Why You Should Track the 34 Symptoms of Perimenopause
Are you tracking your periods? What about tracking symptoms related to your periods and hormonal fluctuations?
If you’re not tracking common symptoms related to hormonal fluctuations alongside your menstrual cycle — let this be your sign to start now!
Here’s why: there are 34 symptoms of perimenopause — including things like poor sleep, brain fog, fatigue, anxiety, and even allergies. They’re all triggered by rising and falling estrogen levels that are indicative of perimenopause.
With most of these symptoms, it’s easy to explain them away and point the blame to ‘something else’. While ‘something else’ may be the cause — if you’re in your late 30s, 40s, or 50s you need to be aware of the common symptoms of perimenopause, because chances are that’s what’s going on! And the sooner you pay attention to them, the sooner you can do something about them.
Why you should log perimenopausal symptoms
When you log perimenopausal symptoms alongside your periods you’ll start to see trends of when symptoms worsen, when they subside, and what symptoms are linked to one another. Knowing what to expect will help you better manage your own wellness (and happiness)!
Keeping a record of your symptoms will also give you a powerful history to take to your next doctor’s appointment so you can better advocate for yourself and your health needs.
Lastly, recording your habits will help you see what it is that you’re doing that is helping (or triggering) certain symptoms.
Now that you know the importance of tracking symptoms, let’s talk about the 34 recognized symptoms of perimenopause.
What are the 34 symptoms of perimenopause?
If you’ve Googled this before you’ll find that most lists are very similar… with some differences here and there. So, what’s the reason for this?
It’s mostly due to various methods of grouping symptoms that have similar features. For example, genitourinary syndrome of menopause (GSM) encompasses things like vaginal dryness, vaginal itching, and more frequent urination, while vasomotor symptoms (VMS) encompass hot flashes and night sweats. You may find these groupings in some lists and not in others, so the list of 34 can vary slightly.
We’ve listed the 34 most commonly recognized symptoms of perimenopause so you can know what to look out for.
Irregular periods
This is one of the first symptoms that most women report! It doesn’t mean it’s the first symptom you’ll have, but it’s often the easiest one to recognize. You may find your periods get longer or shorter, that they are heavier or lighter than before, or even that your time between periods changes. There’s no standard experience here, so it’s all about noticing any differences from your regular rhythm.
Weight gain
Unwanted weight gain — especially around the abdomen — has been associated with perimenopause and menopause for a long time. As estrogen levels drop, your body begins to store fat in the middle region of the body rather than around your hips and glutes. We also naturally lose muscle mass as we age, and metabolism slows down with less muscle, which can further contribute to unwanted weight gain.
Hot flushes
These are the most common symptom that around 80% of women experience during perimenopause. As the name suggests, you’ll likely feel suddenly hot and sweaty, and maybe become a little flushed in the face and neck. The exact cause isn’t known yet, but researchers believe it’s likely linked to lower estrogen levels causing the hypothalamus to become more sensitive, which acts as the body’s temperature regulator.
Insomnia & disrupted sleep
Sleep issues affect around 50% of women during perimenopause. Some find it more difficult to fall asleep, which can be exacerbated by anxiety and heart palpitations. Others find that they wake up more frequently through the night, and this is largely due to fluctuating progesterone levels, as this “sleepy hormone” works to keep you in a deeper state of sleep through the night. Night sweats also contribute to disrupted sleep throughout the night. Ultimately, if you’re not getting a good night’s rest, you might notice other symptoms like mood swings, brain fog, and hot flashes become more prominent too.
Night sweats
Night sweats are basically hot flushes while you sleep. These intense feelings of heat can leave you with slightly damp pajamas in the morning, and make getting that good night’s rest feel quite difficult. Night sweats definitely contribute to disrupted sleep as well, and many women report waking up in the middle of the night with this all-over sweaty feeling.
Difficulty concentrating
Perimenopause is considered a neuroendocrine change process, which means it’s directly linked to interactions between our nervous system (our brain) and our endocrine system (our hormones). Some evidence suggests women are more likely to experience cognitive disturbances earlier on in their perimenopause (like the first year) than women who are further along in their journey. Another symptom that’s similar you may have heard of is…
Brain fog
Feeling like you can’t think as quickly as you used to or struggling to find the right words? All of these feelings can come as a shock and can be quite scary. But knowing that it’s a normal and common experience can make it a bit more manageable. Current research suggests that at least 60% of women experience brain fog in relation to hormonal changes that come with age.
