When people talk about menopause symptoms, they’re usually talking about the symptoms of perimenopause, like hot flushes, sleep disturbances, and changes to your menstrual cycle. These can start years before your period stops.
Perimenopause symptoms occur because your ovaries start releasing fewer eggs and producing less oestrogen. These fluctuations in your hormones can continue for a few years, and often perimenopause symptoms continue into postmenopause.
A study of Australian women found that:
Treatments like hormone therapy can help balance out your hormones and manage your symptoms.
Learn more about the stages of menopause
Menopause affects everyone differently. Some people experience a lot of symptoms, and others don’t experience many at all. For some, the symptoms are severe, and for others they’re quite mild. The duration of perimenopause symptoms is different for everyone, too. It can range from a few months to many years.
Understanding the most common symptoms can help you recognise what’s happening in your body and help you access the treatment that’s best for you. And remember, you don’t need to experience all these symptoms to be experiencing perimenopause.
When your oestrogen levels fluctuate, it can affect your body in a variety of ways. You’ll have heard about some of these symptoms already – others might come as a surprise. Remember that while these symptoms can be stressful, they’re manageable with the right treatment plan.
When you're going through perimenopause, your periods can change a lot. They may get lighter, heavier, longer, shorter, or more irregular. For some people, your periods might stop suddenly and not come back, but it’s more likely that they will become irregular first.
Hot flushes and night sweats are known as vasomotor symptoms, and they're two of the most well-known symptoms of perimenopause. Hot flushes are when you suddenly feel an intense heat in your body, and night sweats are when you wake up sweating or drenched in sweat. You might experience both hot flushes and night sweats, or you might only experience one, or neither. Hot flushes can vary in length, severity, and frequency, but they usually last a few minutes. These symptoms can cause a lot of stress and anxiety, but they usually respond well to treatment.
Less oestrogen can make your skin drier and less elastic. Your hair might also become thinner and more brittle.
When your hormones make your skin drier, it might also get itchy and irritable.
Less oestrogen makes your bladder more sensitive and easily irritated. This can cause urinary problems like needing to urinate more often or more urgently, incontinence (leaking), and being more susceptible to urinary tract infections (UTIs).
You might notice aches and pains during perimenopause or worry you have arthritis. While this is possible, it’s also possible that lower oestrogen is causing your joints to hurt.
Lower oestrogen levels can cause the vulva and vagina to become drier. This might cause itchiness, discomfort, and sometimes painful sex. Vaginal dryness is one of the symptoms that's likely to persevere into the postmenopause stage, but it's easy to treat with topical oestrogen.
Headaches can become more common during perimenopause. And if you have a history of headaches or migraines that were worse around your period (menstrual migraines), these might become more frequent or more severe during perimenopause.
Breast tissue is sensitive to the hormones that fluctuate during perimenopause. This might cause your breasts to hurt. It’s important to see your GP if you notice any new lumps or changes to your breasts or nipples that you’re worried about. Also make that sure you’re up to date with your mammograms. Breast screening is available every two years between the ages 45 of 70, or more frequently for people at a higher risk of breast cancer or people with a family history of breast cancer.
If you feel dizzy or lightheaded, or like the world is spinning, this could be caused by how changing oestrogen levels are affecting your body.
When oestrogen levels fall, the balance of oestrogen and testosterone in your body changes, and this can lead to you growing new facial hair, especially around your chin, cheeks, and upper lip.
You may gain weight during perimenopause as your metabolism slows. Fluctuating hormone levels also mean you gain weight in different places – around your midsection rather than your hips and thighs.
Just like how hormone fluctuations during puberty can affect your mood, when your hormone levels change during perimenopause, there can be psychological effects. Depression and anxiety often creep up on you, and it can be hard to recognise when your hormones could be contributing. If perimenopause is the reason for your low mood, you might find hormone therapy is the best treatment.
There are many symptoms of depression, including feeling generally down, tired, like you’re not coping well, or being unmotivated to do the things you used to enjoy, or not enjoying them. If you’ve had depression before, it’s more likely that you will have depression again during perimenopause.
High anxiety, or feeling anxious or overwhelmed a lot of the time, can be caused by your hormones changing. Even though anxiety is an emotion, it can cause physical symptoms like an increased heart rate, nausea, shaking, and a dry mouth.
Lack of sleep can be one of the most challenging parts of menopause. In some cases, sleep disturbances are caused by other symptoms of menopause (like night sweats or anxiety), and sometimes they’re a symptom on their own.
This is another mood-related symptom of menopause. You might find yourself having a shorter fuse than usual, getting more easily frustrated with others and with yourself.
During perimenopause and beyond, you might find yourself getting more tired than before. This can be caused by problems with sleep, as well as depression and anxiety. Hormonal changes can also make you feel more tired.
The hormones that are responsible for your physical perimenopause symptoms can also affect the way your brain functions and make you more forgetful.
Many people lose interest in sex as they experience perimenopause and postmenopause. They also may find sex less enjoyable. This can sometimes be caused by vaginal dryness, or by the hormonal changes you're going through.
At a Menopause Wellbeing appointment, you’ll talk to your menopause clinician about the symptoms you’re experiencing and put together a treatment plan to manage them.