No doubt you are familiar with hot flashes and mood swings, but did you know there are actually 34 perimenopause symptoms? In this comprehensive guide, we will explore each symptom in detail – and we are going to reveal some of the weirder symptoms as well.

Understanding Menopause and its Phases

Before diving into the symptoms, it’s important to understand the different phases of menopause. Menopause itself is defined as the point when a woman has not had a menstrual period for a full year. However, the journey to menopause is divided into three distinct phases:

1. Perimenopause

Perimenopause is the phase leading up to menopause. It typically begins in a woman’s 40s but can start earlier/ later for some women. During perimenopause, hormone levels, particularly estrogen and progesterone, start to fluctuate, leading to irregular periods and various symptoms.

2. Menopause

Menopause is the official point when a woman has not had a menstrual period for 12 consecutive months. It marks the end of fertility and the beginning of postmenopause.

3. Postmenopause

Postmenopause refers to the years following menopause. During this phase, menopausal symptoms often lessen or disappear, but women may still experience long-term effects, such as changes in bone density and increased risk of certain health conditions.

Awesome. Ugh! It this being a woman thing is never ending!

Now that we have a clear understanding of the different phases of menopause, let’s explore the 34 (and more) symptoms that women may experience during this transformative time.

The 34 Symptoms of Menopause

As women enter perimenopause, the fluctuation of hormone levels, particularly estrogen and progesterone trigger a range of physical and emotional symptoms. And if you are on this site, you have probably experienced some of these already!

1. Hot Flashes

Hot flashes are perhaps the most common symptom of menopause. They are sudden and intense increases in body temperature caused by hormonal fluctuations. About 80% of women experience hot flashes during perimenopause, and they can last for an average of 7.4 years. Not every woman will experience hot flashes, but they can be a significant source of discomfort and disruption in daily life.

2. Night Sweats

Night sweats are basically hot flashes that occur during sleep. They can be particularly disruptive, causing women to wake up drenched in sweat and struggle to fall back asleep. Night sweats are often accompanied by hot flashes during waking hours and can significantly impact sleep quality.

3. Irregular Periods

As hormone levels fluctuate during perimenopause, menstrual cycles may become irregular. Women may experience changes in the frequency, duration, and flow of their periods. Irregular periods are often one of the first signs of approaching menopause and can continue until menstruation stops completely. It is very common, 90% of women experience irregular periods in the lead up to menopause.

4. Weight Changes

Hormonal changes and a loss of muscle mass during menopause can affect the distribution of weight in the body. Many women notice changes in their body shape, particularly an increase in abdominal fat commonly referred to as “meno-belly.” Your body is literally reshaping itself.


5. Breast Tenderness

Erratic hormone levels during perimenopause can cause breast tenderness and soreness. This symptom is often one of the first indicators of hormonal changes and tends to resolve as women progress closer to menopause.

6. Mood Changes

Hormone fluctuations can impact a woman’s mood, leading to mood swings and increased feelings of anger, sadness, or stress. About 20% of women may experience mood changes during perimenopause through postmenopause. Which is less than we thought it would be!

7. Irritability

Increased irritability is a common symptom during the menopausal transition. Hormone fluctuations, compounded by other symptoms, poor sleep, and lifestyle factors such as stress, can all contribute to irritability.

8. Depression

periPenopause may make some women more susceptible to depressed moods. This can be especially true for those who have a history of depression. It’s important to seek support from healthcare providers or mental health professionals if experiencing depressive symptoms.

9. Anxiety

Fluctuating hormones, sleep disturbances, and lifestyle changes can all contribute to increased anxiety during perimenopause. Symptoms of anxiety can include feelings of nervousness, increased heart rate, trouble sleeping, and digestive problems.

10. Panic Disorder

For some women perimenopause can trigger sudden and unexplained panic attacks. Frequent panic attacks and constant worry about when the next one will occur may lead to the development of panic disorder. Anxiety does tend to feed into itself, resulting to more anxiety and panic attacks.

11. Sleep Issues

Menopause-related symptoms such as night sweats and mood changes can disrupt sleep patterns. Many women experience interrupted sleep, poor sleep quality, and difficulty falling asleep or staying asleep during the menopausal transition. It is extremely common, around 47%.

12. Fatigue

Lower estrogen, poor sleep, and increased responsibilities can contribute to fatigue during menopause. Many women report feeling extremely tired and lacking energy during this time.

13. Lessened Libido

Lowered estrogen and progesterone can affect libido during menopause, leading to less interest in sexual activity. Other factors, such as shifts in body image, emotional ups and downs, and uncomfortable physical symptoms like vaginal dryness, can also impact sexual satisfaction.

14. Headaches

Hormone fluctuations during perimenopause can trigger migraines and other types of headaches. Estrogen levels, in particular, play a role in headache frequency and intensity.

