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How To Find Relief From These 9 Weird Perimenopause Symptoms

Perimenopause is the medical term used for the transitionary phase before menopause and it implies big changes mentally as well as physically. However, many people do not talk about the symptoms of perimenopause and tend to focus on menopause and its symptoms.

The age at which perimenopause can begin is variable. It can start as early as in the age 30s and can persist for the next few years; or it can start in your 40s too (1, 2). It is important that people become more aware about perimenopause and what a woman can feel when going through this important phase in her life.

In this article, we will discuss about the less common symptoms of perimenopause, their cause and how to manage them.

Serious Symptoms of Perimenopause Needing Immediate Medical Attention

The symptoms of perimenopause are not that different to menopause and along with changes to menstrual cycle can include: hot flashes, night sweats, decreased libido sleep, sleep issues, mood swings and changes in the vaginal discharge.

However, there are some symptoms which need medical attention and can be an indication of some serious underlying causes. The hormonal fluctuations during perimenopause can cause rapid heartbeat or palpitations, which if persist for a long time need to be seen by a doctor to rule out any cardiac problems.

Other than palpitations, other symptoms which need medical attention are (3):

  • Chest discomfort/pain.
  • Chronic indigestion/ heartburn.
  • Severe anxiety and depression.
  • Unexplained shortness of breath.
  • Persistent heavy vaginal bleeding.
  • Having bleeding during or after sexual intercourse.
  • Vaginal bleeding which starts again after not occurring for a year.
  • Abdominal bloating/ pain.
  • Appetite loss.
  • Change in bowel habits.
  • Weight loss without a cause.
  • Bleeding from rectum.

Some of the lesser known symptoms of perimenopause which some may think are “weird” are:

  1. Dry Eyes because of perimenopause: The eyes feel dry and itchy. There are lacrimal glands in eyes which help with keeping them moist. With the changes in the hormones during perimenopause and also menopause, these glands start to produce less fluid leading to dry eyes.

Some other causes for dry eyes can be smoking, dry and dusty environment and some medications, such as antidepressants (4). Using eye drops and humidifier in your room can help with the moisture element. If it is still bothering, then one should consult an ophthalmologist which is a doctor who specializes in eyes and its disorders.

  1. Changes in Hair in Perimenopause: The changes in the levels of hormones cause hair thinning from the scalp and increased facial hair (5). Other health issues, such as hypothyroidism should be excluded with the help of a blood test. If the cause of all this is perimenopause, then it helps to use revitalizing shampoos and conditioners on the hair and to use wide-toothed comb to gently brush your hair. Stress levels should be managed by doing breathing exercises, yoga etc.
  2. Changes in Skin in Perimenopause: There are lots of skin changes that occur during perimenopause, such as dryness, acne breakouts, itchiness etc (6). The decreasing estrogen levels cause thinning of the skin and it becomes loose with reduced elasticity and visible fine lines and wrinkles (6). To combat all this, it is important to take good care of your skin and consume healthy diet.
  3. The Perimenopause Weight Gain: Unexplainable weight gain is commonly seen with perimenopause. The drop in the estrogen level causes the accumulation of the weight during and before menopause (7). This compounded with poor sleep, decreasing metabolism and laxity in the muscle tone add to the weight gain, more so in the abdominal region. There are some health conditions and medications, such as birth control pills and antidepressants, which can cause fluid retention and they should be ruled out.
  4. Vaginal Dryness of Perimenopause: The reduction of estrogen levels during menopause cause a gradual thinning of the walls of the vagina and this is commonly referred to as genitourinary syndrome of menopause (GSM) characterized by vaginal dryness and also: painful sex, bleeding and discharge from the vagina, itching or burning sensation and a strong urge to urinate. It is important to consult your gynecologist if having the above symptoms as they will not subside on their own (8). Treatment includes hormone replacement therapy and vaginal lubricators.
  5. Headaches during Perimenopause: There are some women who experience worse or frequent headaches during perimenopause and these are known as hormonal headaches. Fluctuating ovarian levels can trigger a type of migraine which can also cause vertigo and dizziness during perimenopause (9).

Other causes of headache include stress, vision problems and insufficient intake of food and water. To treat the headache caused by perimenopause, it is important to regularly exercise and reduce stress. For severe cases of headache consult your doctor.

Some of the lesser known emotional symptoms of perimenopause are:

There is a gamut of emotional and mental symptoms experienced by women going through perimenopause, such as unpredictable mood swings, insomnia, irritability, anxiety, difficulty concentrating etc. Someone who is already suffering from mental health conditions, such as depression or anxiety has worsening of these symptoms during perimenopause.

Some of the less obvious signs to keep an eye out for include:

  1. Rage and Anger Issues: During perimenopause, women can often feel frustrated, irritable and angry (10). Fluctuations in the hormones play a vital role in emotional well-being of a woman and the symptoms can occur as a result of low energy levels and lack of sleep experienced during perimenopause. Similar symptoms are seen in hypothyroidism, so it is recommended to rule this condition out before proceeding with any treatment.  If any triggers, such as caffeine or smoking, are causing these symptoms, then they should be avoided or their intake should be reduced. Participating in relaxing hobbies, such as reading, gardening, yoga and meditation help in keeping these symptoms at bay. A diet rich in healthy food with lots of vegetables and omega-3 fatty acids is also beneficial in managing the symptoms of perimenopause.
  1. Brain Fog in Perimenopause: Brain fog is a condition where there is difficulty in thinking, concentrating and feeling groggy all the time (11). All this occurs as a result of sleep disturbance and changing levels of hormones in the body occurring during perimenopause. Some of the other causes of brain fog are: vitamin B12 deficiency, stress, diabetes, anemia and chronic fatigue syndrome. These symptoms can be alleviated by eating a balanced diet, exercising regularly, and maybe undergoing HRT under the guidance of the doctor.
  1. Mood Shifts of Perimenopause: Not only during perimenopause, the changing level of hormones can effect anyone at any point in life by causing rapid mood shifts, stress, insomnia etc. But during perimenopause, the fluctuating levels of progesterone and estrogen cause problems in producing serotonin, which is a mood regulator. Exercise is a natural way to release serotonin and eating a diet rich in vegetables and fruits, but limited in refined sugars, alcohol and highly processed foods help greatly in the mood swings and anxiety levels (12).

What to discuss with your doctor

Along with exercising, eating a balanced diet, getting sufficient sleep to manage the perimenopausal symptoms, keeping a diary of daily symptoms also help. One can be able to discern a pattern by looking through the diary and it can help the doctor also in understanding and figuring out what to do next.

When consulting your doctor, be concise and honest about everything. Writing the symptoms in the diary is also helpful in case you forget some of them or hesitate to mention them out loud. The doctor will also rule out other causes that can cause these symptoms, such as overactive bladder or thyroid problems.

Treatments, such as hormone replacement therapy can be suggested by the doctor to rebalance levels of hormone and the patient can be referred to a doctor who specializes in mental health and menopause if needed.


Perimenopause is inevitable and every woman has to go through this; however, it doesn’t mean that one should cope with it in silence, but should actively seek out treatment and other ways to combat the perimenopause symptoms. No symptom is too weird to discuss with your doctor, hence it is important to convey anything and everything which is affecting your daily life. The doctor will help you with maintaining your quality of life and to relieve these symptoms during this important transitional phase of a woman’s life.


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Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:July 7, 2024

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