Headaches
Headaches and migraines can be caused by a dip in estrogen levels, similar to PMS headaches that you might get before a period. Since hormone fluctuations can be unpredictable, headaches might happen more frequently, and erratically. If you were prone to PMS headaches, you may be more likely to get them in perimenopause.
Dizziness
Getting a dizzy spell is never fun, and it can lead to falls or trouble balancing. As estrogen levels drop and impact insulin production, it can become more difficult to keep blood sugar levels stable which can lead to dizziness. One Japanese study found around 1/3 of women felt dizziness a minimum of once a week.
Heart palpitations
These palpitations are feelings of a flutter, racing, or irregular beat that only last a few seconds or minutes. They can feel alarming but aren’t necessarily a cause of concern. Low estrogen levels can lead to an overstimulation of the heart that can cause non-threatening arrhythmias. However, if you have any concerns at all, please bring them to your doctor. If you have a family history of heart disease, it’s important to have other more serious conditions fully ruled out.
Mood swings
Estrogen regulates a key influencer of your brain chemistry: neurotransmitters. Serotonin, dopamine, and norepinephrine are neurotransmitters that all influence mood, memory, and cognition. So as estrogen and progesterone fall out of sync, our emotions and ability to focus can become out of balance, too.
Depression
When hormonal imbalances hit, so can mood disorders like depression. Approaching menopause increases your risk of major depressive disorder, and it’s believed that 38% of women in late perimenopause experience symptoms of depression. Depression is also closely linked to other mood disorders, including the next two symptoms below…
Anxiety
As fluctuating hormones play a role in our emotional regulation, over 50% of women in perimenopause experience symptoms of anxiety, including panic attacks (more on those below). If you have a previous diagnosis of mental illness, you may be particularly sensitive to hormonal imbalances during this time. Check out this post to learn about the link between hot flushes and anxiety.
Panic disorder
If someone’s experiencing heavy anxiety, they may experience moments of panic that can significantly impact their quality of life. These can happen unexpectedly and cause you to breathe heavily, sweat, tremble, and feel an impending sense of “doom”. Panic disorders are generally more immediately debilitating than generalized anxiety, and will subside more quickly, which is why they are recognized as their own symptom.
Irritability
One study found that irritability might be one of the most common symptoms, as it occurs in about 70% of women! Scientists hypothesize that increased irritability is rooted in massive hormonal changes that tip the balance between key neurotransmitter systems in the brain. As estrogen and progesterone naturally wane, testosterone spikes lead to shifts in mood and can make feelings of anger or irritability more likely.
Low libido
Libido is largely driven by testosterone. As females, we do have testosterone naturally present in our bodies, but our levels can drop as we age and that can impact our sex drive. It might take you longer to get aroused, but it also might be compounded by vaginal dryness that makes intercourse more uncomfortable, making you less interested in initiating physical intimacy.
Vaginal dryness
Low estrogen in women can cause dryness and thinning of bodily tissues — and this impacts your vaginal tissues as well. Vaginal discomfort and itching are common in perimenopause— with studies suggesting that it impacts 1 in 3 women.
Stress incontinence
Your pelvic floor muscles weaken over time, and there is a decrease in muscle mass that can contribute to less control of your bladder. Things like age or if you’ve had a previous pregnancy or childbirth can contribute to how significantly you experience this symptom. Some women might experience an occasional leak when sneezing, coughing, or laughing, but pelvic floor exercises are a great way to strengthen these muscles!
Digestive problems
Progesterone (another key reproductive hormone) acts as a diuretic and fluctuating levels can lead to some less-than-fun bathroom issues, like constipation and bloating. But as your hormones fluctuate, your gut microbiome changes too, and certain foods may no longer sit well in your stomach.
Bloating
Estrogen helps your body retain water. When estrogen levels are higher than usual, it can lead to bloating. Remember — in perimenopause estrogen isn’t just depleting it’s actually rising and falling more erratically than usual! Bloating looks different than weight gain, as it should only be short-lived, and can seem as though your stomach is changing throughout the day depending on what you eat and drink. You may notice this comes and go around the time of your period.
Joint pain
Estrogen helps keep joints lubricated and moving smoothly as it regulates fluids in the body and decreases inflammation. In addition, a decrease in collagen production can lead to less joint cushioning and weaker muscles overall — putting more strain on your joints.
