10 Lesser-Known Perimenopause Symptoms You Should Know About

Transitioning into menopause, a time known as perimenopause, can be confusing and tumultuous. Most people have heard about the classic symptoms of hot flashes and mood swings. But perimenopause can start at least ten years before menopause, and the stage lasts, on average, four years.

And while there are more discussions about menopause, most people don’t really understand what happens during perimenopause. Here’s what you need to know.

Understanding Perimenopause

Perimenopause is a natural part of aging. It can occur at any point between your mid-30s and mid-50s. This phase can also last anytime between a few months to nearly a decade.

Perimenopause refers to the hormonal changes caused by declining estrogen. As estrogen decreases, hormones fluctuate wildly. By menopause, the body no longer produces enough estrogen for the ovaries to release eggs. This change coincides with no longer getting a period. You are officially in menopause when you go a full year without having a period.

Irregular menstruation is one of the first telltale signs of perimenopause. This is especially true if cycles are typically predictable and consistent.

Other common symptoms of perimenopause include:

  • heavier or lighter periods
  • hot flashes
  • increased vaginal dryness
  • mood swings
  • insomnia and other sleep problems
  • increased need to urinate

10 Lesser-Known Symptoms of Perimenopause

Perimenopausal symptoms exist on a wide spectrum. Some people experience symptoms more intensely than others. It’s also common for certain symptoms to ebb and flow, especially because perimenopause can last such a long time.

Changes in Body Odor

Some women notice they smell differently when experiencing perimenopause. This change can come from numerous factors. For one, hot flashes and night sweats increase perspiration. In addition, hormonal changes impact vaginal pH levels and natural lubrication, which can impact your natural odor.

Voice Changes

Estrogen helps lubricate the throat, and some research suggests that nearly half of post-menopausal women indicate voice changes. Some people experience a shakier voice. Others have more hoarseness and throat dryness, causing their pitch to sound deeper. These changes range in severity, but they may be problematic for singers, actors, or other professionals where having a specific voice is important.

Bloating and Digestive Discomfort

Estrogen and progesterone changes sometimes trigger the body to release the stress hormone, cortisol. These shifts may coincide with indigestion, constipation, gas, and diarrhea.

Brittle Nails and Hair

Declining estrogen affects collagen and keratin, which can directly impact your nails and hair. Many women experience noticeably drier, thinner, or frizzier hair during this time. They also may lose hair, and some research shows that up to two-thirds of post-menopausal women experience alopecia.

Tingling Sensations

Some people experience tingling sensations in their hands, feet, arms, and legs. This is also due to declining estrogen levels and how estrogen communicates with the central nervous system. Although these sensations feel uncomfortable (and sometimes scary), they are generally harmless.

Breast Changes

Estrogen levels impact breast tissue, and many women notice that their breasts feel less dense or full during perimenopause. At the same time, some women also experience their breasts looking larger. That’s because the fatty component of post-menopausal breasts increases. Furthermore, weight gain can happen during this time, and the fat often goes to the midsection.

Brain Fog

Losing your keys more than usual? Forgetting names all of a sudden? Fluctuating hormonal changes can cause brain fog, making it challenging to focus and recall information. Symptoms may be mild and go away on their own. But if cognitive issues impact your daily life- or continuously worsen- seek medical attention.


Hormonal changes can also impact organ functions. This can affect how your inner ear accounts for balance and motor control. As a result, you may notice yourself feeling more dizzy or lightheaded than usual.


Estrogen supports full-body lubrication, and this loss of lubrication can cause the skin to experience more unpleasant sensations. In addition to increased itchiness, you may notice chafing, reactions to certain clothes, and sensitivities to fragrances.

Burning Tongue Sensation

Burning mouth syndrome (BMS) refers to a burning, hot, or scalding sensation in the mouth. It typically affects the tip of the tongue, but it can occur anywhere in the mouth. This sensation may also include dry mouth, bitter or metallic taste, or a loss of taste altogether. The level of discomfort varies based on the individual, and symptoms are likely due to hormonal changes. Certain ointments and vitamin supplements may provide relief- if you are experiencing pain, consult with your doctor.

How Therapy Can Help

There is nothing inherently wrong or concerning about experiencing perimenopause. That said, many people find themselves feeling anxious, depressed, or unsettled during this transition. Likewise, perimenopause can coincide with other stressors, including raising children (or children leaving home), retirement, relationship issues, and other obstacles associated with growing older.

If you are struggling during this time, therapy can help. Together, we can explore your stress and discuss healthier coping symptoms to manage your symptoms. Contact me today to get started!

4601 Spicewood Springs Road Building 3, Suite 200
Austin, TX 78759

(512) 988-3363

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