The signs and symptoms of perimenopause are being covered more in the media but too often the signs and symptoms described are menopause not perimenopause symptoms.
Perimenopause starts in our late thirties – a decade before we hit full menopause – and the symptoms of perimenopause are very different from those of menopause.
As a result many of us don’t recognise weird symptoms in our forties as sure signs of perimenopause or know how to ease them.
So I have got for you here a guide to key symptoms of perimenopause including :
- Major Menstrual Cycle Changes
- Nutritional Deficiencies
- Inflammation
- Mental Health Issues
- Body Image Problems
PLUS the key warning signs these symptoms are flagging about our overall body health and how addressing these symptoms can ease menopause when it does come.
This post is not qualified medical advice. See a doctor for unexplained symptoms.
Perimenopause Symptoms
Table of Contents
Menstrual Cycle Changes During Perimenopause
Perimenopause initiates key changes in our menstrual cycle we all need to know about :
- Heavier Periods
- More Frequent Periods
Heavier Periods
Heavier periods are common in early perimenopause. They may become so heavy we need to change sanitary protection hourly which can fuel stress and anxiety.
Many women have to double up protection with tampons or a menstrual cup PLUS sanitary towels or period pants.
If you are struggling do have a read of this article on heavy periods during perimenopause – you really are not alone.
More Frequent Periods
More frequent periods is another common sign of perimenopause. Your regular four week cycle may become three weeks or even fortnightly with all the PMS and period pain challenges that go with that.
Changes in period frequency can be signs of other medical problems so do seek medical advice if they become more frequent.
Perimenopause & Serious Nutritional Deficiencies
The changes in our menstrual cycle can in turn cause severe nutritional deficiencies and serious health problems including :
- Anaemia
- Extreme Fatigue
- Poor Immunity
- Bad Gut Health
Anaemia
Menstruating girls and women are always at risk of iron deficiency but heavier, more frequent periods in our early forties can increase our risk of anaemia.
Common symptoms of iron deficiency such as extreme fatigue and brain fog are often mistaken for hormone imbalance from perimenopause and menopause.
If you have heavy, frequent periods and do not eat red meat get your iron checked.
The good news is we can remedy iron deficiency fast with a diet of iron rich foods.
Extreme Fatigue
Perimenopause can trigger extreme fatigue in which we struggle to get through the day.
Fatigue is a common symptom of iron deficiency – do get checked – but also a sign our body is not handling hormonal changes.
Hormone balancing issues in perimenopause are often rooted in our :
- Pancreas : due to excess sugar
- Liver : from excess alcohol
- Adrenal glands : magnesium deficiency.
A six week sugar and alcohol fast combined with a magnesium rich diet may help hormonal health and ease fatigue.
Poor Immunity
Heavy and frequent periods during perimenopause undermine our immune system. Nutritional deficiency from excess blood loss e.g. anaemia makes us vulnerable to infections and conditions like pneumonia.
It is essential to feed our immune system during perimenopause so it efficiently fights infection without triggering inflammation.
Gut Health
It is easy to write gut health off as a fad but there is a complex connection between our gut bacteria and reproductive hormones.
Gut bacteria levels and diversity impact the flow of oestrogen in our body but oestrogen flow may also impact gut bacteria diversity.
So gut health issues in our forties e.g. gastritis, IBS, can be a sign of oestrogen processing problems in perimenopause.
Use these simple steps to restore gut health without forking out for fancy probiotics.
Perimenopause & Inflammation
Perimenopause is often tied to a wide range of inflammation symptoms in our bodies :
- Lumps In Glands
- Bloating
- Swollen Joints
- Constipation
- Sinusitis
- Migraines
Take medical advice for such symptoms as they can indicate severe illness.
Lumps In Glands
During perimenopause you may find lumps in glands e.g. in armpits, crotch and neck.
Always see a doctor as they can be symptoms of serious conditions.