Muscle tension
Similar to joint pain, estrogen is key for keeping muscles and joints happy and pain-free. A drop in estrogen levels could lead to feeling stiffer and less flexible, which is why proper warm-ups before exercising are key! Practice daily stretching to help relieve muscle tension and joint pain and increase synovial fluid that keeps joints lubricated.
Body odor & excessive sweating
Hormonal changes can affect many things such as body odor and sweating. As your skin health changes and your skin microbiome is impacted by hormone changes, you should see odor changes level out as your hormones do. You may simply be sweating more with hot flashes and night sweats, and high levels of anxiety or stress can also lead to more sweating.
Breast soreness
Similar to the soreness you may feel around your period, hormonal changes can cause a buildup of fluid in the breasts that can cause them to be more tender and swollen. Some may feel this as throbbing pain, while others feel it as a dull ache or burn. Breast changes during perimenopause are normal, but it’s always good to stay on top of breast health. It’s recommended to talk with your doctor about breast cancer screening after 40 years old.
Hair loss
As estrogen levels fall and testosterone becomes more dominant (relatively speaking) this comparably higher level can lead to what is known as androgenic symptoms, such as hair loss. Collagen is also critical for skin, hair, and bone health, and by age 30, we start producing less and less collagen. It’s possible to lose around 1% of collagen per year, even if we’re getting all the right nutrients. Another symptom linked to collagen is…
Brittle nails
Keratin is a primary protein in hair and nails, and some of the amino acids needed to build keratin are found in collagen. A decrease in collagen and keratin can lead to an overall change in your nail and skin health.
Itchy skin
This has to do with collagen production as well! Lower estrogen levels associated with perimenopause contribute to thinner, dry skin and a reduced moisture barrier. This can mean getting itchy skin more often. Focusing on internal and external hydration will pay off!
Burning mouth
As estrogen drops, this could mean a few changes like more sensitive teeth and yes, a burning mouth. Burning mouth syndrome causes burning, tenderness, and pain around the mouth, tongue, cheeks, and lips. It’s not common, with only around 2% of the population experiencing it, and it’s more common in post-menopause.
Changes in taste
Food might be tasting a bit different than usual, or your mouth might taste different even when you’ve not had anything to eat or drink. This could mean experiencing stronger flavors, or even a metallic or salty taste in your mouth during perimenopause. Estrogen impacts your saliva production and as hormone levels lower, a dry mouth makes it harder to taste food can make it taste a little different. Your taste buds need saliva to break down food for sweet, sour, salty, bitter, and savory taste receptors.
Bleeding gums
Estrogen plays a role in regulating inflammation, and as those levels decline, gum inflammation can be more likely to happen and cause bleeding gums. So even if you’re flossing and brushing every day, you might still experience minor bleeding in the gums.
Tingling extremities
While it’s not incredibly common, you may experience tingling ‘pins-and-needles’ feelings! As hormones impact the central nervous system, these feelings could happen in the feet, legs, hands, or arms, and typically subside after only a few minutes.
Electric shocks
Electric shock feelings are often painless and short-lived sensations often described as zaps, shocks, or tingling. This can be localized to one place or experienced all over your body. When your hormones start to go haywire, signals may get crossed, amplified, short-circuited, or otherwise distorted, causing these ‘shock’ sensations to occur. Some studies believe it may be linked to neuropathic pain, which is when the nervous system mistakenly triggers a pain sensation as estrogen impacts nerve function.
Osteoporosis
About half of women over 50 will break a bone due to osteoporosis at some point in their life. That’s because testosterone isn't the only muscle-building hormone in your body — estrogen also plays a role here! Estrogen helps absorb calcium which keeps bones strong and boosts bone-making cells called osteoblasts. Strength training helps to build muscle, increase strength, and can also decrease the risk of osteoporosis by increasing bone density.
Allergies
We saved this one for last because it’s just that important! Heightened allergies can make just about every other symptom of perimenopause worse, and it’s one of those symptoms that’s easy to brush off. But you may be needing a different allergy regimen than you’re used to! Your body’s immune-regulating cells have estrogen receptors, and when estrogen levels fluctuate, this can impact how they react to a potential allergen. Estrogen also plays a role in regulating inflammation in the airways, and both of these factors may be why some women experience asthma symptoms for the first time during perimenopause.
Are you ready to start tracking your symptoms alongside your cycles? The MBODY app makes it easy to do so! Complete your daily guided daily check-in and log your symptoms to get personalized recommendations to help you better manage whatever it is you’re dealing with. Download today on the App Store and Google Play Store. Be sure to check out our Instagram @mbody.official for the latest healthy aging tips.
