Uncommon Signs of Perimenopause Explained
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When it comes to perimenopause, most of us likely think of hot flushes or mood swings. But did you know, while there are 34 globally recognised symptoms, there are potentially over 50, 60, or even more—some suggest over 100!—symptoms women may experience? Estimates vary depending on the source, but the wide distribution of estrogen receptors throughout the body means nearly every organ system can be affected. From frozen shoulder to burning mouth and itchy skin, if you experience any of these lesser-known symptoms, they can catch you by surprise and often go unrecognised as being hormone-related. Here we explore some of these symptoms, why they occur, and how you can support your body through this transition.
1. Neurological and Sensory Symptoms
Strange sensations like electric shocks, pins and needles, or dizzy spells can feel extremley unsettling. These are linked to the nervous system’s response to fluctuating estrogen, which affects nerve signals and blood flow. Estrogen also supports sensory processing, so changes in taste and smell—like foods tasting metallic or scents seeming stronger—can occur.
Dry eyes are another common but less talked-about symptom. Estrogen helps maintain hydration in tissues, including the eyes, so declining levels can lead to irritation and discomfort.
What can help? Magnesium-rich foods, keeping well hydrated, and plenty of nutrient-dense meals can support nerve and sensory health.
2. Emotional and Cognitive Symptoms
Mood swings are a well-known symptom of perimenopause, but feelings of overwhelm and panic attacks can often come as a surprise. These emotional changes are closely tied to hormonal shifts, as estrogen influences key neurotransmitters like serotonin and dopamine, which regulate mood and emotional stability. Meanwhile, brain fog—a frustrating mix of difficulty concentrating, memory lapses, and mental sluggishness—is linked to changes in blood flow and how the brain uses energy during this transitional phase.
What can help? Exercising, learning to pull back on commitments when feeling overwhelmed, and practicing mindfulness can create space for emotional balance. Supplementing with clinically proven ingredients like St John’s Wort and Saffron—studied for their ability to support mood and anxiety—can also provide significant relief (featured in our Mood supplement). For cognitive support, nootropics like Bacopa and Ginkgo Biloba, known as cognitive enhancers, can help boost clarity and memory (found in our Focus supplement).
3. Musculoskeletal Symptoms
Joint pain, aching muscles, and frozen shoulder are surprising but common complaints during perimenopause. These symptoms often stem from declining estrogen, which supports collagen production and reduces inflammation. Without this hormonal support, connective tissues can feel stiff and inflamed, and muscles may not recover as efficiently after strain.
What can help? Low-impact exercise like yoga or swimming can improve mobility and flexibility, while anti-inflammatory foods such as turmeric and omega-3-rich fish may help ease discomfort. Magnesium is also highly beneficial for its anti-inflammatory properties, support for adrenal function, and ability to relax muscles. Found in our Sleep formula, magnesium can also ease restless legs—another symptom many women experience during perimenopause.
4. Skin, Hair, and Nail Symptoms
Declining estrogen during perimenopause can lead to noticeable changes in your skin, hair, and nails. Reduced estrogen levels decrease collagen production and hydration, leaving skin thinner and drier, nails more brittle, and hair prone to thinning. Hair follicles rely on estrogen for growth, so its decline often results in shedding or slower regrowth.
At the same time, as estrogen levels drop, androgens—including testosterone—can become more dominant. This relative increase in androgens can stimulate oil production in the skin, potentially triggering acne or spots. It may also lead to changes like more noticeable facial hair and thinning hair on the scalp.
What can help? Collagen-boosting foods, drinking plenty of water, hydrating serums, and adjusting skincare routines can help restore skin balance. Supporting hair health with scalp treatments and nutrients like biotin—found in our Energy complex—can also reduce thinning and improve strength.
5. Reproductive and Breast Symptoms
Vaginal dryness and painful intercourse are common as estrogen levels drop, thinning the vaginal walls and reducing natural lubrication. Additionally, breast pain—often described as tenderness or aching—can result from fluctuating levels of estrogen and progesterone, which affect breast tissue.
What can help? Supplements like Vitamin A and ingredients like Tribulus—found in our Libido formula—are known to support vaginal health and lubrication. For breast health, maintaining a nutrient-rich diet with healthy fats, antioxidants, and key vitamins like Vitamin E and Omega-3s can help reduce discomfort and support overall breast tissue resilience.
