You know about common perimenopause symptoms like hot flashes, night sweats, irregular periods and mood swings. But what about unexpected bothers that are part of the menopausal transition like itchy ears, a metallic taste in your mouth or body odor? Could they signal you’re entering perimenopause? Experts say there are at least 34 different symptoms that occur both internally and externally during perimenopause and menopause. Keep reading to better understand these perimenopause symptoms and how you can treat them.
Common perimenopause symptoms
“While many women know about hot flashes and mood changes, there are many other symptoms that are commonly experienced during perimenopause—the time leading up to and one year after the last menstrual period,” explains Elena Bryce, MD, a board-certified OB-GYN and Menopause Society Certified Practitioner (MSCP) with Advantia Ob-Gyn Shady Grove.
Signs of perimenopause can occur both internally and externally. According to the State of Perimenopause Report from Oova, mood changes anxiety, bloating, decreased interest in sex, joint pain and swelling were the symptoms women in the U.S. reported most frequently.
“Oova interviewed over 700 women from all 50 states for the report, focusing on women between the ages of 35 and 52,” says Amy Divaraniya, PhD, lead author on the report, founder and CEO of Oova Inc. “Additionally, anonymized hormone data was collected from over 1,700 Oova users.”
Lesser-known perimenopause symptoms
While those symptoms—along with issues like night sweats and vaginal dryness—tend to get a lot of attention, these other complaints can be just as bothersome.
External perimenopause symptoms
You’ll likely notice changes to your appearance during perimenopause, whether that be your weight, skin, hair or nails. ”Symptoms that often go unmentioned are skin dryness, thinning hair and changes in body odor or weight distribution,” says Divaraniya. Women in the Oova survey reported at least one, if not more, of these symptoms.
Dr. Bryce shares that other possible symptoms of perimenopause include breast and nipple changes that can feel similar to the premenstrual period or pregnancy.
Internal perimenopause symptoms
“Internally, women may feel nausea, dizziness, palpitations, brain fog and joint pain,” says Dr. Bryce. “Some women may experience other surprising symptoms, including a burning feeling in their mouth, change in taste or metallic taste, ringing in their ears or tingling or shock sensations in their bodies.”
These symptoms are more common than you’d expect: Dr. Bryce notes that anywhere from 15 to 40 percent of women experience them during this transition.
What causes perimenopause symptoms?
If you guessed that hormones are the reason you experience discomfort during perimenopause, you’d be correct. “During perimenopause, our bodies produce less estrogen [levels] and progesterone, the hormones responsible for regulating the menstrual cycle,” says Tara Scott, MD, board-certified in OB-GYN, functional medicine, and integrative medicine and Versalie Medical Advisor. “As a result, this disrupts the balance of reproductive hormones.”
Dr. Scott adds that certain foods, poor sleep quality, being dehydrated and a lack of vitamins and minerals can also further disrupt hormones at this time.
How to treat perimenopause symptoms
Since this transition looks different for everyone, how you treat perimenopause symptoms will also vary. “Sometimes, estrogen-progesterone therapy [also known as hormone replacement therapy, or HRT] or a hormonal contraceptive is the best option to treat perimenopausal symptoms. However, there are also other non-hormonal medications and non-pharmacological methods [such as diet and exercise modifications] to address many of these symptoms,” says Dr. Bryce.
Another useful tip in addition to hormone therapy is to monitor your hormones. “At-home hormone monitoring can provide insights into your specific hormone levels and help you track fluctuations alongside your symptoms,” says Divaraniya.
Maintaining a healthy diet, exercising regularly and getting a good night’s sleep are also key to feeling better during perimenopause.
When should you see a doctor about perimenopause symptoms?
Dr. Scott recommends seeing a doctor as soon as you start to notice changes in your body. “While you may not even realize you’re experiencing perimenopause symptoms, speaking to a menopause-trained clinician can help you figure out first steps in your menopause journey,” she says.
Also, some perimenopausal symptoms may “mimic other midlife conditions such as hypothyroidism, arthritis, obstructive sleep apnea, hypertension and diabetes, so it’s important to get insight as soon as possible,” says Dr. Bryce.
This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.
