Common Symptoms


This is such a major symptom for many of us. It isn’t just that you want a bit more sleep, it’s that you reach a point in the day when you simply can’t do anything more.

If you’re working full time, this may manifest as finding it nigh on impossible to get up in the morning, and wanting to go straight to bed when you get home.

If you work more flexibly it may mean you have to start taking naps. But hang on, isn’t a daytime snooze called a Nanny nap for a reason? Aren’t I too young to need this?

Some say that HRT gives them their energy back, others find diet and lifestyle changes really help, some find exercising is the answer, while others work on mindset and learning to say no.

This is one where there isn’t a one size fits all solution.

Visit Nutrition Hub, Medical Hub, Fitness Hub, Holistic Hub & Acceptance hub for more information.

Mood changes

One minute you’re happy and everything is fine, the next minute you’re sobbing because a crumb from your biscuit fell on the floor.

And it feels like it’s the end of the world. This symptom is one of the really difficult ones to deal with as it is so unpredictable.

For some HRT alleviates it, for others a low does anti-depressant can help. It’s definitely worth speaking to your doctor, rather than trying to soldier on.

Irregular periods

As we get closer to the menopause, levels of oestrogen and progesterone stop following their usual pattern.

For a woman with a regular cycle, the cycle starts with menstruation at day 1, this usually lasts 3-5 days. This is also the beginning of the follicular phase, which lasts until ovulation. Ovulation happens about 14 days before the next cycle will start. This second fortnight is the luteal phase, which is when progesterone is released to enable a fertilised egg to implant in the uterus.

Towards the end of this phase is the time when some women will suffer with PMS and have certain food cravings. As we enter perimenopause, the follicular phase can shorten or lengthen, causing our periods to become irregular. Also, we may not ovulate in every cycle, as our supply of eggs decreases.

This can cause us to have very heavy long periods, or very short light periods, and with no real warning as to which to expect. For some women a low dose hormonal birth control pill can help to regulate these symptoms.

Others find that dietary changes can help. Others choose to get the Mirena coil inserted. Some, however, are stuck with these symptoms.

Visit the Nutrition Hub & Medical Hub for more information.

Short term memory issues

This is one of the symptoms that has women worrying that something is seriously wrong with them.

They find themselves googling “early onset dementia” because they have times when they can’t find a word they need, or they turn the house upside down because they’ve lost the car keys only to find them in the fridge.

If you are finding your short term memory is not what it used to be AND you are getting some of the other perimenopause symptoms, it may just be your hormones playing up.

Poor concentration

“Right, I’m typing this document”… “Ooh, look an eagle”… “What’s for dinner”… “Nice shoes”… “Document? What document?”… “Oh, a unicorn” If this sounds familiar, you may be experiencing the poor concentration that many of us experience in this stage.

As women we are all too used to multi-tasking all the time, and we expect our brain to keep up, but while there are so many hormonal changes going on, sometimes our brain has a meltdown and we find ourselves getting distracted by the slightest thing.

Depending on your lifestyle and job, you may find you need to adjust certain things to adapt to this so you are better able to focus on the things you need to get done. If you’re struggling, please ask for help.

Weight gain

The hormone changes at this time can cause us to gain weight. Often with us not having done anything differently, and suddenly we find we have extra fat around our abdomen.

“Why is this happening to me?”

“I hate what I see in the mirror.”

“How come I can’t shift this weight?”

“Maybe I should be stricter with my calories.”

“I am such a failure.”

“I must have no willpower.”

And so many more internal statements. It’s horrible to feel you’ve lost control of your body, but now is not the time to sign up to a diet or to start massively restricting your calorie intake.

So why is it happening? Well, in very simple terms, as we get older, we lose muscle mass. Muscle mass increases metabolism, while a higher body fat % equates to a slower metabolism. Also, we often have disturbed sleep, whether from night sweats or from insomnia, and many studies show that people who haven’t had enough sleep will snack more to try to keep energy levels up.

What can I do? Well, in terms of exercise, brisk walking is great, as is weight training. If you can do weights 3-4 times a week, you will redress some of the muscle loss, and therefore keep your metabolism working a bit better. Speak to a personal trainer to get a programme that suits you.

A good trainer should take into account your age and any physical restrictions you have when putting together your plan. In terms of food, please don’t do anything drastic. Your metabolism is already confused – the last thing it needs is restriction and the idea it is in starvation.

If you want more structured help, speak to a one of our nutritionists, who will look at your diet and make tailored suggestions.

Visit the Nutrition Hub for more information.

Vaginal problems

From vaginal dryness through to atrophy, this is no laughing matter.

These symptoms can mean sex (or indeed going for a smear test) feels like you are being ripped apart from the inside. Please overcome any embarrassment you might feel and speak to your doctor about this, as there are types of HRT that can help.

