Surprising Signs of Perimenopause

Hormonal fluctuations during perimenopause can affect many parts of the body, leading to some unexpected changes. If you’re in your 40s (or even late 30s) and noticing strange new symptoms, you’re not alone. Perimenopause – the transition phase before menopause – is infamous for hot flashes and irregular periods.

But it can also bring a whole host of lesser-known symptoms that might catch you off guard. As a women’s health professional (and fellow woman), I want to reassure you: it’s not “just you,” and you’re not imagining things.

These surprising signs of perimenopause are real, common, and valid. Below, we’ll explore some of these unexpected symptoms (beyond the classic hot flashes), with a warm dose of empathy and credible medical insight to help you feel informed and understood.

Sign of Perimenopause 1: Mood Swings, Anxiety, and the Emotional Rollercoaster

One day you’re fine; the next, you’re inexplicably irritable, anxious, or down. Sound familiar? Perimenopause can bring intense mood swings, new onset anxiety, or even depression (Sneaky symptoms of perimenopause | UCLA Health) (Signs Perimenopause Is Ending).

Fluctuating estrogen levels can disrupt brain chemicals like serotonin, which regulate mood (How to Find Relief for ‘Weird’ Perimenopause Symptoms: 16 Tips). The result: you might find yourself crying over commercials or snapping at loved ones without clear reason. These emotional ups and downs can be scary if you aren’t expecting them.

Take heart: this emotional rollercoaster is a normal part of perimenopause.

In fact, experts note that worsening moodiness or anxiety at midlife is often hormonally driven (Sneaky symptoms of perimenopause | UCLA Health).

It’s important to validate your feelings – they have a physical basis. If you’re feeling extra anxious or blue lately, know that you’re not “going crazy” – your body is reacting to shifting hormones. (Of course, if mood symptoms become overwhelming, reach out to a healthcare provider for support.) Remember, you’re not alone in this, and it will get better with time or treatment.

Sign of Perimenopause 2: Brain Fog and Memory Lapses

Have you walked into a room and forgotten why, or struggled to find the right word in the middle of a sentence? This “brain fog” can be an unsettling perimenopausal symptom. Many women in perimenopause report trouble with memory and concentration – for example, difficulty finding words or remembering things (Menopause – Symptoms and causes – Mayo Clinic).

These cognitive blips are partly due to hormonal fluctuations and often aggravated by poor sleep (another peri symptom). Rest assured, this fuzzy thinking is typically temporary and common. One study even calls brain fog a very common complaint in menopause transition, describing that many women say their brains feel like “cotton wool” during this time (Brain fog – The Menopause Charity).

While it’s frustrating to feel scatterbrained when you’re normally on top of things, it’s a normal response to your changing body. To cope, it can help to write things down, slow down and give yourself grace. Most importantly, don’t self-judge – you’re not losing your intellect! If needed, mention it to your doctor to rule out other causes (like thyroid or vitamin issues (How to Find Relief for ‘Weird’ Perimenopause Symptoms: 16 Tips)), but in most cases, midlife memory lapses are just another annoying but normal sign of perimenopause.

Sign of Perimenopause 3: Sleep Problems and Daytime Fatigue

Perimenopause doesn’t just affect your days – it can mess with your nights, too. Trouble sleeping is a common yet sometimes surprising symptom of this transition (Signs Perimenopause Is Ending).

Even women who’ve been good sleepers their whole lives may start struggling with insomnia – difficulty falling asleep or staying asleep (Perimenopause: Age, Stages, Signs, Symptoms & Treatment). You might find yourself tossing and turning at 3 AM, or waking up drenched from night sweats (the nocturnal cousin of hot flashes). Even without intense night sweats, lighter sleep can occur thanks to hormone swings. Naturally, poor sleep can lead to dragging fatigue and brain fog the next day. If you’re feeling utterly exhausted despite getting to bed on time, your changing hormones could be to blame.

Check out our blog post: Perimenopause Sleep Issues: Why Can’t I Sleep Anymore?

Validating this can be a relief: you’re not lazy or doing something wrong – your body chemistry is shifting. To help, experts often suggest maintaining good sleep hygiene (cool, dark room, and a calming routine) and managing stress, as stress can worsen sleep issues (How to Find Relief for ‘Weird’ Perimenopause Symptoms: 16 Tips). The good news is that this phase isn’t forever. In the meantime, listen to your body: if you need a cat nap or a restful break, take it. Your body is working hard to adjust, and it deserves compassion.

Sign of Perimenopause 4: Heart Palpitations and Dizzy Spells

One of the more alarming surprises can be heart palpitations – that feeling that your heart is suddenly racing, fluttering, or skipping beats out of nowhere.

Many women are startled to experience these during perimenopause. In reality, fluctuations in estrogen can affect your cardiovascular system and nervous system, triggering palpitations or even brief dizziness (Menopause).

