This post is for informational purposes only and is not medical advice. Always consult your healthcare provider about your symptoms and treatment options.
If you’re trying to figure out what’s actually happening in your body, you can also start here: itsapowersurge.com
I want to tell you about the day I bought a 30X mirror.
I didn’t buy it because I was feeling glamorous. I bought it because I needed to see the whiskers before the sun did.
Yes . . . Whiskers, on my chin. One of them is grey.
And before you ask, yes, I now keep a pair of tweezers in my car. Because it turns out that sunlight is basically a searchlight for things your bathroom mirror was politely hiding from you. The sun has no such manners.
Nobody told me about this part of perimenopause. Not my mother, not my doctor, not the approximately 4,000 articles I’d read about “the change.” Hot flashes? Sure. Irregular periods? Yep, heard that one. But surprise facial hair that grows back stronger every time you pull it, like some kind of hormonal weed?
Complete silence.
So consider this your warning. Your real warning. The one your doctor probably glossed over because there are only so many things you can cover in a 15-minute appointment.
Quick Answer: What Are Common Perimenopause Symptoms?
- Brain fog Sleep disruption
- Anxiety and mood swings
- Heart palpitations
- Joint pain
- Body changes
- Hot flashes
WHAT IS PERIMENOPAUSE, REALLY?
Here are 12 perimenopause symptoms nobody warned you about, and for each one, we’re answering the question I know you’re asking: is this bad enough to talk to someone about, or do I just . . . suck it up?
Before we get into the list, let’s be clear about what perimenopause actually is because most of us were taught exactly nothing about it.
Perimenopause is the transition period before menopause, when your ovaries start producing less estrogen. It can start as early as your late 30s, but most women notice it in their mid-40s. It can last anywhere from 2 to 10 years. Yes, you read that right, up to a decade!
Menopause itself is just one day, the day that marks 12 consecutive months without a period. Everything before that is perimenopause and everything after is post-menopause.
Now that we’ve cleared that up, let’s talk about what’s actually happening to your body.
Facial Hair (Yes, Really!)
- FACIAL HAIR
Let’s start with the one nobody wants to talk about. As estrogen drops, the ratio of estrogen to testosterone shifts, and testosterone, even in small amounts, can cause hair to grow in new and very unwelcome places. Chin . . . Upper lip . . . Jawline.
My personal experience: One stubborn grey one that comes back within days of being pulled. A 30X mirror, tweezers in the car because the sun reveals what the bathroom mirror kindly conceals.
You are not turning into a different species. This is hormonal and completely normal.
Suck it up or see someone? Suck it up . . . tweeze, wax, or thread as needed. If it’s significant or comes on very suddenly, mention it to your doctor as it can occasionally signal other hormonal issues worth checking.
Brain Fog During Perimenopause
- BRAIN FOG SO THICK YOU FORGET YOUR OWN PHONE NUMBER
You walk into a room and have absolutely no idea why you’re there. You’re mid-sentence and the word just . . . leaves. You forget the name of someone you’ve known for 15 years.
This is brain fog, and it’s one of the most alarming perimenopause symptoms because it feels like something is genuinely wrong with your brain. It’s not. Estrogen plays a significant role in cognitive function, and as levels fluctuate, so does your mental clarity.
As my cousin Melissa, 50, put it: “I thought I was losing my mind. Turns out it’s just a really common symptom.” She’s right!
Suck it up or see someone? Mild forgetfulness . . . suck it up and know it’s normal. If it’s significantly impacting your work or daily life, or if you’re experiencing confusion or memory loss that feels more serious, talk to your doctor.
Sleep Problems During Perimenopause
- SLEEP THAT JUST . . . STOPS WORKING
Not just the occasional bad night. I mean waking up at 3am completely wide awake, soaked, heart racing, unable to get back to sleep. Night after night.
The sleep disruption of perimenopause is real and it compounds everything else. When you’re not sleeping, the brain fog gets worse, the mood gets worse, the patience gets thinner, and everything is harder.
In my house, this required a complete bedroom overhaul. I went from pajama bottoms and a t-shirt to underwear and a tank top. Then came the fan, aimed directly at my face, which meant negotiating with my husband, who was suddenly living in a wind tunnel. Now there’s a pillow wall between us to redirect airflow, plus layered blankets on my side that I pull on and off throughout the night. Hot. Cold. Sweating. Cold again. Repeat until morning.
Suck it up or see someone? If you’re having occasional rough nights, suck it up and try some cooling strategies. If you’re chronically sleep deprived, meaning this has gone on for weeks and it’s affecting your functioning, please talk to your doctor. Sleep deprivation is serious.
Emotional & Mental Changes During Perimenopause
Not all symptoms show up in your body. Some show up in your thoughts, your mood, and your ability to tolerate . . . well . . . anything.
- ANXIETY THAT CAME OUT OF NOWHERE
You were never an anxious person. And now suddenly you’re lying awake at 3am catastrophizing about things that would never have bothered you before.
Estrogen has a calming effect on the nervous system. When it drops, anxiety can spike, sometimes significantly. Many women are diagnosed with anxiety disorders during perimenopause when the real driver is hormonal.
Suck it up or see someone? If it’s mild, suck it up and know it’s hormonal. If it’s affecting your quality of life, your relationships, or your ability to function, please talk to someone. Both therapy and hormone support can help.
