Perimenopause Symptoms No One Talks About (But Really Should)

When we think about perimenopause, the usual suspects tend to come to mind: hot flushes, irregular periods, night sweats, maybe a bit of moodiness. But for many women, this transitional phase - sometimes lasting up to 10 years before menopause officially begins - is filled with a whole host of lesser-known symptoms that often go unmentioned, misdiagnosed, or flat-out dismissed.

If you’ve ever found yourself wondering “Is this normal?”, this one’s for you. Below, we explore the hidden and under-discussed symptoms of perimenopause that deserve far more attention—and compassion.

1. Electric Shock Sensations

Yes, you read that right. Some women report experiencing sudden, sharp, almost zapping sensations under the skin - often in the head, chest or limbs. These fleeting shocks are thought to be linked to fluctuating oestrogen levels affecting nerve function, but because they’re so unexpected and unusual, they’re rarely discussed.

2. Skin Crawling or Itching (Formication)

Another nerve-related issue, formication feels like ants crawling across your skin. This can come with or without visible irritation, often driving women to distraction. Hormonal shifts can alter skin sensitivity, hydration, and collagen production - making dryness, itching, or tingling more common during perimenopause than many realise.

3. Joint Pain and Muscle Tension

Oestrogen plays a role in keeping inflammation in check, so when levels start to drop, aches and stiffness can sneak in—especially in the morning. This isn’t just “getting older” or sleeping funny. Perimenopausal joint pain, sometimes called “menopausal arthritis,” can affect the hands, knees, neck, and lower back.

🔗 Read more on oestrogen and joint health

4. Burning Mouth Syndrome

A strange one, but very real. Some women experience a burning, tingling, or scalding sensation in the mouth, tongue, or lips during perimenopause. It may be related to decreased saliva production and changing pain perception due to hormonal shifts.

🔗 NHS guide to burning mouth syndrome

5. Heightened Anxiety or Panic Attacks

You may never have experienced anxiety before and suddenly find yourself unable to sleep, worrying excessively, or waking up in a panic. Hormonal fluctuations, especially falling progesterone and oestrogen, affect the brain’s GABA and serotonin systems—key players in calmness and mood regulation.

This isn’t “just stress.” It’s a neurological and hormonal shift that deserves understanding and support.

6. Heart Palpitations

A fluttery heartbeat, skipped beat or racing pulse can be alarming. For some women, these start to appear out of the blue during perimenopause, often tied to oestrogen drops. While it’s always worth getting checked out to rule out heart conditions, hormone-related palpitations are more common than you’d think.

🔗 British Menopause Society on cardiovascular symptoms

7. Changes in Body Odour

Surging and dipping hormones can alter how your body metabolises sweat, and even the bacterial composition on your skin. You might find you smell different - stronger or just not like “you.” Totally normal, yet hardly ever discussed.

8. Digestive Shifts

Bloating, constipation, sudden food sensitivities? As oestrogen and progesterone levels change, so too does your digestive rhythm. Add to that the stress hormone cortisol, and you’ve got a recipe for unpredictable gut behaviour. Many women even develop symptoms that mimic IBS during this stage.

🔗 Read more on gut health and perimenopause

9. Loss of Confidence or Motivation

Perimenopause isn’t just a physical experience - it’s deeply emotional. Many women describe a sense of losing themselves, feeling overwhelmed, or no longer trusting their instincts. This isn’t weakness - it’s your brain rewiring itself during a major hormonal transition. With the right support, you will find your footing again.

10. Tinnitus or Increased Sound Sensitivity

Some women notice ringing in their ears or an increased sensitivity to noise. Though the link between oestrogen and the inner ear isn’t fully understood, hormone shifts seem to affect hearing and auditory processing in a small but significant number of women.

So, Why Don’t We Talk About These Symptoms?

Perimenopause remains one of the most under-discussed phases in a woman’s life. Many symptoms are subtle or easily mistaken for other conditions. Others are brushed off by healthcare providers unfamiliar with the full spectrum of perimenopausal experiences.

But knowledge is power - and talking about it openly helps all of us.

What You Can Do:

• Track your symptoms: Use a journal or an app to monitor patterns—it helps with clarity and medical conversations.

• Seek support: Whether through a menopause-literate GP, therapist, nutritionist or community group, you don’t have to go through this alone.

• Support your nervous system: Sleep, breathwork, adaptogens, and functional mushrooms (like Reishi and Lion’s Mane) can help balance mood, brain fog, and inflammation.

• Explore lifestyle and dietary changes: Prioritise gut health, reduce stimulants, stay active, and focus on nourishing whole foods.

• Advocate for yourself: If something feels off, it probably is. You deserve to be heard.

Final Thoughts

Perimenopause can feel like your body is rewriting the rules without your permission—but the more we speak up, the more empowered we become. These “invisible” symptoms are very real, and recognising them is the first step toward easing the journey.

You’re not imagining it. You’re not alone. And no, you’re not going mad—you’re perimenopausal.

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