These are considered vasomotor symptoms too, right along with hot flashes. You might notice your heart pounding for a minute or feel light-headed when standing up quickly, even if you’ve never had issues like that before. Understandably, this can be anxiety-provoking – it’s hard not to worry when your heart does weird things. But know that palpitations are a noted symptom in menopause transition (Sneaky symptoms of perimenopause | UCLA Health).

Often, they are benign and pass quickly. Try some slow, deep breaths to calm your system when it happens. Of course, always mention heart symptoms to your doctor to rule out other causes, especially if they’re frequent or severe. But in many cases, that sudden thumping in your chest is yet another surprising (and normal) effect of perimenopausal hormone swings. You’re not alone if your heart feels like it’s doing gymnastics occasionally – many women report the same, and it often improves over time.

Sign of Perimenopause 5: Achy Joints and Muscles

It’s not just your emotions and energy that fluctuate – your body might suddenly feel older and achier during perimenopause. Many women are caught off guard by joint pains or muscle aches that appear around midlife (Sneaky symptoms of perimenopause | UCLA Health). You might notice your knees protesting more, or you wake up with stiff hips or back, even though you haven’t changed your exercise routine.

What gives?

Declining estrogen may play a role here – estrogen has anti-inflammatory properties and helps protect joints, so as levels drop, some women feel more inflammation or pain in muscles and joints. In fact, research suggests estrogen receptors are found throughout the body (joints, muscles, etc.), so lower estrogen can cause aches in those areas (Sneaky symptoms of perimenopause | UCLA Health).

The result: you feel creaky, stiff, or sore, much to your surprise. It can be disconcerting if you’ve always felt spry. Know that this is common. Women often describe feeling like they’ve “aged overnight” when perimenopause hits, but it’s largely hormonal.

Gentle exercise, stretching, and staying active can help keep you limber (and actually can ease symptoms), but remember not to beat yourself up. If your body is asking for a bit more TLC or rest, that’s okay. The important thing is recognizing these aches as a real physiological symptom – you’re not just imagining it. If pain is significant, consult your doctor; otherwise, some self-care and patience go a long way. This too is part of the journey, and you’re certainly not alone in those aches.

Sign of Perimenopause 6: Skin and Hair Changes

Hormones affect the skin and hair, so it’s no surprise that as levels shift, your skin and hair may act differently – yet many women don’t realize midlife changes can be hormone-related. You might see drier skin than usual, newfound itchiness, or even the return of acne (yes, pimples in your 40s – so unfair!). Lower estrogen reduces collagen and oil production, which can make skin less hydrated and elastic (How to Find Relief for ‘Weird’ Perimenopause Symptoms: 16 Tips).

You might notice your skin feels thinner or more prone to fine lines seemingly overnight (How to Find Relief for ‘Weird’ Perimenopause Symptoms: 16 Tips). At the same time, you could experience hair changes.

Many women see thinning hair on the scalp or more hair shedding during perimenopause (How to Find Relief for ‘Weird’ Perimenopause Symptoms: 16 Tips). You might also find surprising new sprouts of coarse hair on the chin or upper lip – a result of hormonal imbalance giving a bit more influence to androgens (male hormones) in the mix (How to Find Relief for ‘Weird’ Perimenopause Symptoms: 16 Tips).

All of this can be distressing, especially when it catches you off guard. But once again, these symptoms are a known part of perimenopause. In fact, doctors note that menopause-related estrogen loss can lead to scalp hair thinning (even a female-pattern hair loss) and occasionally increased facial hair (hirsutism) (Menopause) (Menopause).

The key takeaway: if your skin is suddenly acting up or your hairbrush has more hair in it, you’re not alone and it’s not just “aging” – it’s the hormonal transition at work. Moisturizers, gentle skin care, and avoiding harsh hair treatments can help. And remember, this is a natural process. Be kind to yourself and your body’s changes. They often level out post-menopause with proper care or treatment if needed.

Sign of Perimenopause 7: Vaginal Dryness and Low Libido

While hot flashes get all the press, vaginal dryness is an often quietly experienced (but very common) symptom that can start in perimenopause. You might notice increased vaginal dryness or discomfort during sex, even before your periods stop. This happens because dropping estrogen levels cause the vaginal tissues to lose moisture and elasticity (How to Find Relief for ‘Weird’ Perimenopause Symptoms: 16 Tips).

Along with dryness, you might feel burning or itching, or even a bit of spotting after intercourse due to the delicate tissue (How to Find Relief for ‘Weird’ Perimenopause Symptoms: 16 Tips).

Understandably, these changes can make sex less comfortable or desirable – and indeed, many women report a lower libido (sex drive) during perimenopause (Signs Perimenopause Is Ending).

