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15 symptoms of perimenopause & how to manage them

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15 symptoms of perimenopause & how to manage them

Looking for information on perimenopause symptoms? You’ve landed in the right place. In this blog, we’ll go through 15 common perimenopause symptoms, why they happen and go through tips on how to manage them. 

What is perimenopause?

The perimenopause is the period of time before menopause during which your body begins to transition to menopause. For further information, check out our blog where we answer 10 questions about the perimenopause.

What are the symptoms of perimenopause?

Symptoms can vary from person to person, severity can range from mild to extreme and how long you experience symptoms can also fluctuate. Everyone will experience perimenopause differently and in some cases, you may not experience any symptoms at all. 


Here’s a look at some of the symptoms of perimenopause.

1. Night sweats

Periods of heavy sweating that occur in the night are common during perimenopause. In some cases, night sweats can wake people up from sleep.

What causes night sweats during perimenopause?

During perimenopause, you’ll experience a range of hormonal fluctuations and one that can cause night sweats are changes in the hypothalamus, the part of the brain that regulates body temperature. Whilst they can be uncomfortable, night sweats are your body’s reaction to all the hormonal changes associated with perimenopause. 

How to manage night sweats during perimenopause:

  • Try to keep your bedroom cool & well ventilated. 
  • Wear loose, light & breathable clothing to bed - think organic cotton PJs!
  • Same goes for bed linen, avoid heavy blankets and stick with breathable organic cotton sheets.
  • Avoid alcohol & caffeine before bed.
  • Establish a calming routine in the lead-up to bedtime. 
  • Try practising meditation techniques or yoga.
  • Get in as much exercise and time outside in the fresh air as possible.


2. Irregular periods

What makes a period irregular? When the time between periods varies widely or the duration of bleeding is different from one cycle to the next. We’re not talking about if you have a 30 day cycle rather than 28 days, we’re all different, your period can be considered irregular when your cycle routinely comes and goes when you’re not expecting it and your cycle shifts in length considerably. 

Your cycle may be classed as irregular if:

  • If it regularly shifts in length, e.g. from 28 to 31 to 25 days.
  • If it’s shorter or longer than whatever is ‘normal’ for you.
  • You experience no bleeding or excessive bleeding.

What causes irregular periods during perimenopause?

During perimenopause your body produces less estrogen & progesterone and these hormonal fluctuations can cause changes in your menstrual cycle like irregular periods.  

How to manage irregular periods during perimenopause:

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3. Vaginal dryness

Also known as vaginal atrophy, this is the thinning, drying & inflammation of the vaginal walls. 

What causes vaginal dryness during perimenopause?

Due to the decline in estrogen levels (the hormone that helps to keep the vaginal tissue healthy & lubricated) the vaginal tissue can become thin & dry, leading to discomfort and pain and this can be especially painful during sexual activity. 

How to manage vaginal dryness during perimenopause:

  • Swap to organic cotton period care so there’s zero chance of causing irritation to your sensitive skin.
  • Drink plenty of water.
  • Use a quality lubricant when having sex.
  • Practice meditation, kegel exercises or yoga.
  • Limit your sugar intake 

Want to know how to help relieve symptoms of vaginal dryness? Read more about how to help with vaginal dryness. 


4. Mood changes

By now, you know that your hormones fluctuating during perimenopause can cause a range of symptoms, so it’s no surprise that your mood can be affected too. Mood swings, irritability or an increased risk of depression may happen during perimenopause. 

What causes mood changes during perimenopause?

The decline of estrogen levels during perimenopause can affect the levels of neurotransmitters, specifically serotonin - the hormone responsible for regulating mood, appetite & sleep!

How to manage mood changes during perimenopause:

  • Establish a consistent sleep routine.
  • Manage stress through relaxation techniques like yoga, meditation or exercise.
  • Eat a balanced & healthy diet.
  • Stay active & exercise regularly.
  • Avoid alcohol & caffeine.
  • Seek support from friends & family or look into therapy - talking outloud to an impartial person can work wonders!


5. Weight gain

You may find that you gain a few pounds whilst experiencing perimenopause. The other symptoms you experience, such as fatigue, mood changes or muscle aches may play a part in weight gain as you may find it more difficult to keep up with an active lifestyle or maintain a healthy balanced diet. 

What causes weight gain during perimenopause?

The hormonal changes during perimenopause can have an effect on the body’s metabolism, which can make it more difficult to lose weight. 

How to manage weight changes during perimenopause:

  • Try to stay active - whether it’s walking, swimming, yoga, cycling or something else, it’s important to keep your body moving. Remember: this doesn’t have to be vigorous exercise, you can focus on regular but gentle exercise, it’s all about moving your body & feeling food! Aim for at least 30 minutes a day. 
  • Eat plenty of fresh fruit & vegetables and maintain a healthy balanced diet.
  • Get your sleep and plenty of it! Your body is going through so many changes, make sure you listen to it when it needs a rest.
  • Drink plenty of water.
  • Avoid drinking alcohol.