However, they can also be signs of :
- Hormone imbalance
- And / or a weakened immune system.
And the underlying triggers of these as we have seen can be alcohol and sugar, magnesium deficiency and anaemia.
The good news is you may be able to fix these underlying triggers fast with :
- 6 week sugar fast
- 6 week alcohol fast
- Good quality, free range red meat
- Magnesium rich food such as green soup
- And plenty of daylight daily.
Bloating
Uncomfortable bloating is a pretty common symptom during perimenopause and is often connected to other perimenopause symptoms such as anxiety and constipation.
Use this guide to quick natural bloating remedies to get to the bottom of yours.
Always see a doctor for persistent or frequently recurring bloating symptoms.
Swollen Joints
Some women experience swollen joints e.g. ankles, knees in perimenopause in addition to bloating. These can be as a result of hormone imbalance causing fluid retention.
The quickest ways to improve hormone balance are again sugar and alcohol fasting and magnesium rich food PLUS good quality fats. Fats are actually needed to produce hormones so low-fat diets can be disastrous.
Make sure your diet includes fats from :
- Nuts
- Seeds
- Eggs
- Non-farmed fish
- Pasture fed dairy from cows, goats & sheeps that have not had hormone supplements
- Meat free from added hormones.
Seek qualified medical advice for persistent or recurrent swollen joints.
Constipation
Constipation is a common problem during periods that aggravates pain and PMS. It can become worse during perimenopause.
Follow this guide for quick, simple steps to relieve constipation relief naturally.
Sinusitis & Sinus Infections
Repeated bouts of sinusitis and sinus infections can – very strangely – be signs and symptoms of perimenopause.
Again the underlying issues are hormone imbalance – ditch sugar & alcohol, boost magnesium & great fats – but these simple sinus remedies can give quick relief.
Migraines
Acute migraines can be a very distressing symptom of perimenopause. The underlying triggers are again typically nutritional deficiency and / or hormone imbalance.
Simple natural headache remedies can help us avoid dependency on pain killers but we need to tackle the common core causes :
- Iron deficiency
- Magnesium deficiency
- Frequent constipation
- Poor liver function due to excess alcohol
- General inflammation from sugar.
Some of us will have other migraine triggers but these 5 are the base line. We must tackle them for other treatments to work.
Seek qualified medical advice for recurrent headaches and migraine.
Perimenopause & Mental Health
Perimenopause is the start of a new stage of our lifecycle. Our body and the supporting chemistry of our emotions are changing.
The process of change can make emotions erratic just as it does in puberty. And the change itself can be discombulating – we’re meeting a new self we don’t yet know!
So perimenopause can be associated with mental health challenges including :
- Overwhelming anxiety
- Explosive anger
- Panic attacks.
However, these perimenopause “symptoms” can – yet again – be big red flashing light signs of basic issues with our metabolism.
That doesn’t mean the symptoms aren’t very real but it can mean the basic cause of the problem is NOT “the change” but our body’s inability to handle the change smoothly.
Luckily there are lots of simple ways to help our metabolism cope with the change better.
Overwhelming Anxiety
Increased and erratic waves of anxiety can be common in perimenopause. Some women experience high waves of anxiety in the morning during perimenopause.
The stress hormones such as cortisol are closely connected – for very good reasons – to our reproductive hormones as effective anxiety keeps us and our babies alive!!
So our experience of anxiety will change as our reproductive hormones decline.
However poor metabolism due to our diet can send these changes haywire :
- Caffeine over stimulates cortisol
- Sugar makes it very erratic
- Persistent iron deficiency undermines production of hormones and neurotransmitters such as serotonin which we need to balance out stress hormones
- As can low fat diets
- And diets low in protein.
Many of us in our forties are on faddish low fat, semi-vegetarian diets with little protein and no red meat that leave us so tired we devour cookies and caffeine to keep going.
So for some of us the simple solution to anxiety in perimenopause is to slash sugar and enjoy slap-up steaks instead!