These sexual health changes can be frustrating or even embarrassing to talk about, but they are absolutely normal. In fact, up to half of women going through menopause experience vaginal dryness (Postmenopause: Signs, Symptoms & What To Expect), and it often begins in the peri years. It’s not in your head, and it’s not a reflection on your relationship – it’s biology.

The good news is there are solutions (from over-the-counter lubricants and moisturizers to hormone therapies), but even before seeking those, just knowing why this is happening can be a relief. If you’ve been feeling a bit disconnected from your sex life or noticing physical changes “down there,” give yourself grace.

It’s okay – perimenopause can do that. And if it bothers you, don’t hesitate to mention it to your healthcare provider; these symptoms are treatable and nothing to be ashamed of.

Sign of Perimenopause 8: Frequent Urination or “Gotta Go” Urgency

Finding yourself rushing to the bathroom more often these days? Or maybe sneezing now comes with a tiny worry of leakage? Changes in urinary habits can be another unwelcome surprise of perimenopause.

The same drop in estrogen that leads to vaginal dryness can affect the urinary tract and bladder, since those tissues have estrogen receptors too.

This can cause the urethra and bladder lining to become drier and less elastic, leading to urinary urgency (needing to pee more frequently or suddenly) (Sneaky symptoms of perimenopause | UCLA Health) (Signs Perimenopause Is Ending).

You might notice you can’t hold it as long as before, or you’re waking at night to pee. Some women also experience an increase in urinary tract infections during this time, or slight stress incontinence (leaking a bit when coughing or laughing), all due to those tissue changes.

It’s not exactly a fun topic, but it’s a common issue that many perimenopausal women quietly deal with. One Cleveland Clinic article specifically lists “more frequent need to pee” as a perimenopause symptom alongside things like hot flashes (Signs Perimenopause Is Ending) – so yes, it’s real!

If you’re constantly scouting for the nearest restroom, know that there’s a physiological reason.

Don’t be embarrassed – it’s not lack of control on your part. Pelvic floor exercises might help strengthen those muscles, and if urinary changes are significant, talk to your doctor (there are treatments that can help here too).

Above all, remember this: your body is adapting to hormonal changes, and that sometimes means extra bathroom trips. It’s another totally normal part of this phase of life.

Validation & Support is Here

Perimenopause is a natural transition, but it sure can come with a grab-bag of surprising symptoms. If you’re experiencing any of these lesser-known signs, hopefully you feel a little more validated now – these symptoms are common and real, even if we don’t hear about them as often.

Every woman’s experience is different; you might have just a couple mild symptoms, or you might feel like you’ve been hit with the whole list. No matter what, try to be patient and kind to yourself. Your body is doing exactly what it’s built to do (even if it’s a bit inconvenient at times!).

And remember, this stage doesn’t last forever; menopause is on the horizon when many of these symptoms will level out. In the meantime, surround yourself with support – whether that’s a good friend who understands, a menopause-savvy healthcare provider, or reliable information (no myths here!).

You’re not alone in this journey.

By understanding the common but surprising signs of perimenopause, you empower yourself to navigate it with a little more ease and a lot more self-compassion.

Hang in there – brighter (and cooler) days are ahead!

Sources:

Reputable medical sources confirm these symptoms and the hormonal changes behind them. For example, the Cleveland Clinic notes that perimenopause can cause mood changes, memory issues, low libido, dry eyes/skin, and frequent urination (Signs Perimenopause Is Ending).

UCLA Health experts likewise list symptoms like anxiety, brain fog, palpitations, hair loss, joint pain, and insomnia as lesser-known effects of hormonal shifts (Sneaky symptoms of perimenopause | UCLA Health).

Mayo Clinic adds that “brain fog” (trouble with memory and finding words) and sleep problems often start during the menopausal transition (Menopause – Symptoms and causes – Mayo Clinic).

These references (and others cited throughout this post) underline that the experiences you’re having are genuine and medically recognized – a normal part of the perimenopause transition.

So, take a deep breath, stay informed, and know that what you’re feeling is real, shared by millions of women, and worthy of care and attention. You’ve got this, and we’re here cheering you on through the journey! (Menopause – Symptoms and causes – Mayo Clinic) (Signs Perimenopause Is Ending)

How Menovation Can Help Women’s Health

We are here at Menovation to help support and empower you through your perimenopause sleep issues and beyond. It features exercises, nutrition plans, and education for improved well-being, reduced symptoms, and inspiring self-care for confidence and vitality. Then tell a friend – we are trying to keep the lines of communication about perimenopause open, right?

As always, talk to a doctor or mental health professional about your experience. Be sure to reach out to a professional for additional support, especially if you are experiencing severe symptoms, want to explore hormone therapy, or have other health concerns.

Take the “What stage am I in?” quiz here to find out what stage of perimenopause or menopause you are in and receive a free guide to help you feel your best during that time!

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