendous cramping, bloating, and all the lovely fun that comes with me actually having a period. I’m guessing I’m in the beginning stages of perimenopause, and couldn’t be more excited. 😎 At this point in my life, had three pregnancies, resulting in two amazing kids, so it’s just wasted space in my book!
So happy I stumbled upon this blog. I truly don’t feel alone anymore!


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