34 Symptoms? A Clear Guide to Perimenopause Signs

Menopause is officially one day: 12 months after your last period. Perimenopause is the years leading up to it, when hormone levels — particularly oestrogen — rise and fall unpredictably. For most women it begins in their 40s and lasts around four to eight years, although it varies a great deal.³⁴

Because hormones affect almost every system in the body, the list of possible symptoms is long. That does not mean you will have them all. Here they are, grouped.

Periods

Often the first sign. Periods may become closer together or further apart, heavier or lighter, or skip months.¹

Temperature

• Hot flushes
• Night sweats

See what helps with hot flushes.

Sleep and energy

• Difficulty falling or staying asleep, often waking in the early hours
• Fatigue

Mood and mind

• Low mood, anxiety, irritability or mood swings
• Brain fog and difficulty concentrating
• Forgetting words¹

Body

• Joint and muscle aches
• Headaches or changes in migraines
• Heart palpitations
• Weight gain, particularly around the middle
• Breast tenderness

Skin and hair

• Dry or itchy skin, new sensitivity or adult acne
• Thinning hair

Read how perimenopause changes your skin.

Intimate and urinary

• Vaginal dryness and discomfort during sex
• Lower sex drive
• Needing to urinate more often, or recurrent urinary infections¹

If you are in your 40s and several of these sound familiar, perimenopause is a reasonable explanation — and a good reason to talk to a doctor.

Getting a diagnosis

Guidelines say women over 45 with typical symptoms can usually be diagnosed on symptoms alone, without blood tests, because hormone levels fluctuate so much in perimenopause.² Tests may be helpful if you are under 45. Keeping a simple symptom diary for a few weeks makes your appointment much more useful. See how to prepare for a menopause appointment.

Do not assume everything is hormones

Some symptoms overlap with other conditions, such as thyroid problems, low iron, depression or diabetes. See a doctor promptly if you have:

• very heavy periods, bleeding between periods or after sex;
• any bleeding more than 12 months after your last period;
• chest pain, or palpitations with dizziness or breathlessness;
• low mood that is not lifting, or thoughts of self-harm.