Uncommon Perimenopause Symptoms Explained

When it comes to perimenopause, most of us likely think of hot flushes or mood swings, but there are many other menopausal symptoms that can catch you by surprise. 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.

Understanding Perimenopause

Perimenopause is a natural biological process that typically occurs in women between the ages of 40 and 55, marking the transition towards menopause. During this phase, hormone levels fluctuate, leading to a variety of physical and emotional symptoms. Perimenopause can last anywhere from a few months to up to 10 years, with symptoms varying in severity and duration.

One of the hallmark signs of perimenopause is changes in menstrual cycles. You might notice irregular periods, heavier or lighter bleeding, and changes in the duration of your periods. These hormonal fluctuations can also bring about hot flashes, night sweats, and mood swings, making this phase a rollercoaster of experiences. Understanding perimenopause is crucial for preparing yourself for these changes and managing them effectively.

1. Neurological and Sensory Symptoms

Strange sensations like electric shock sensations, pins and needles, or dizzy spells can feel extremely 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 fluctuations in estrogen level influence 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.

Additionally, changes in hormone levels can lead to an increase in body odor, as fluctuations in estrogen can affect sweating and odor-causing bacteria.

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, burning sensation, 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 perimenopausal symptoms 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 menopause symptoms 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. Vasomotor Symptoms

Vasomotor symptoms are a common experience for women during perimenopause and menopause, primarily caused by the decline in estrogen levels. These symptoms include hot flashes and night sweats, which can be quite disruptive. Hot flashes are sudden feelings of intense heat, often accompanied by sweating, flushing, and even heart palpitations. Night sweats are essentially hot flashes that occur during sleep, leading to disrupted sleep patterns and fatigue.

Managing vasomotor symptoms can involve several lifestyle changes. Dressing in layers allows you to adjust to sudden temperature changes, while avoiding triggers like spicy foods and caffeine can reduce the frequency of hot flashes. Practicing relaxation techniques such as deep breathing and meditation can also help. For those seeking medical intervention, hormone replacement therapy (HRT) is an effective treatment option that can provide significant relief.

9. Weight Gain and Redistribution

Weight gain and redistribution are common concerns for women during perimenopause and menopause. The decline in estrogen levels often leads to an increase in body fat, particularly around the abdomen. This shift not only affects appearance but also increases the risk of chronic diseases such as diabetes, heart disease, and certain types of cancer.

Managing weight gain and redistribution involves adopting a healthy lifestyle. A balanced diet rich in nutrients, regular physical activity, and effective stress management can make a significant difference.

10. Sleep Disturbances

Sleep disturbances are a frequent complaint among women going through perimenopause and menopause. Hot flashes and night sweats can severely disrupt sleep patterns, leading to fatigue, mood swings, and a decreased quality of life.

To manage sleep disturbances, consider incorporating relaxation techniques into your nightly routine. Avoiding caffeine and electronics before bedtime can also promote better sleep. Creating a sleep-conducive environment—cool, dark, and quiet—can make a world of difference. Hormone replacement therapy (HRT) is another option that can help alleviate sleep disturbances, allowing for more restful and uninterrupted sleep.

By understanding and addressing these symptoms, you can navigate perimenopause with greater ease and confidence.

11. Headaches and Migraines

Headaches and migraines often worsen during perimenopause as estrogen level fluctuates. 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.

12. Burning Mouth and Other Mucosal Symptoms

Burning mouth syndrome (BMS)—characterized by a persistent burning sensation or tingling—is another unexpected symptom of perimenopause. 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.

13. Allergies and Sensitivities

Have you noticed new allergies or that you’re suddenly more sensitive to things that never bothered you before? These can be perimenopausal symptoms linked to hormonal changes. 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 and menopausal symptoms 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.