Posted on: April 1, 2026
Do you find yourself wondering if your random symptoms are pointing to something else? Do you wake up in the middle of the night for no reason? Finding you are not adapting to stress like you used to be? Find your mid-section creeping up despite not changing anything? Maybe you have spoken to a doctor or friend about it just to be told that it's stress or you are just getting older. If you're in your late 30s or older it's possible that these symptoms all have one reason, perimenopause. Perimenopausal hormones are not consistently released, which can make women feel confused about whether or not their experience is related to their hormones or not.
There are some common perimenopause signs that you should pay attention to that could mean you are in perimenopause. Remember it is always important to discuss new symptoms with your doctor to make sure other causes have been ruled out.
- Hot flashes: Hot flashes are one of the most common perimenopausal symptoms I hear about, and the most popular one we see in the media. Images of a lady fanning herself wearing a t-shirt while everyone else is in a sweater are common.
- Sleep disturbance: Sleep issues are the second most common perimenopause symptom I see with my patients. Trouble falling asleep can occur but it’s more common to have trouble staying asleep or to wake up earlier than you want to. Hot flashes and night sweats contribute but often the sleep changes seem to be for no reason.
- Menstrual cycle changes: Menstrual cycle irregularities begin in perimenopause. Your cycle may become longer or shorter. Your cycle may also become lighter or heavier than you’re used to.
- Spotting: Bleeding that occurs between your periods can be from hormonal changes as a result of perimenopause. New and unusual spotting should always be discussed with your doctor.
- Brain fog: Trouble thinking clearly or trouble finding the right word are common complaints in perimenopause. Memory issues are also common.
- Sore breasts: New sore, and swollen breasts may be a sign of shifting hormones from perimenopause. Breast tenderness can be a common PMS symptom but for women who have never had tender breasts, perimenopause can be a time that it occurs.
- Weight changes: Weight changes and changes to body composition without changing what you are eating or exercising could be from hormone changes that occur in perimenopause. Unintentional weight loss should be discussed with your doctor.
- Mood changes: Have you found yourself unusually irritable and snapping at others for no reason? It could be perimenopause hormone changes causing irritability. New or worsening anxiety and depression can also occur in perimenopause.
- Joint pain: Hormone changes, especially a decrease in estrogen can impact bone, cartilage, muscles, and tendons, leading to joint pain. A frozen shoulder is a common perimenopausal MSK issue I hear from patients.
- Libido changes: Libido can change and lower during perimenopause. Hormone fluctuations can cause vaginal dryness, a lower desire, as well as pain during intercourse.
- Urinary symptoms: Increased urinary frequency, urgency, and burning with urination can occur from fluctuating hormones in perimenopause. There can be an increased risk of urinary tract infections.
- Migraines: New or a noticeable increase in migraines may be related to hormonal fluctuations. New and lasting headaches should be evaluated by a doctor, but otherwise could be a sign of shifting hormones.
- Itching ears: Believe it or not itchy ears is a complaint I’ve heard from patients. It is a lesser-known symptom caused by fluctuating and declining estrogen levels. A decline in estrogen can reduce natural oil production, causing dry and sensitive skin within the ear canal.
- Hair and Skin changes: Hair loss, thinning hair, dry skin, and brittle nails can occur during perimenopause. As with many symptoms on this list, they should be evaluated for other causes, but hormone changes in perimenopause may be the reason.
- Body odour: Body odour may become stronger or change during perimenopause. Lower estrogen and higher testosterone can lead to the body odour changes along with changes to sweating from hot flashes and night sweats.
Do you have any questions or are you curious about how naturopathic medicine could help you manage your perimenopausal symptoms? Book an appointment today to find out more.