6. Fatigue

Constantly feeling tired no matter how much sleep you got? Feeling lethargic is a common symptom of perimenopause and can leave you feeling like you’ve been awake for days. 

What causes fatigue during perimenopause?

Once again caused by hormonal changes in the body and often with an increase in stress, your body can experience general fatigue.

How to manage fatigue during perimenopause:

  • Make a habit of relaxing before bedtime to encourage adequate sleep.
  • Get at least 30 minutes of exercise a day.
  • Eat plenty of fresh fruit & vegetables and maintain a healthy balanced diet.
  • Avoid drinking caffeine & alcohol.
  • Practice relaxation techniques & meditation.


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7. Decrease in fertility

As the ovaries begin to produce less estrogen & progesterone and menstrual cycles become less regular, it’s common for people to experience a decline in fertility and this increasingly difficult to conceive. It’s important to note, whilst the chances of falling pregnant decreases each year as you approach menopause, the point at which you’ve not had a period for 12 consecutive months, it’s not impossible to fall pregnant during perimenopause. So, if you’re not looking to conceive, it’s been to continue using your preferred form of contraception. 

What causes a decrease in fertility during perimenopause?

During perimenopause, the ovaries will gradually begin to produce less estrogen & progesterone and menstrual cycles will become less regular, meaning the ability to conceive decreases. 

How to manage decrease in fertility during perimenopause:

  • If you’re not looking to conceive, continue to use your preferred form of contraception.
  • If on the other hand, getting pregnant is on your agenda, discuss your options with a medical professional. There’s options such as fertility treatment & hormonal therapy which all have the potential to help. 


8. Joint & muscle aches

Feeling stiff and altogether achy can be common during perimenopause, whether it’s your back, muscles or joints.

What causes joint & muscle aches during perimenopause?

The hormonal changes during perimenopause can cause inflammation and a decrease in collagen which can lead to joint & muscle paint. Additionally, the decrease in estrogen can also lead to a decrease in bone density, which can cause pain and weakness in the joints & muscles. 

How to manage joint & muscle aches during perimenopause:

  • Maintain a healthy and enjoy a balanced diet.
  • Engage in regular physical activity. Gentle exercise such as yoga, swimming or yoga can help strengthen muscles & improve flexibility.
  • Consider taking calcium & vitamin D supplements to support bone health.
  • Over-the-counter pain relievers such as ibuprofen can provide temporary pain relief. Speak with a medical professional or pharmacist to find the best course of treatment.


9. Incontinence

Having the need to pee more often or not being able to hold your pee is a common symptom of perimenopause. Stress incontinence, when you leak urine during physical activity or during a cough, a sneeze or even laughing hard, is also a common type of incontinence.

What causes incontinence during perimenopause?

The hormonal changes happening during perimenopause can cause the muscles of the pelvic floor to weaken. Additionally, the decrease in estrogen levels can also lead to a thinning of the urethra & bladder, which can make it more difficult to hold in urine. 

How to manage incontinence during perimenopause:

  • Maintain a healthy diet & active lifestyle.
  • Practise pelvic floor muscle exercises (Kegels) to strengthen the muscles of the pelvic floor. 
  • Avoid caffeine, spicy foods and alcohol - they can all irritate the bladder and worsen incontinence. 

10. Hot flashes

Suddenly feeling hot in the upper body & experiencing sweating, flushing and a rapid heartbeat are all symptoms of hot flashes. 

What causes hot flashes during perimenopause?

Most research suggests that hot flashes happen because of the decreased estrogen levels which cause your body’s thermostat (hypothalamus) to become more sensitive to even the slightest changes in temperature. So, when it thinks your body is too warm, it starts a chain of events (a hot flash) to try and cool you down. 

How to manage hot flashes during perimenopause:

  • Avoid triggers such as caffeine, alcohol & spicy foods.
  • Speak to your doctor about going onto Hormone Replacement Therapy which can be used to replace the estrogen that the body is gradually not producing.
  • Some medical professionals may also prescribe antidepressants or other medications to help reduce symptoms.
  • Some people find relief from alternative therapies such as herbal supplements, acupuncture or yoga.

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11. Headaches

A headache is bad news at the best of times, it can completely cloud your day and leave you feeling rundown and uninspired. During perimenopause you may find that headaches come in a little more often than usual. 

What causes headaches during perimenopause?

It’s not just the changes in levels of estrogen and progesterone during perimenopause that can cause headaches. Stress and lack of sleep can also contribute to headaches during perimenopause. 

How to manage headaches during perimenopause:

  • Ensure you’re getting enough sleep every single night and encourage a relaxing bedtime routine.
  • Try to avoid as much stress as possible (easier said than done, we know!) and take some time to destress from the day to day and find relaxing activities that can take your mind off things. 
  • Deep breathing exercises and yoga can also help alleviate daily stressors.
  • Drink plenty of water.
  • Physical therapy such as stretching, massages or swimming.


12. Trouble sleeping

Getting enough sleep can be difficult at the best of times, let alone when you’re going through a hormonal overhaul. During perimenopause, you may find yourself experiencing bouts of insomnia or not getting a good enough night’s sleep. 

