
The signs and symptoms of perimenopause are getting more and more coverage in the media. That sounds great as the more we midlife women understand about perimenopause and menopause the better.
But too often the symptoms and signs described are menopause symptoms and NOT perimenopause symptoms at all. Perimenopause actually starts in our late thirties – a good decade before most of us will hit full menopause – and the symptoms of perimenopause are often completely different from menopause.
Because of this confusion many of us suffer with a whole load of weird symptoms in our forties, not recognising they are sure signs of perimenopause and not realising what we can do about them.
We think because we are still having regular periods we can’t possibly be menopausal.
But heavier and more frequent periods are actually a big sign of perimenopause.
So I have got for you here a guide to 20 different symptoms of perimenopause.
PLUS the key warning signs these symptoms are giving us about our overall body health and how addressing these symptoms can actually make menopause much easier when it comes.
Use the index below to find quickly symptoms you are suffering with.
Then I have for you a separate guide to the simple natural perimenopause remedies and lifestyle changes you can make right now to ease both the physical and mental symptoms of perimenopause.
I do hope these guides help. I would love to hear your thoughts. Do save or bookmark it for reference and please do share with friends if you found it helpful.
But please remember I am not a doctor and this post does not provide qualified medical advice. If you have any unusual or unexplained medical symptoms at any stage of your life you should always see a doctor.
Perimenopause Symptoms
Table of Contents
Menstrual Cycle Changes During Perimenopause

Heavier Periods
Heavier periods are very common during early perimenopause and in some cases they can become so much heavier it’s distressing and debilitating because we need to go to the loo at least every hour to change sanitary protection.
Many women find they have to double up their protection with tampons or a menstrual cup plus sanitary towels and period pants. Very heavy periods during perimenopause can leave us feeling out of control and fuel our anxiety.
If you are struggling do have a read of this article on heavy periods during perimenopause – you really are not alone.
More Frequent Periods
Another common symptom of perimenopause is more frequent periods. Your regular 4 week cycle may switch to a 3 week cycle and in some cases you may have a period every fortnight with all the PMS and period symptoms and challenges that go with that.
Changes in period frequency can be signs of other medical problems so it is always worth getting medical advice when they become more frequent.
Anaemia
Anaemia is a significant risk for menstruating girls and women all the way through our life but heavier, more frequent periods in our early forties puts many women at increased risk of anaemia.
If you have heavy and / or frequent periods during your forties it is definitely worth getting tested.
Many of the symptoms we associate with hormone imbalance in perimenopause and menopause including extreme fatigue and brain fog are actually symptoms of iron deficiency. The good news is we can actually remedy this with a diet full of iron rich foods.

Extreme Fatigue
Without getting tested for iron deficiency we won’t know if we are anaemic or not but we will know we’re extremely, extremely tired to the point we long for bed and struggle to get through the day. This can be very hard to cope with but can often be significantly improved by dealing with underlying anaemia.
Poor Immunity
Anaemia and other nutritional deficiencies arising from heavier and more frequent periods can really undermine our immune system and leave us vulnerable to severe infections and conditions such as pneumonia. So it is important to get tested and to feed our immune system.
Gut Health
Gut health has become a trendy subject and it is easy to write it off as a fad. But there is actually a complex relationship between our gut bacteria and our reproductive hormones. It seems that levels of different bacteria in our gut can actually impact how much oestrogen our body produces.
Poor gut health in our forties – fuelled by the sugar and caffeine we mainline to “cope” with fatigue – can cause excess oestrogen in perimenopause which in turn causes a whole load more problems in menopause.
This guide to natural perimenopause remedies includes tips on how to improve gut health.
Perimenopause & Inflammation
Inflammation In Glands
You may find lumps in your glands in your armpits, crotch and neck during perimenopause. Obviously, these can be symptoms of other serious conditions, so you should always consult a doctor but they may be relieved by addressing underlying hormone imbalances triggered by perimenopause.
Bloating
Many women experience bloating during perimenopause. Although common bloating can be a symptom of serious medical conditions and you should always seek medical advice if it persists or returns frequently.
Uncomfortable bloating in perimenopause can be triggered by a range of other perimenopause symptoms including anxiety, constipation and poor immunity. This guide to quick natural bloating remedies has got an in depth explanation of all the different triggers to help you get to the bottom of yours.