- RAGE. JUST . . . RAGE.
Not regular irritability. Actual disproportionate fury at things that should not be fury-inducing. The cabinet door left open, the way someone is chewing, the audacity of a slow driver!
Mood dysregulation is real during perimenopause. Fluctuating estrogen and progesterone affect the neurotransmitters that regulate mood, including serotonin and dopamine.
Suck it up or see someone? Know that it’s normal and give yourself grace. And look for strategies that help . . . when I start to get annoyed (which can quickly move to the rage category) I try to check in with myself and I ask, “Does this even matter?” That is often enough to keep me at annoyed or under on my self-regulation meter, and keep the rage at bay. If you’re feeling like you’re genuinely out of control or it’s harming your relationships, bring it up with your doctor.
Physical Changes in Perimenopause (What’s Happening in Your Body)
This is where things start to feel more obvious, your body doing things you didn’t sign up for, often without warning.
- HEART PALPITATIONS
Your heart randomly feels like it’s skipping a beat, fluttering, or pounding harder than usual. This one scared me the first time it happened.
Here’s what’s going on: estrogen helps regulate your cardiovascular system, including your heart rate. As levels fluctuate, so can your heart’s rhythm. Palpitations during perimenopause are common and usually harmless.
Suck it up or see someone? This one . . . see someone, at least once. Heart palpitations should always be checked out to rule out anything cardiac. Once you’ve been cleared by a doctor and know they’re hormone-related, you can relax about them. But don’t skip this one.
- JOINT PAIN AND STIFFNESS
You wake up and your hands are stiff. Your knees ache, and you feel approximately 85 years old getting out of bed in the morning.
Estrogen has anti-inflammatory properties. Less estrogen means more inflammation, which means joints that suddenly feel their age (and then some).
Suck it up or see someone? Mild stiffness that loosens up with movement, commit to a mastering a few good stretching or yoga poses, and suck it up. Significant pain that limits your activity, see someone . . . there are options.
- DRY SKIN, DRY EYES, DRY . . . EVERYTHING
Estrogen helps your body retain moisture. When it drops, things dry out. Skin gets thinner and dryer, eyes feel gritty. And yes . . . vaginal dryness, which we will absolutely talk about on this blog because pretending it doesn’t exist helps nobody.
Suck it up or see someone? Good moisturizers and eye drops handle the surface stuff. For vaginal dryness, please talk to your doctor. There are safe, effective, local treatments that make an enormous difference and you don’t have to just live with it.
- CHANGES IN YOUR PERIOD — BEFORE IT STOPS
Heavy. Light. Early. Late. Two in one month. Missing for three months then back with a vengeance. All of this is normal during perimenopause as ovulation becomes irregular.
Suck it up or see someone? Normal variation . . . suck it up. But: soaking through a pad or tampon every hour for several hours, bleeding that lasts more than 7 days, or spotting after sex . . . see your doctor.
- A COMPLETE CHANGE IN YOUR BODY SHAPE
You’ve been the same size for 20 years. You haven’t changed how you eat, and suddenly your waistline is going somewhere without you.
Declining estrogen shifts fat distribution toward the abdomen. This is not a willpower failure, this is hormones doing what hormones do.
Suck it up or see someone? This is largely hormonal and lifestyle adjustments genuinely help. If you’re gaining weight rapidly and unexpectedly, it’s worth a conversation with your doctor to rule out thyroid issues.
- HOT FLASHES THAT DON’T CARE WHERE YOU ARE
In a meeting, at a restaurant, in the checkout line. Suddenly your entire body is a furnace and you are on fire from the inside out . . . plus you are absolutely certain everyone can see it happening.
Hot flashes, sudden waves of heat usually starting in the chest and moving upward, are caused by estrogen’s effect on the hypothalamus, the part of your brain that regulates temperature.
Suck it up or see someone? Mild and manageable . . . suck it up and dress in layers. Severe hot flashes that are disrupting your sleep and quality of life . . . talk to your doctor. This is one of the most treatable symptoms of perimenopause.
- FEELING LIKE YOU DON’T QUITE RECOGNIZE YOURSELF
This one isn’t purely physical symptom. It’s something you are probably trying to ignore.
You look in the mirror and there’s a moment, just a moment, of not quite recognizing the person looking back. Not because of the whiskers (though those don’t help), but because so much is changing so fast, inside and out, and nobody prepared you for how disorienting that would feel.
You’re not falling apart. You’re in the middle of a significant biological and life transition that would disorient anyone. The women who come out the other side, and they all do, tend to say the same thing: they didn’t know how powerful they were about to become.
Suck it up or see someone? Talk to someone . . . a friend, a therapist, your doctor, or just this little corner of the internet. You don’t have to navigate this alone.
THE BOTTOM LINE
Perimenopause comes with a lot of symptoms that nobody puts on the official list. The whiskers, the tweezers in the glove compartment, the pillow wall between you and your husband, the 3am catastrophizing, and the rage about the cabinet door.
All of it is real, all of it is normal, and all of it deserves to be talked about . . . loudly, honestly, and with a little humor, when we can manage it.
Got a symptom nobody warned YOU about? Drop it in the comments. I promise you, you’re not the only one!
Want help figuring out what’s actually happening in your body?