6. Digestive and Oral Health Symptoms
Digestive issues like bloating or changes in bowel habits are common during perimenopause and are often linked to hormonal shifts. Estrogen influences gut motility—the movement of food through the digestive system—and its decline can slow digestion or disrupt the balance of gut bacteria, leading to discomfort.
Estrogen also supports the connective tissues in your gums. As levels drop, gums may become more sensitive, recede, or be more prone to inflammation, increasing the risk of gum disease and even tooth loss.
What can help? Incorporate fiber-rich foods, prebiotics, and probiotics to support gut health, and schedule regular dental checkups to maintain oral health. Use a soft-bristle toothbrush and practice gentle dental care to protect sensitive gums.
7. Cardiovascular and Thermoregulatory Symptoms
Heart palpitations and cold sweats are often overlooked but can be directly tied to hormonal fluctuations. Estrogen helps regulate circulation and temperature, so its decline may leave you feeling flushed or experiencing sudden heart flutters.
What can help? Deep breathing exercises, lightweight bedding, and cotton fabrics can help with these symptoms. Persistent heart palpitations, or anything that gives you any concerns, should always be discussed with your doctor.
8. Headaches and Migraines
Headaches and migraines often worsen during perimenopause as estrogen levels fluctuate. This can cause blood vessels to become more sensitive, triggering headaches in those already prone to them.
What can help? Staying hydrated, eating balanced meals, and identifying triggers like caffeine or alcohol can help reduce the frequency and intensity of headaches.
9. Burning Mouth and Other Mucosal Symptoms
Burning mouth syndrome (BMS)—characterised by a persistent burning or tingling sensation—is another unexpected symptom of permenopause. This occurs as estrogen levels drop, affecting the mucous membranes and potentially disrupting the nerves responsible for sensation in the mouth and tongue. These changes can heighten sensitivity and alter pain perception, leading to discomfort around the mouth and tongue.
What can help? Be sure to stay hydrated—sip water throughout the day to keep your mouth moist and comfortable. Alcohol-free, hydrating oral rinses can also help ease irritation. Keeping soothing foods like cucumber or watermelon to hand can feel refreshing and support hydration. For extra support, supplements with magnesium or B vitamins can help calm sensitive nerves and promote overall comfort.
10. Allergies and Sensitivities
Have you noticed new allergies or that you’re suddenly more sensitive to things that never bothered you before? Hormonal changes, particularly declining estrogen, can affect immune function, making your body more reactive to allergens or irritants.
What can help? Take note of any new triggers and consider keeping a symptom diary to identify patterns. Consulting with your doctor can provide clarity and strategies to manage these sensitivities more effectively.
Why recognising perimenopause symptoms matters
Understanding the wide-ranging effects of perimenopause is the first step toward reclaiming your well-being. These symptoms aren’t “just in your head”—they’re the result of complex hormonal changes affecting multiple systems in the body. By recognising them, you can take proactive steps to support your body and seek the right help when needed.
When to seek professional support for perimenopause symptoms
While some women find that symptoms of perimenopause and menopause can be managed with lifestyle adjustments and natural solutions, many others experience symptoms that significantly interfere with their quality of life. If issues like severe anxiety, chronic pain, or persistent sleep disturbances are affecting your daily well-being, it’s important to consult a doctor or menopause specialist. They can guide you in exploring prescribed menopause and hormone treatments, such as HRT (hormone replacement therapy), which may provide the relief you need.
How The Menopause Co. can support you
We know that every woman’s experience of perimenopause and menopause is unique, which is why we’ve created supplements that work with your body to address a range of symptoms. Using only premium, science-backed ingredients, paired with best practices from Ayurvedic, Chinese, and Western Herbal Medicine, our supplements are developed to help you feel supported and ease symptoms—whether you need help managing stress, balancing mood, or restoring your sleep.
Navigating perimenopause can be challenging, but it doesn’t have to be isolating. With knowledge, self-care, and the right support, you can make the transition so much smoother. Explore our blog for more resource, expert insights and practical tips, or visit our shop to discover supplements tailored to your needs.
Discover our range of evidence-based supplements, developed with mind and body nutrients to support your body and your needs before, during, and after this transitionary life stage.
This article has been reviewed by our expert advisory team.