30 Oct 2020

The 34 symptoms of perimenopause and menopause -
symptom checker

There are 34 symptoms that women may experience during perimenopause and menopause. This article explains each of the symptoms and what to look out for. We have also produced a symptom tracker that you can download and complete to help you keep track of your own symptoms.

When do the 34 symptoms of perimenopause and menopause begin?

Menopause can affect women in many different and individual ways. After the age of about 40 our hormone levels (oestrogen, progesterone and testosterone) start to decrease and fluctuate and women enter into ‘perimenopause’ - the phase of life leading up to menopause. These hormonal changes lead to a wide range of symptoms - with 34 symptoms most commonly identified as part of this phase.

For some women, symptoms can begin much earlier than 40 years old, and for others it can be later in life too. Menopause is officially confirmed once a women has had no periods for 12 months.

How do you know if you are going through perimenopause and menopause?

We have produced a symptom list to help you identify and track your own symptoms against the common list of symptoms.

We recommend that you take a copy of this list along with your notes to any appointment with a GP or other healthcare provider.

You do not need to experience all 34 symptoms to be in perimenopause or menopause. Likewise, you may experience some of these symptoms for reasons other than menopause too.

All information contained within our symptom tracker has been verified by Dr Tina Peers, founder of The Menopause Consultancy

The information in our symptom tracker document is also outlined below.

For more information on perimenopause and menopause, please visit our dedicated resources area.

The 34 symptoms of menopause and perimenopause explained:

The symptoms below are divided into physical symptoms (1-25 and emotional and mental symptoms (26-34). Click on each heading to read about each in detail:

Hormones are very closely linked to your immune system. This is why, even if you’ve not suffered from allergies before, you may find some allergies developing. Common allergies may include hayfever, eczema, asthma and also food allergies.

While we may be used to experiencing bloating, especially around the time of our period, during perimenopause you may find that you are constantly bloated. This is often one of the first signs that you are entering perimenopause. 

Look out for a significant increase in sweat and also a change in your own body odour.

As we age our bones weaken and they are at a greater risk of breaking. A broken bone, back and neck pain, or a stooped posture could all be a symptom of osteoporosis - a serious condition that can be diagnosed through a bone density scan.

Menopause breast soreness is similar to that experienced during your period or during pregnancy which are the other points during a woman’s life when hormones fluctuate. 

Track if your nails begin to flake, break or snap more often than usual.

Lots can happen in your mouth during menopause. You may find you have less saliva and a dry mouth, a metallic taste, or a burning sensation - this will feel like your mouth and tongue is tingling, hot and painful.

You may experience a gradually declining desire to have sex and when having sex it may be less pleasurable with fewer orgasms. Sometimes sex is painful too (see Symptom 24: vaginal dryness). Often a decrease in libido is a result of other menopausal symptoms such as low mood, anxiety and mood swings.

Bone health can affect your jaw bone leading to tooth movement and even tooth loss. Less severely, keep track of any receding gums, bleeding gums and bad breath.

Collagen, the protein that keeps our skin feeling plump, full and healthy, can also decrease in midlife. This may lead to drier, itchier skin.

Feeling lightheaded and experiencing dizzy spells can be linked to hormonal changes, but also a result of other menopausal symptoms such as fatigue.

A tingling feeling in your body, or more acutely a sharp sensation that feels like an electric shock from inside can feel uncomfortable and unexpected. It’s a result of changes happening in your nervous system due to your hormonal changes.

This is a very wide-ranging symptom which can appear in a few or many joints in your body. You may feel mild aching in your joints through to severe joint pain. In some cases this can signal the beginnings of arthritis.

One of the most visible and emotionally upsetting symptoms of menopause. You may notice your hair thinning, particularly around the top of the head, as hair growth slows down and new hair does not appear to take the place of old hair. Diet, lifestyle and stress can all contribute to hair loss in midlife as well as the hormonal changes. We spoke to a celebrity hairdresser for tips on what to do about thinning hair.

Look out for a change in the frequency and intensity of headaches and / or migraines (if you suffer from these too). Migraines can be a particularly debilitating symptom, as this article from Dr Stephanie Goodwin explains.

