Perimenopause Can Look Different for Every Woman
Symptoms vary considerably from one woman to another
Menstrual Changes
Changes in your menstrual cycle are a hallmark of the menopause transition.
You may notice:
- Shorter or longer menstrual cycles
- Periods occurring more or less frequently
- Heavier or lighter bleeding
- Changes in the number of days you bleed
- Occasional skipped periods
Although menstrual changes are common during perimenopause, not every change should automatically be attributed to changing hormones.
Unusual, very heavy, or concerning bleeding should be discussed with your healthcare provider so other potential causes can be considered.
Hot Flashes and Night Sweats
Hot flashes can begin during perimenopause, sometimes while your periods are still relatively regular.
A hot flash is a sudden sensation of warmth, often involving the face, neck, chest, or upper body. Sweating, flushing, a rapid heartbeat, or chills may accompany the heat.
When hot flashes happen during sleep, they are commonly called night sweats.
For some women they are mild and occasional. For others, they can interfere with work, sleep, and everyday activities.
Vaginal Dryness & Low Libido
Changes in estrogen during the menopause transition can affect vaginal tissues and sexual wellbeing.
Some women experience vaginal dryness, irritation, or discomfort during sex. Sexual desire and arousal may also change during perimenopause.
Hormones may contribute, but sexual wellbeing can also be influenced by sleep, stress, mood, medications, health conditions, relationships, and other life circumstances.
These changes are common, but that does not mean you simply have to live with them. Treatment and management options are available.
Sleep Changes
Sleep can become more difficult during perimenopause.
You may have trouble falling asleep, wake more frequently during the night, or wake earlier than you once did. Night sweats can also interrupt sleep.
Repeated sleep disruption may leave you feeling tired the following day and can affect concentration, memory, mood, and overall wellbeing.
Not every sleep problem during midlife is caused by perimenopause, so persistent sleep difficulties are worth discussing with your healthcare provider.
Brain Fog and Concentration
Walking into a room and forgetting why. Losing your train of thought. Struggling to find a familiar word or concentrate on a task.
Changes in memory and concentration are commonly reported during the menopause transition.
Hormonal changes may contribute, but sleep disruption, stress, anxiety, and fatigue can also affect cognitive function.
Brain fog can be frustrating, but experiencing occasional forgetfulness during perimenopause does not necessarily mean something is seriously wrong.
New, persistent, worsening, or concerning cognitive changes should be discussed with a healthcare provider.
Mood, Anxiety and Irritability
Some women notice emotional changes during the menopause transition.
You may feel more irritable, anxious, emotionally sensitive, or experience changes in mood that seem different from what is usual for you.
Hormonal changes may play a role, but they are not necessarily the only factor. Poor sleep, stress, changing life circumstances, and other health conditions can also influence emotional wellbeing.
If changes in mood are persistent, severe, or affecting your daily life, talk with your healthcare provider.
Fatigue and Low Energy
Feeling unusually tired or lacking energy can occur during perimenopause.
Changing hormones may play a role, but fatigue can also be connected to other symptoms. Night sweats, difficulty sleeping, stress, and mood changes can all leave you feeling less rested and energetic during the day.
Heavy menstrual bleeding may also contribute to iron deficiency or anemia in some women, which can cause fatigue.
Because tiredness can have many causes, persistent, severe, or unexplained fatigue is worth discussing with your healthcare provider.
Urinary Health
Hormonal changes during perimenopause can also affect tissues around the bladder and urinary tract.
Some women notice urinary urgency, needing to urinate more frequently, discomfort, or recurrent urinary tract infections.
Urinary symptoms can have many possible causes, so new, persistent, or bothersome changes should not automatically be assumed to be due to perimenopause.
Talk with your healthcare provider if you develop urinary symptoms, particularly pain, burning, blood in the urine, or recurrent infections.
Other Physical Changes
Perimenopause can also coincide with a variety of other physical changes.
Some women report changes involving joint or muscle discomfort, headaches, skin and hair, body composition, weight distribution, or other symptoms during the menopause transition.
Not every change that occurs during midlife is caused by perimenopause. New, persistent, severe, or unexplained symptoms should be discussed with your healthcare provider rather than automatically attributed to changing hormones.
When Should You Talk to Your Healthcare Provider
Consider talking with your healthcare provider if:
- Your periods have changed significantly.
- Bleeding is unusually heavy or otherwise concerning.
- Symptoms interfere with sleep, work, relationships, or daily activities.
- You are experiencing symptoms before age 45 and think you may be entering menopause early.
- You are unsure whether your symptoms are caused by perimenopause or another condition.
- Mood changes are persistent or difficult to manage.
- You develop new or worsening symptoms that concern you.
- You would like to discuss treatment options.
You do not need to wait until symptoms become severe to ask questions about perimenopause.
Want a More Comprehensive Guide?
Looking for a complete guide to every stage of menopause? Explore Menopause Spotlight: Your Essential Guide to Perimenopause, Menopause, and Beyond.
Available in paperback, hardcover and eBook.
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