Alternatively, you can seek advice from our sexual health expert in the acceptance hub.

Visit the Acceptance Hub for more information.


This is no laughing matter. It may be that you can’t get to sleep, or it may be that you wake up at 3am every night without fail.

Insomnia and the associated tiredness can be debilitating.

You know you need to sleep, but the more it evades you the harder it gets to achieve a good night.

Among our experts we have a sleep science expert who might be able to give you some pointers; some find that exercise helps, while others get better sleep with nutritional changes, and others use mindfulness techniques; for others HRT helps. Speak to your doctor or consult one of our experts.

Visit the Medical Hub, Nutrition Hub, Fitness Hub, Holistic Hub for more information.


This is one of the most debilitating symptoms for those who experience it.

You’ve been confident at work and in your home life until now, and suddenly you can’t bear the idea of going anywhere out of your comfort zone; the prospect of driving somewhere new fills you with dread; you doubt yourself on every level; you may start having panic attacks.

Please don’t suffer in silence. Whether you prefer to manage your mental health by a medical route or a holistic route, please seek help. You can find someone local to you, or you can see if one of our experts can help you.

Visit the Medical Hub & Holistic Hub for more information.

Hot Flushes

You suddenly find you’re boiling hot, how come nobody else is desperately opening the windows. Hang on, they’re putting jumpers on. What? It’s boiling in here.

This is one of the “headline” symptoms, and is often what we expect from perimenopause, however it tends to occur as we’re getting closer to menopause due to declining oestrogen levels.

Perimenopause symptoms

Other Symptoms

Decreasing fertility

Throughout the perimenopause our fertility is getting lower.

For some this comes as a relief, as their parenting days are over, while for others this can be incredibly hard as they still yearn for motherhood.

In among the irregular periods, there will be some which are anovulatory (no egg is released) while others will be normal.

If you want to get pregnant at this stage, it is well worth speaking to a fertility specialist to understand how you can increase your chances.

If you don’t want to get pregnant make sure you keep using contraception – although your fertility is decreasing, you can still potentially fall pregnant.

Changes in sexual function/Low libido

During perimenopause, a lot of women find that their libido changes.

For some, this manifests as a total disinterest in sex, while others have a higher sex drive than previously.

Vaginal dryness can be a problem for many of those who do still want to have sex, with it becoming painful.

If you are experiencing this, there are products available to help you – speak to your doctor or check out our Acceptance Hub for more support.


These can range from a fluttery butterfly sensation in your chest through to the impression that you can feel your heart pumping each beat.

As with many of the symptoms, if it is in conjunction with the irregular periods and others on this list, it may well be hormonal and nothing to worry about unduly; however, with any heart issue, if you are concerned please speak to your doctor.

Feeling cold

Although hot flushes are well known as a symptom of perimenopause, some women find their temperature regulation goes the other way and they are constantly freezing, despite the heating being on and wearing lots of layers.

For some, the cold feeling alternates with hot flushes.

Joint stiffness, aches and pains

Some days you feel more like you’re 90 than 40 something.

Your lower back aches, your knees click and you make an involuntary noise when you stand up.

If you are experiencing general aches more often than you used to, adapting your exercise patterns may help. If you have severe pain, please seek advice.

Reduced muscle mass

We naturally lose muscle mass over the age of 40. Weight training is the best thing for maintaining muscle mass, while yoga and pilates are great for core strength.

Visit the Fitness Hub for more information.

Recurrent UTIs

You have shares in cranberry juice and seem to be back and forth to the toilet, but these UTIs won’t shift.

Assuming you’ve been checked by your doctor for any obvious causes, you might like to speak to a nutritionist or a sexual health expert and see if there are preventative things you can do.

Visit the Nutrition Hub & Acceptance Hub for more information.

Loss of bone density, which can lead to osteoporosis

Our oestrogen levels help us maintain strong bones, so it follows that as our body produces less we may become prone to osteoporosis.

Weight bearing exercises such as walking and weight training can help hugely with this; also it’s advisable to work on maintaining good balance to avoid future trips and falls.

Visit the Fitness Hub for more information.

Itchy/crawly skin

Officially called formication, this is the sensation of having ants crawling over you. Many will experience general itchy skin, but if you get formication speak to your doctor or consult one of our medical experts.

Visit the Medical Hub for more information.


Hormonal migraines plague some women throughout their fertile years, while others start to get them as a counterindication from the pill.

Unfortunately for those of us who suffer with them, the migraines may get worse while your hormones are out of balance.

Please seek medical advice if you are newly getting migraines.

Visit the Medical Hub for more information.

Extreme PMS

A lot of us experience PMS as part of our usual monthly cycle, however it can become worse as we go through perimenopause.