Some people need professional mental health support for severe anxiety.
Flashes of Anger
Some women struggle with explosive bouts of anger in perimenopause. It can put pressure on family and work relationships and be a source of great shame.
The causes again can lie in the balance between reproductive hormones and mood boosters such as serotonin and oxytocin.
HRT is often prescribed for extreme anger in menopause to rebalance hormones.
But simple lifestyle changes when we first have flashes of anger in perimenopause can reduce the need for HRT later :
- Huge dollop of daylight daily for melatonin
- Good range of healthy fats
- More magnesium rich food
- Slash sugar and caffeine
- Sufficient protein including collagen from DIY bone broth & meat cooked on bone …
Panic Attacks & Palpitations
Anxiety and anger in perimenopause can turn into panic attacks. Erratic oestrogen decline can also rapidly increase our heart rate and cause palpitations.
Panic attacks and palpitations can both trigger more anxiety. But we can easily :
- Boost mood with the simple changes above
- Steady heart rate with breathing exercises.
Always seek qualified medical advice if you experience palpitations.
Perimenopause & Body Image
Our body image can change in surprising and striking ways in perimenopause :
- Acne
- Deepening Voice
- Facial Hair
Acne
Sadly, acne in our forties can be a symptom of perimenopause as hormone imbalance brings us out in spots as it did in our teens!!
We can end up feeling insecure about sudden spots but it makes sense to tackle our hormone imbalance before following typical treatments for the perimenopausal acne itself which can be very harsh.
The 3 simplest ways to balance hormones and relieve perimenopause acne are :
- Seriously slash sugar
- Eat magnesium rich greens
- Spend at least an hour outdoors daily.
If you don’t eat red meat, skin cells can also be weakened by B12 and iron deficiency.
Deepening Voice
A deepening voice in our late thirties can be the first symptom of perimenopause as our larynx is sensitive to declining hormones.
Some women love it but others find it very challenging for their body image. We can strengthen our larynx and voice control with simply humming and breathing exercises.
Facial Hair
Facial hair growth is typically a late perimenopause symptom but starts earlier for some women and can be distressing.
Body hair changes are a natural consequence of changing reproductive hormones but they can be exacerbated by :
- Too much sugar and insulin resistance
- A diet high in carbohydrates
- Excess cortisol from persistent stress triggers including constant phone and screen use.
Other Weird Signs And Symptoms Of Perimenopause
Perimenopause symptoms really do come in all sorts of shapes and sizes and in some cases are downright weird including :
- Morning Sickness
- Metallic Taste
Morning Sickness
Morning sickness in our forties can actually be a sign of perimenopause. Who knew?
The underlying trigger is falling oestrogen but protein deficiency on a semi-vegetarian or vegan diet can exacerbate symptoms.
If you are suffering try these simple pregnancy nausea remedies for instant relief.
Metallic Taste
A strange metallic taste in our mouth can also be a sign of perimenopause.
The glands that produce our saliva are actually very sensitive to hormone fluctuations and low saliva leaves our mouth dry or burning and make food taste weird.
Falling saliva is part of ageing but also a handy warning flag our hormones aren’t happy and need bringing back.into balance.
Simple Energy Boosting Perimenopause Remedies
All these perimenopause symptoms are clear warning signs to check in on our core metabolism and show it some love.
Super simple tweaks can transform our forties and help us thrive through our fifties :
- Slash all added sugar PLUS sodas
- Eat great red meat twice weekly (or take B12 & iron supplements and test regularly)
- Eat leafy greens daily
- Give up alcohol for 6 weeks yearly
- Eat natural fats daily e.g. organic dairy, seeds, nuts, eggs, non-farmed fish
- Include protein in every meal
- Spend an hour outside daily
- Walk or cycle 30 minutes daily
- Do an hour’s active work daily e.g. cleaning, gardening, DIY if your job is sedentary
- Detox for 6 weeks annually from addictive stress triggers e.g. caffeine, social media.
