The 30+ Symptoms of Perimenopause

The menopause transition can affect how we think, how we sleep, and how we feel. On average, each of us will experience about seven symptoms related to the menopause transition.  The reality is there are 30+  symptoms of perimenopause. For many women these symptoms can be managed with a combination of lifestyle changes, medication(s), and/or menopause hormone therapy.1 

Women need trusted information to feel prepared and be on the lookout for symptoms that may significantly impact their well-being and quality of life during these years. To help women navigate this, we pulled together a researched list of recognized (peri)menopause symptoms based on current reliable resources (listed below). 

Recognized symptoms of (peri)menopause:

Bladder Health

  • Urinary frequency and urgency 2,3,4
  • Urinary incontinence (or leakage)1,2,4,5,6
  • Urinary tract infections 1,2,4,5

Body changes (size & strength)

  • Increased fat tissues (mostly visceral fat) 3,4,5
  • Loss of muscle mass or tone 2,3,4,5
  • Thickening in the middle of body (or increase in girth) 2,4,5
  • Weight gain 3,4,7 

Body changes (other)

  • Acne2
  • Changes in eye & oral health 7
  • Dental pain or issues 7
  • Dry eyes or tearing 2
  • Dry skin 2
  • Hair changes 1
  • Increased facial hair 2
  • Skin changes or issues 1,2,7
  • Thinning hair (or hair loss) 2

Bone Health

  • Less than optimal bone mineral density 2,5
  • Loss of stature / height 5
  • Increased risk of fracture due to bone loss 5

Breasts

  • Loss of fullness / density 2
  • Soreness / tenderness 2,3

Gut / Bowel

  • Anal incontinence (or stool leakage) 2
  • Bloating 2
  • Constipation 2

Heart

  • Heart palpitations 1,2,7

Memory and Thinking (temporary)

  • Difficulty concentrating (or with attention) 3,4,5,7
  • Memory loss or “brain fog” 1,3,4,5,7
  • Difficulty learning 3,4,6

Mental Health 

  • Anger or rage 3
  • Anxiety 1,2,3,6,7
  • Depression 1,2,4,5,6,7 
  • Feeling blue or low mood 2,3
  • Irritability 2,3,5,7
  • Mood swings 1,5,7
  • Panic attacks 7
  • Tearfulness 6,7

Pain

  • Back pain 5
  • Body aches (muscle and joint pain) 1,4,5,7
  • Headaches/migraines 1,2,3

Period changes  

  • Abnormal menstrual bleeding 1,4
  • Bleeding in between periods 4
  • Heavy periods 2,3,4,5
  • Increased cramps or worsening PMS 3
  • Irregular periods (stopping, starting, skipping) 2,4,5,6
  • Longer cycles 2,4,5,6
  • Shorter cycles 3,5

Sex

  • Decreased arousal during sex 1,2 
  • Decreased desire for sex (or libido) 1,2,3,4,5
  • Pain during sex (or intercourse) 1,2,3,4,5

Sleep 

  • Fatigue 1,2,5,7
  • Insomnia 2,4,5
  • Sleep disturbances 1,2,3,4,5,6,7
  • Trouble falling asleep 2,3,4,6
  • Waking up at night 2,3,4,6
  • Waking up too early 2,4,6

Vaginal and Vulvar Health

  • Thinning of the vaginal tissues (atrophy) 2,4,5,6
  • Higher frequency of infections 5
  • Vaginal and vulvar dryness (or itching or burning) 1,2,3,4,5

Vasomotor symptoms 

  • Hot flashes / flushes 1,2,3,4,5,6,7
  • Night sweats 1,2,3,4,5,6,7
  • Chills 4,5

All of the symptoms listed here are fair game, in any combination and to any degree. While some are more common than others, you don’t have to have vasomotor symptoms or period changes to be in perimenopause. If you’re in your 40s or 50s and notice a change, maybe you’re waking up at night, or your hair is thinning, or you’re having more frequent migraines, it could be due to the hormonal changes inside you, and you should talk to your doctor. We do a deeper dive on some of the more common symptoms in our story – Knowing the Perimenopausal Signs & Symptoms

The ones to watch

We’ve also compiled a second list of symptoms, the ones we are keeping an eye on because they may be related to menopause, but more research is needed. 

Other reported symptoms of (peri)menopause

Body changes (other)

  • Allergies worsening
  • Bleeding gums
  • Brittle hair and nails
  • Burning mouth/tongue 
  • Changes in body odor
  • Changes in taste 
  • Dry mouth and bad breath 
  • Itchiness
  • Runny nose / post nasal drip

Neuro symptoms

  • Dizzy spells / vertigo 
  • Electric shock sensations 
  • Tingling extremities 
  • Tinnitus 
  • Skin crawling 

Vasomotor

  • Hot feet

Want to learn more? Check out our story – Knowing the Perimenopausal Signs & Symptoms.

Resources:

  1. “The Silence and the Stigma: Menopause in Canada”. Menopause Foundation of Canada, 2022, menopausefoundationcanada.ca 
  2. “The Menopause Guidebook, 9th edition”. The North American Menopause Society, 2020 
  3. “Common Symptoms”. Women Living Better, 26 Jan 2023, womenlivingbetter.org/perimenopause_symptoms/
  4. Gunter, Jen. The Menopause Manifesto: Own your health with facts and feminism., Citadel, 2021 
  5. “Menopause Symptoms”. Canadian Menopause Society, 26 Jan, 2023, www.sigmamenopause.com/consumers/menopause/symptoms
  6. Samar, R et al., “The menopause transitionand women’s health at midlife: a progress report from the Study of Women’s Health Across the Nation (SWAN)” Menopause, vol. 26, no. 10 Jul. 2019, pp 1213-1227.
  7. “Menopausal symptoms”. The Society of Obstetricians and Gyaecologist of Canada, 26 Jan, 2023, www.menopauseandu.ca/am-i-in-menopause/menopausal-symptoms-close-2/