15. Vaginal Dryness

Declining estrogen levels during menopause can cause vaginal dryness, leading to discomfort, itching, and pain during intercourse. Vaginal dryness can persist even after menopause and may require treatment for symptom relief.

16. Thinning Hair

The decline in estrogen and progesterone can contribute to hair loss and thinning. These hormones both work to block DHT (an adrogen associated with hair loss). More than half of women over 50 experience hair loss to some degree, and it can significantly impact self-esteem and confidence. See our review articles on science backed treatments such as Rogaine for Women, Rosemary oil and our review on Biotin.

17. Brittle Nails

Lower estrogen levels during menopause can result in weakened nail layers, leading to brittle nails. Inadequate keratin production, the protein responsible for hair, skin, and nail health, can contribute to this symptom.

18. Bloating

Perimenopause can lead to water retention. Excess water gives rise to bloating and a feeling of fullness. Dietary and stress-related factors can also contribute to bloating during perimenopause.

19. Digestive Issues

Estrogen can influence the gut microbiome, leading to changes in digestion during perimenopause. You may experience digestive issues such as bloating, gas, or even changes in bowel movements

20. Brain Fog

Difficulty concentrating and memory problems are reported by many women. Feeling mentally foggy and experiencing lapses in memory during this time is not uncommon, and yet this particular symptom courts controversy within the medical field. Flo Hive has heard of some women feeling unable to continue in their jobs, and leaving employment for this reason.

21. Joint Pain

Estrogen plays a key role in keeping joints lubricated and preventing inflammation. As it declines during menopause, some women may experience increased joint pain and swelling.

22. Muscle Aches

Loss of estrogen can contribute to musculoskeletal pain and sore muscles. Many women report experiencing muscle aches and discomfort.

23. Osteoporosis

The decline in estrogen levels during menopause can increase the risk of osteoporosis, a condition characterized by weak and brittle bones. Women are more susceptible to fractures and breaks due to bone density loss.

24. Itchy Skin

Reduced estrogen levels can lead to decreased collagen production and also less oil – the result is dry and itchy skin. The skins barrier is looser, not a tight mesh as before.

25. Dizziness

Perimenopause can affect the inner ear and blood sugar levels, leading to dizziness. Dehydration caused by night sweats and hot flashes can also contribute to feelings of dizziness. Be sure to drink plenty of water to recoup what is lost from sweating!

26. Heart Palpitations

One of the more frightening symptoms for women is heart palpitations. The sensation of a racing or irregular heartbeat. While usually harmless, it’s important to consult a healthcare provider if you experience concerning changes in your heartbeat.

27. Burning Tongue and/or Mouth

You may have had the sensation of burning, numbness, or tingling in the tongue or mouth. These symptoms are related to the presence of sex hormone receptors in the oral mucosa.

28. Changed Sense of Taste

The same sex hormone receptors that can cause mouth and tongue burning can also affect a woman’s sense of taste. Some women may experience changes in their taste perception.

29. Tingling Limbs

Hormone fluctuations during menopause can occasionally cause tingling sensations in the extremities, such as the hands, feet, arms, or legs. These sensations usually last for a few minutes at a time.

30. Shock-like Sensations

Some women may experience sensations similar to electric shocks under the skin. These shocks occur due to disrupted estrogen which is neuroprotective.

31. Allergies

You may have noticed your allergies getting worse. Or that you are experiencing allergies for the first time in your life. Perimenopause can increase histamine production, resulting in a heightened immune response.

32. Urinary Changes

Perimenopause can bring about various urinary changes, including frequent urination and urinary incontinence. Weakened pelvic floor muscles, hormone fluctuations, and other factors can contribute to these symptoms.

33. Body Odor

Increased perspiration from hot flashes and night sweats can lead to changes in body odor. And an increase in odor-causing bacteria. You might find you want to take more showers than you are used to having.

34. Vaginal Odor

Changes in the vaginal microbiome during menopause can result in vaginal odor. Perimenopause can disrupt the balance of bacteria in the vagina, leading to changes in odor.

The extra symptoms!

Flo Hive recognises that every woman is different and whilst the 34 symptoms above are the most common, there are some others that are worth mentioning as well.

These are some of the weird symptoms that have been reported to Flo Hive:

35. Nausea

36. Tinnitus

37. Shifting teeth

38. Clumsiness

39. Excess facial and body hair

40. Acne

41. Skin tags

42. Melasma

43. Milia

44. Reduced focus (eyes)

These symptoms may vary for each woman. It’s important to remember that not all women will experience all of these symptoms (thank goodness), and some may experience them to a lesser degree.

Remember, each woman’s experience is unique, and seeking support from healthcare professionals early to address your concerns. See our symptom scorecard to help you prepare for your appointment.


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