Why do you struggle to sleep during perimenopause?

Those pesky hormonal fluctuations play a big part of insomnia during perimenopause as they can cause night sweats & hot flashes. If you’re suffering from stress & anxiety, experiencing an increase in night-time urination or general discomfort from joint pain, you may also find yourself suffering from insomnia. 

How to sleep better during perimenopause:

  • Try your best to go to bed and wake up at the same time every single day (even on weekends). A regular sleep schedule will put you into a routine and should encourage sleep over time. 
  • Create a comfortable sleep environment. Spoil yourself with some little luxuries and always ensure your mattress, pillows and bed linen are comfortable. 
  • Relax before bed. In the lead up to bedtime, try some relaxation techniques such as deep breathing, yoga or meditation to help calm your mind & body. And avoid watching TV or using your phone at least one hour before bed as those pesky blue lights can suppress melatonin - that lovely hormone that helps regulate sleep.
  • Limit your caffeine & coffee consumption, especially during the evening as they can interfere with sleep. 
  • Avoid heavy meals or exercising too close to bedtime and make sure your bladder is empty before jumping into the sheets. 


13. Changes in sex drive

Not feeling ‘up to it’ is a common symptom of perimenopause and there’s plenty of reasons for a change in sex drive whilst you’re experiencing perimenopause.

Why do you experience a change of sex drive perimenopause?

The decrease in estrogen levels can affect your sex drive. The decrease can cause vaginal dryness, which can make sex painful & uncomfortable (PSA: sex should never hurt.) Plus, the other physical symptoms of perimenopause like hot flashes, fatigue & muscle aches and pains can also contribute to a reduced sex drive. Stress, emotions, mood changes & relationship issues can also have an affect on your sex drive during perimenopause.

How to manage your sex drive back during perimenopause:

  • Communicate with your partner. Relationships require constant work and open & honest conversations, so be sure to share your feelings and concerns with them so that they understand what’s going on and can support you.
  • If you’re suffering from vaginal dryness, try using a quality & organic lubricant to reduce the risk of any pain or discomfort. 
  • Estrogren Replacement Therapy or Hormone Replacement Therapy can help to alleviate other symptoms and may then increase your sex drive. Speak to your doctor for further information. 
  • Get plenty of exercise & eat healthy. Regular physical activity and plenty of fresh, healthy foods can help improve energy levels and your overall wellbeing. 
  • Consider counselling or therapy. Talking with someone impartial, like a therapist, can help address any emotional or psychological issues you may be experiencing that’s affecting your sex drive. 

14. Brain fog

Also known as cognitive impairment, is another common symptom of perimenopause. Forgetting things you wouldn’t normally, 

Why do you experience brain fog perimenopause?

Brain fog during perimenopause is caused by all of those hormonal fluctuations going on inside your body, the levels of estrogen progesterone in the brain are affected. These changes can affect the function of neurotransmitters -  the chemicals that help transmit signals between nerve cells in the brain.Plus, stress, lack of sleep and other physical symptoms like hot flashes & fatigue can also contribute to brain fog during perimenopause. 

How to manage brain fog during perimenopause:

  • Get enough sleep! Aim for 7-8 hours of sleep each and every night to improve focus and concentration.
  • Ensure you get regular exercise to help improve brain function and reduce stress.
  • Include plenty of fresh fruit, vegetables and healthy fats in your diet to help support brain health.
  • Practise deep breathing exercises, yoga or meditation to help reduce stress & anxiety. 
  • Try practising memory techniques like mnemonic devices, repetition & visualisation techniques. 
  • Don’t be too hard on yourself if you experience brain fog. You’re definitely not the only person experiencing it. 

15. Changes in cholesterol levels

During perimenopause you may experience a change in cholesterol levels, this may be an increase in “bad” cholesterol and a decrease in “good” cholesterol.

Why do you experience a change of cholesterol levels perimenopause?

The decrease in estrogen levels during perimenopause may lead to an increase in LDL (low-density lipoprotein) cholesterol, AKA the “bad” cholesterol. With this comes an increase in heart disease. However, at the same time, high-density lipoprotein (HDL) - ASAO the “good” cholesterol, decreases in many people as they age.

The changes in weight, diet & physical activity levels that can occur during perimenopause can also affect cholesterol levels - which is why it’s so important to keep a healthy diet & active lifestyle. 

How to manage change of cholesterol levels during perimenopause:

  • Eat a healthy diet that includes plenty of fresh fruit, vegetables, whole grains, lean proteins & healthy fats.
  • Engage in regular exercise to help improve heart health, increase “good” cholesterol levels and decrease those bad ones. 
  • If you’re overweight, losing excess weight through a healthy diet and exercise can help improve your cholesterol levels. 
  • If you’re a smoker, you need to quit as smoking can increase bad cholesterol levels and decrease the good ones.


Want to know more? Got a perimenopause question? We'd love to hear from you! Drop us a message:

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