Perimenopause symptoms beyond periods

Perimenopause can bring broken sleep, an aching joint, or moments when you lose your train of thought. Changes to your periods are often an early sign, but they’re only part of the picture. Symptoms can disrupt work and relationships, or be barely noticeable.

Perimenopause is the time leading up to menopause. WHO says it starts with the first changes of this transition and ends one year after your last period. Some symptoms carry on afterwards, including joint pain and vaginal dryness.

Heat, sweat and broken sleep

Hot flushes (called hot flashes in US information) are sudden feelings of heat, often around the face, neck and chest. They can come with sweating, anxiety, dizziness or a heartbeat you can feel. Hot flushes at night are often called night sweats.

Sleep problems can also mean struggling to fall asleep, or waking up and not being able to get back to sleep. Night sweats can make this worse. Poor sleep can leave you irritable, stressed and anxious during the day. So tell the clinician about your sleep, not just the sweating.

Mood, concentration and aches

You may have mood swings, low mood, or trouble remembering things or concentrating. These memory and concentration problems are often called brain fog. They can feel worse when you’re very tired or sleeping badly.

You may also have aching muscles and joint pain. Headaches or migraines may get worse, and some people notice dry, itchy skin or changes to their hair. The National Institute on Aging notes that some changes in midlife may be due to getting older, so menopause may not explain every new symptom.

If low mood or other mood problems don’t go away, talk to your GP, doctor or a mental health professional. Treatment is available. Describe how you feel, rather than trying to decide beforehand whether hormones are the cause.

Vaginal and bladder changes

Dryness, irritation, itching or a burning feeling around the vagina can make sex painful. You may need to pee more often, including at night, or find it harder to control when you pee.

The NHS says that at this stage you may get more urinary tract infections (UTIs), or symptoms that feel like an infection. Tell your clinician if it burns when you pee so they can check it.

Contact an urgent GP service or NHS 111 today (UK), or your doctor or urgent care service (US and elsewhere), if problems peeing come with fever or shivering, pain low in your tummy or in your back just under the ribs, blood in your pee, or symptoms that get worse quickly.

Get palpitations checked

Palpitations mean you become aware of your heartbeat. They can happen around menopause. Other possible causes include anaemia from low iron, an overactive thyroid and problems with heart rhythm. For palpitations that don’t stop, or that come with warning signs, use the urgent advice below. Otherwise, contact a GP or doctor about them rather than using a symptom list to explain them away.

What to put in a symptom diary

A short diary can help you sort out what you want to talk about. Write down your period dates if you have them, the symptoms you noticed and what they got in the way of. Use everyday words, such as “Woke up sweaty and changed the bedding” or “Lost my place during a meeting.” Use whatever words fit what happened to you.

Describe what happened, such as “burning when peeing”, and don’t guess the cause. Add questions about the symptoms that matter most to you. If you can’t remember some days, leave them blank.

Tell the clinician if you use hormonal contraception too. It can change your bleeding and make it harder to tell which stage you’re at. A doctor can look at your symptoms and history alongside your age.

When to contact a clinician

Call 999 now (UK) or 911 (US), or your local emergency number, if palpitations don’t go away, or if they come with chest pain, shortness of breath or feeling faint or fainting. If you had those symptoms and they have now stopped, contact an urgent GP service or NHS 111 today in the UK, or your doctor or urgent care service in the US and elsewhere.

Book a GP appointment in the UK, or see your doctor in the US and elsewhere, to talk about your symptoms and treatment options. Ask for a check if your bleeding gets heavier. Get any vaginal bleeding after menopause checked, even if it happens once or is only a small amount.