Swollen Joints
Some women experience swollen joint symptoms in perimenopause in addition to bloating. This can be as a result of hormone imbalance causing fluid retention. Again you should seek medical attention for these symptoms.
Constipation
Constipation is a common problem during periods that can make period pain and PMS worse. It can become worse during perimenopause. Constipation is another symptom of hormone imbalance during perimenopause that can itself trigger other symptoms.
Use this guide to get constipation relief naturally.

Sinusitis & Sinus Infections
This is a strange one but you may find yourself getting repeated bouts of sinusitis and resultant sinus infections at certain points of your menstrual cycle during perimenopause. Again addressing the underlying unbalances in our bodies is the long term answer but these simple sinus relief remedies can help in the short term.
Migraines
The onset of acute migraines can be a very distressing symptom of perimenopause. Learning about natural headache remedies is important to reduce dependency on pain killers but again the only real way to address severe migraines during perimenopause is to sort out the underlying nutritional deficiencies and hormone imbalances.
Perimenopause & Mental Health

Overwhelming Anxiety
We express our general anxiety in very different ways but you may find it becomes overwhelming during perimenopause. Knowing that you’re not alone helps but some women – I was one of them – find we need to make quite significant changes to our lifestyle during perimenopause to manage the anxiety.
Some women experience high waves of anxiety in the morning during perimenopause.
This seems to be connected to changes in the way our reproductive hormones respond to the rise in cortisol – the stress hormone – that helps get us out of bed in the morning. Pre-perimenopause these hormones dampen down the cortisol; in perimenopause the cortisol plays merry havoc.
This is why – as explained in more detail in the natural remedies for perimenopause – that reducing caffeine and managing stress everyday are so key during perimenopause.
Flashes of Anger
Other women find they struggle with explosive bouts of anger at some stages of perimenopause. It can put intense pressure on family and work relationships and be a source of great shame.
Again the causes of this perimenopause symptom lie in the balance between our reproductive hormones and other hormones such as serotonin and oxytocin.
HRT is often recommended for extreme anger during perimenopause to rebalance hormones but improving gut health may actually deal with the more fundamental problems.
Panic Attacks
Both anxiety and anger can escalate into panic attacks but its worth knowing that palpitations are a symptom of perimenopause for some women. They can be very frightening, and we should always seek medical attention for them but it can be helpful to know that these physical and emotional symptoms can have different triggers that may need addressing separately.
Perimenopause & Body Image
Acne
Acne in our forties!! Really!!!
Yep, I am sorry to say hormone imbalance can bring us out in spots just like it did when we were teens.
Perimenopausal acne can obviously be very distressing especially if its severe. Typical treatments for perimenopause acne can be pretty heavy handed so it is always worth trying natural perimenopause remedies to improve gut health and restore hormone balance first.
Deepening Voice
For some women a deepening voice in their late thirties can be one of their first symptoms of perimenopause. Some women love it but for others it can be very challenging.
Facial Hair
This is more typically a late perimenopause symptom as full menopause gets under way but for some women it starts right at the beginning of perimenopause and can be distressing.
Changes to our overall body hair are a natural consequence of our declining reproductive hormones but yet again the problem can actually be other hormones such as cortisol getting out of control.
There are obviously a wide range of treatments for facial hair removal but it really is worth investing in our gut health to see if this can help,
Other Weird Perimenopause Symptoms
Perimenopause symptoms really do come in all sorts of shapes and sizes and in some cases are downright weird.
Morning Sickness
Morning sickness in our forties can actually be a sign of perimenopause. Who knew?
If you are suffering check out these simple pregnancy nausea remedies that can give instant relief.

Metallic Taste
Alternatively you may experience a strange metallic taste in your mouth which doesn’t make you nauseous but does put you off some of your favourite meals.
Perimenopause Remedies
Our experiences of perimenopause obviously vary greatly but hopefully this list of perimenopause symptoms will help you know that you’re not alone in these sometimes distressing changes.
The good news is we can start relieving many of these perimenopause symptoms right away with simple lifestyle changes and natural remedies.
So now you understand why you are experiencing all these weird symptoms in your late thirties and forties do now read my guide to natural perimenopause remedies. The guide takes you through 8 key changes that ease perimenopause symptoms by :
- Rebalancing hormones
- Strengthening our immune system
- And improving our gut health
By relieving our current symptoms these simple perimenopause remedies can improve our overall wellbeing in midlife and prepare us for a happier and healthier menopause. So do give it a read.

I truly hope these guides to perimenopause symptoms and perimenopause remedies help you as much as they have me. For more simple tips on relieving other common conditions so you can flourish in midlife do check out these other guides :
- 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