One of the first signs of perimenopause is a change to your periods. Common symptoms include hot flushes, night sweats, sleep problems, mood changes, and memory and concentration problems. Perimenopause is different for everyone, and you may have symptoms with a big impact on your daily life or hardly any at all.
What Perimenopause Is and When It Starts
Perimenopause is the stage before menopause, when your periods become irregular. There is a good chance that you will notice some changes in your 40s, and some women have symptoms in their 30s. These symptoms can come and go as your hormone levels change.
Most women reach menopause between the ages of 45 and 55. You reach menopause when you have not had a period for 12 months. Perimenopause lasts a few years for most women.
Changes to Your Periods
A change to your periods is one of the first signs of perimenopause. Your periods may happen more often or less often, and the bleeding may get heavier or lighter.
Your cycle may become unpredictable, with changes in timing and flow, including:
- A period every two or three weeks, or none for months at a time
- Spotting or brown discharge in between periods
- Heavier periods or episodes of flooding, which is often a marker of being perimenopausal
It is most helpful to track your cycle so you can note changes.
Speak to a doctor if you still have periods but your bleeding pattern has changed and you are bleeding more, not less, than before. It is also important to speak to a healthcare professional about bleeding that does not seem like a period.
Common Symptoms of Perimenopause
The Menopause Charity names hot flushes as the most common symptom, affecting three out of four women.
Hot Flushes and Night Sweats
Hot flushes are when your face, neck and chest suddenly feel very hot or cold, and they can last for several minutes. They can make you sweat a lot, cause palpitations or anxiety, or make you feel dizzy. If you sometimes wake up drenched in sweat and need to change your pyjamas or bed sheets, you are experiencing night sweats, which can disrupt your sleep.
Sleep Problems
Not being able to get to sleep or stay asleep can affect your daily life. It can make you feel irritable, stressed and anxious. Sleep problems may be worse if you also have night sweats.
Mood Changes, Memory and Brain Fog
You may have mood swings, low mood or depression, and you may also notice problems with your memory or concentration. You might also have brain fog, with forgetfulness and poor concentration. These symptoms may feel worse if you have sleep problems and feel very tired.
Vaginal and Bladder Symptoms
You may get dryness, a burning feeling, irritation or itching in and around the vagina, and these symptoms can also make sex feel painful. You may also get more urinary tract infections (UTIs), or symptoms that feel like a UTI, such as pain or a burning sensation when you pee and needing to pee more often than usual, including at night. You may also feel the need to pee more, or not be able to control when you pee.
Other Symptoms
There are over 34 symptoms of perimenopause and menopause. Other symptoms you may notice include:
- Headaches and migraines that are worse than usual
- Muscle aches and joint pains
- Hair thinning or hair loss
- Skin changes, including dry and itchy skin
- The onset of adult acne
- Reduced sex drive
- Sensitive teeth, painful gums or other mouth problems
- Tinnitus, a ringing or buzzing sound in your ears
- An increase in facial hair
- A sensation of dryness, itchiness or grittiness in your eyes
- A sudden, brief sensation of electric shocks on your skin
- Nails that are more prone to breakage, splitting or peeling
How to Tell If Your Symptoms Are Perimenopause
Under National Institute for Health and Care Excellence (NICE) guidance, if you are 45 or over and otherwise healthy, perimenopause is identified from your symptoms, without a blood test. This applies when hot flushes or night sweats have recently started and your periods have changed.
If you are aged 40 to 45, a blood test to measure your hormone levels may be carried out to confirm whether you are menopausal. If you are under 40 and have menopausal symptoms, blood tests may be carried out to help diagnose suspected premature menopause.
The signs are easy to miss, because you may think your symptoms are the result of stress or just a normal part of getting older. Some symptoms can also be caused by other conditions. An overactive thyroid can cause hot flushes.
Sleep problems can also be linked to the normal ageing process or other conditions such as depression, anxiety or sleep apnoea. Muscle and joint pains may be linked to a decrease in oestrogen levels, but other causes such as osteoarthritis and rheumatoid arthritis are possible. A symptom tracker can help you and your doctor work out whether you may be experiencing perimenopause and rule out any other underlying conditions.
Get Perimenopause Support at Meyer Clinic
At our menopause clinic, we provide hormonal support to women throughout every life stage, including perimenopause, menopause and post-menopause. An in-depth consultation starts with listening followed by investigating.
We take a detailed medical and symptom history and review your reproductive and health background, and we then assess which investigations you may need. We also help with thyroid disease, detected early and managed carefully.
You will see Dr Annelize Meyer, In-person appointments are available. Patients can self-refer and book directly, with no referral needed. To book, call 01243 771455 or book online. To ask a question, use our online enquiry form.