That really is it – we truly can balance our hormones and fight fatigue without fancy diets or expensive supplements!!
By caring for our core we allow our bodies to embrace change, not fight it.
I do hope this guide to perimenopause signs helps – if nothing else, do slash sugar and fix your iron if you’re not a red meat eater.
For more simple healthy tips to help you flourish in midlife check out these posts :
- How To Sleep Better
- Reduce Inflammation Fast
- Quick Constipation Relief Naturally
- Quick Natural Bloating Remedies
- Natural Remedies For Headaches
- 75 Iron Rich Foods
- Natural Remedies For Stomach Pain
- Natural Remedies For UTI
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Kim says
Thanks for this informative post. I didn’t know perimenopause causes heavier periods. That might explain some of my issues.
Alice says
So glad it helped. Like you I hadn’t got a clue and it caused all sorts of problems including anaemia.
Vanessa says
Very informative thank you! & l find it interesting about bouts of sinus infections as l hadn’t heard of thst being a symptom & l suffer from them anyway.
Alice says
Hi Vanessa – so glad you found it helpful. Very frequent sinusitis has been a big issue for me during perimenopause though not previously. I found upping the anti inflammatory food helped but biggest helps iron and vitamin D as really settled my immune system and stopped it getting in such a tizzy!! Best wishes Alice
Vanessa says
Thank you! I’m already taking vitamins D but not iron. Did you take an iron supplement & when you say gut health does that include heartburn & indigestion?
Alice says
Hi Vanessa – initially I ended up on iron medication as iron supplement I had been taking wasn’t helping. Finally I gave up decades of being a vegetarian and started eating small amounts of very red meat plus slices of black pudding as medicine!! Absolutely life changing – I have to say. Gut health definitely helps big time with general inflammation – yoghurt, kefir, raw cheese all good easy ways to improve without supplements. If you are suffering with heartburn have a read through this post https://sloely.com/instant-heartburn-relief-naturally/ if you haven’t already – it’s a bit of a monster as I was trying to capture so much information but the big take away is to prioritise healing damage to the food pipe and stomach lining by cutting out trigger foods (there’s a list in the post) for 6 weeks or so. Without healing the damage we just get locked in a cycle of pain and inflammation. Do hope this helps – please shout if any more questions, best wishes Alice
Vanessa says
Thank you! I’ve just been reading more helpful information that you have for sinus congestion remedies. There really is a wealth of it! I find orange can give me a headache & definately makes it worse if l have one. I’m I’m prone to getting headaches so avoid it. Do you know what l could have instead for a vitman c boost?
Alice says
Hi Vanessa – sorry for slow response, have been away on holiday. Bell peppers, strawberries, blackcurrants, guava, kiwi and papaya are all good for a vitamin C boost. Lots of green vegetables e.g. broccoli, cabbage & spring greens are also pretty rich. One cup can have 40/50% of your daily vitamin C and they are super rich in loads of other good stuff as well. Best wishes Alice
Daphne says
Hi Alice, this is really very informative. I have been seeing a menopause consultant. She said that even when you have your blood levels checked at my gp he/ she will say that everything is within the correct values.And yes thats what my gp said. Still she drew my attention to the fact that all results are average for everyone BUT when we get to different stages in our life ( puberty, pregnancy, peri menopause) our body uses and requires more than the average levels. This is something most gp’s fail to see. The levels are ‘normal’ yes, still why do I feel ‘bad’….. we are not average so it would help out a lot of women if this is more common knowledge.
Alice says
Hi Daphne – absolutely agree it’s critical we understand how our nutritional needs vary at different times of our lives. I think another big issue GPs don’t recognise is all the damage done through many years of nutritional deficiency e.g. iron, Vitamin D and that menopause nutrition needs to address both immediate needs and long term healing. Best wishes Alice