There are over 40 different symptoms of perimenopause, and women can experience them all differently. Read more to see what signs and symptoms to expect.

Over 80% of women experience symptoms associated with declining estrogen and progesterone levels in perimenopause and menopause. Symptoms often begin when you enter perimenopause and can continue for a few years after your last menstrual period. Of course, there is a lot of variety in the duration and type of symptoms you can experience.

One of the first signs that you are starting your menopause journey is an irregular period. For example, your period can be longer or shorter in duration, you can have spotting in between periods, and you may also experience an increase or decrease in your flow.

There are a surprising number of symptoms associated with the menopause transition. You can experience physical and mental symptoms that may be due in part to changing hormones. Here is the rundown of symptoms you may experience as you journey through menopause:

Physical Symptoms

  • Irregular periods – You can experience a change in the duration, flow, and frequency of your period as estrogen and progesterone levels begin to wane. 
  • Hot flashes and night sweats – The exact cause is unknown, but this notorious symptom of menopause is likely caused by hormone shifts that affect your hypothalamus (your internal thermostat).
  • Decreases libido – Declining sex hormones can cause your interest in sex to wane during perimenopause and menopause. 
  • Vaginal dryness – Estrogen is responsible for sending the blood supply to your vagina. A decreased blood supply can lead to thinning of the vaginal and vulvar tissues and can decrease your natural lubricants.
  • Joint pain – While it is unclear whether joint pain is related to declining hormone levels, other health conditions, or the aging process, women in menopause often suffer from aches and pains.
  • Weight gain – The decrease in estrogen often correlates with an increase in abdominal fat.
  • Dry skin, hair loss, and brittle nails – Estrogen increases collagen, elastin, and keratin in your skin. Thus, declining estrogen levels can leave your hair and skin lacking critical building blocks that make you skin and hair moisture, supple, and strong.
  • Headaches – Women with a history of migraines and headaches often report a worsening in severity during menopause. However, many women find their headaches improve once they are postmenopausal.
  • Digestive issues – We have estrogen receptors all over our body, including in our digestive tract. Sometimes, estrogen levels will sporadically increase in perimenopause which can lead to bloating. Constipation, nausea, diarrhea, and abdominal cramps are also related to fluctuating hormone levels. 
  • Burning tongue – Hormonal shifts can decrease the amount of saliva in your mouth, which can create a metallic taste and burning sensation.
  • Breast soreness – Many women experience breast soreness related to their menstrual cycle. Breast tissue is exceptionally sensitive to estrogen fluctuations, which can make your breast tender and may even change the consistency of the tissue.
  • Fatigue – Hormonal shifts can disrupt your sleep cycle and create an overwhelming feeling of exhaustion. 

Mental Symptoms

  • Mood swings – We have estrogen receptors in certain regions of our brain that are responsible for our mood. When hormones fluctuate, it can make you feel like you are on an emotional rollercoaster.
  • Cognitive changes – Women commonly report brain fog, difficulty concentrating, and trouble with memory during the menopause transition. Fortunately, this often resolves once your hormones even out.  
  • Anxiety – This debilitating state can start or worsen during menopause. While mild anxiety can be expected, severe and debilitating anxiety and/or panic attacks are not normal and should be evaluated by your doctor. 
  • Depression – Women in menopause are undergoing significant physical, mental, and emotional shifts. Often, women can experience mild depression related to changes during this phase. However, if you are feeling depression it is important to talk with your doctor. 
Written by:
Team Caria
Caria is the leading app for women's health & wellness during perimenopause and beyond. Thousands of women around the world use Caria to track symptoms of menopause, get data-driven insights, connect with experts, and find support from other women. Caria has been featured by Apple as App of the Day and by FemAging as one of the top global innovations for women's health over the age of 40.
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