Some have described it as an almost out of body experience – you can hear yourself screaming awful things at a loved one, but you have no control.

Learning to spot your triggers, as well as maintaining blood sugar levels can help. You may find some useful help in the Acceptance Hub or the Nutrition Hub.

Visit the Acceptance Hub & Nutrition hub for more information.

Burning mouth syndrome

As the name implies, this is when your mouth feels as though it is burning. It is one of the more overlooked symptoms, but for those who experience it it’s very uncomfortable.


Our pelvic floor starts to become less taught as we get older, which can lead to leaking when laughing or coughing.

You do not need to put up with this, but if you wish to address the symptom you will need to do some pelvic floor exercises. In more extreme cases you can ask for a referral to a physio.

Night sweats

You wake up at 2am drenched. What on earth happened there? Night sweats can be pretty worrying when they first start happening.

For many they are a 2 nd half of the cycle problem, when progesterone is higher.

Advice for dealing with them ranges from sleeping with the fan on to using a lightweight duvet and making a cold water bottle (like a hot water bottle, but pop it in the fridge so it’s ready for bedtime).

Increased breast size

Your bra suddenly isn’t very comfortable and your shirts are straining at the buttons.

What’s that about? Yup, for some this “2 nd puberty” gives a growth spurt to the breasts.

Make sure you get fitted properly for your bras so you remain as comfortable as possible.

Tender breasts

Just as some women get very tender breasts around the time of their period, so some find that perimenopause causes their breasts to become sore.

Brain fog

The easiest way to describe this is like when you have a head cold and it feels like your brain is made of cotton wool. You can’t make decisions, you can barely remember your own name. Don’t panic.

It is a symptom of your hormones being off kilter, you will get through this.

Lack of motivation

Before perimenopause you would be brandishing the vacuum cleaner and dashing through your to- do list. Now the sofa seems a better option.

This lack of motivation is so out of character, but you can’t seem to shake it.

It may be linked to fatigue or insomnia, it may have its roots in anxiety; it may be that this cocktail of hormones has got you reassessing what really matters to you.

For the former please get checked by the doctor, for the latter maybe speak to a counsellor or life coach to see if your priorities need to change to make room for you.

Visit the Medical Hub & Acceptance Hub for more information.

Food cravings

A bit like in pregnancy, your body knows what it is lacking and may give you some weird food cravings as it tries to get the missing nutrients.

Within reason this is fine, but if you find you’re constantly craving particularly unhealthy food consider a chat with a nutritionist to see what you might be missing so you can redress the balance in your diet.

Visit the Nutrition hub for more information.


Some women experience clumsiness at certain points in their usual menstrual cycle, and this can get exacerbated during perimenopause.

Perhaps you find yourself regularly dropping things, or maybe you keep catching door frames with your arms or hips; either way, this is normal.

Vivid dreams

You wake up in the morning exhausted from all the antics you’ve been up to in dream land, and then as the day goes on you struggle to differentiate the real life things from the dream things.

“Did I really go and say that to Bob in accounts or was that in my dream?”


It’s like you’re a teenager again, you’re suddenly getting spots on your face. Unfortunately, this can be a side effect of changing hormones. If it gets really bad, please speak to your doctor.

Changes in body odour

For some women, their body odour changes during this stage of life. They may find they sweat more (even aside from hot flushes), and some report having sweat that smells totally different to earlier in their life, often with a curry tinge.

Change in skin texture

You will have noticed that older women tend to have drier skin, perhaps you wondered why your mother’s skin got more papery as she aged. Yes, it’s another menopause thing that we can start to see signs of in perimenopause.

Brittle nails

All of a sudden your nails are bendy and split really easily. Can this really be another symptom? I’m afraid so.

Breast sagginess

You’ve always had relatively pert breasts, and suddenly they seem to have emptied out and gone saggy.

What on earth is that about?

Sadly it’s another side effect for some with the changing hormones.


Having a constant noise in your ear can be a very very difficult symptom to deal with.

Tinnitus can come about as a result of having worked in a noisy environment, but can also come about in perimenopause for no apparent reason.

Be sure to include it in the list of symptoms you take to your doctor when you next speak to them about this.

Hair loss/thinning hair

Just as the change in hormones can cause skin to get thinner and more papery, it can bring about thinning hair.

And not just the hair on your head, some women rejoice in not needing to address their leg hair or pubic hair any longer.

There are some positives, you see!


That awful sick feeling can be a symptom. If it is impacting on your life, speak to your doctor or a nutritionist to see how you can manage it.

Visit the Nutrition Hub & Medical Hub for more information.


You’re going about your usual life, and suddenly you feel very dizzy as though you’d stood up too quickly, or as if you had over-exerted in an exercise class.

If this has come on along side other symptoms in this list, it may well be perimenopause.