Probably the symptom that is most synonymous with the word menopause! Also known as hot flashes, a hot flush starts without warning and can be described as a sudden feeling of heat and redness that spreads quickly throughout the body. The redness in particular can be apparent on the face and neck.

As periods come to an end during menopause, you will begin to notice a reduction in the frequency and heaviness of periods. Your periods may become less predictable and will not fit into a regular monthly cycle anymore. This could mean a shorter or longer cycle than you’ve been used to - and it’s likely that the length of your cycle will begin to vary month to month.

Muscle tension will lead to a feeling of tightness in the muscles and soreness from the tension too. The neck, back or shoulders are common areas to feel the tension and this can be heightened by increased stress levels too. Achy, restless legs are most commonly a symptom at night, contributing to insomnia as well.

The changes happening in your body due to hormones can show up noticeably as nausea and digestive problems. You may experience sickness, diarrhoea, pains such as cramping and indigestion and bloating. 

Night sweats are hot flashes that happen during the night. The difference between a night sweat and simply being overly hot at night is that a night sweat will leave you with sweat-drenched night clothes and bedding.

If you feel like your heart is beating irregularly or faster than normal this could be a heart palpitation. Heart palpitations may last from a few seconds up to a minute or so, and often coincide with a hot flush.

Your legs and arms, feet and hands are common places to feel a tingling sensation and could be another symptom of perimenopause and menopause.

Bladder weakness is caused by the weakening of the pelvic floor muscles. With stress incontinence you may notice that you begin to leak urine particularly when laughing, sneezing, coughing, exercising or lifting heavy objects. With urge incontinence you will experience a sudden and frequent urge to urinate.

Also known as vaginal atrophy, this can be an extremely painful and debilitating symptom. With mild to moderate symptoms you may feel sore or itchy from the decrease in vaginal discharge and lubrication. As this becomes more severe, you may feel a burning sensation and find it hard to have sex, wear tight clothes or be as active as you normally would be. If this is a symptom that you experience, this first-hand account from Jane Lewis about living with vaginal atrophy may be of support.

It’s extremely common for us all to gain weight as we age and also due to our own lifestyles and genetics. In perimenopause and menopause in particular you may notice additional weight gain around the abdomen. This can be accelerated due to comfort eating and decreased activity as a result of other menopausal symptoms such as low mood, low energy and anxiety.

Feeling anxious can involve feelings of panic, impending doom and consistent overthinking of situations and problems. If you feel constantly on edge with racing thoughts this could be anxiety. Sometimes, anxiety coupled with some of the other menopausal symptoms can lead to a feeling of low confidence too. 

Many women experience feelings of ‘brain fuzziness’ during perimenopause and menopause. It can become harder to find the right words when in conversation, or to remember seemingly simple things. Confusion, forgetfulness and the inability to think clearly can lead some women to fear that they are in the early stages of dementia.

If you are experiencing a general loss of interest in your usual hobbies or interests and you are feeling low, this could be caused by perimenopause or menopause. You may find yourself crying more often than usual and preferring to stay at home rather than socialise with friends and family. 

It’s normal to lose concentration from time to time. During perimenopause and menopause you may find that this happens more often and that it’s harder and harder for you to regain concentration or to focus on the task at hand. 

You may find that it is harder than usual to get to sleep at night or you may wake up more often through the night too. Coupled with night sweats, this can lead to very disturbed sleep patterns.

If you find you are becoming more impatient and more easily annoyed in more situations than usual, this could be a sign of menopausal irritability. An increase in your irritability can also be closely tied to other menopausal symptoms such as difficulty sleeping and stress.

Menopausal mood swings can have you feeling irritable, low and anxious one moment, followed by feeling happy and joyful the next. You may find that you cycle through feelings of highs and lows from day to day or even within the same day. 

A short but intense episode of anxiety is known as a panic attack. It can be a scary experience, although it usually passes relatively quickly. It’s important to keep a note of any noticed triggers to a panic attack and where and when the attack happened. Repeated panic attacks can lead to a diagnosis of a panic disorder.

Extreme tiredness or fatigue can result in a feeling of very low energy and a loss of ‘get up and go’. It can be exacerbated by other menopausal symptoms such as low mood, night sweats and difficulty sleeping.


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