Guide to Recognising Symptoms of Perimenopause and Menopause

You would be forgiven for thinking that we've only just begun to understand the wider impact of hormonal changes in perimenopause and menopause. But healthcare providers have used the 34-item "Greene Climacteric Score" to assess menopausal symptoms since the 1970's. This means that for over 50 years, we've known about the widespread nature of symptoms during menopause. Despite this, they are still often overlooked.

Spotting the Signs: Symptoms to Look Out For

We now recognise over 60 symptoms impacting every system in the body. How many do you recognise?

• Irregular periods
• Changes in menstrual cycle length or flow
• Heavy or prolonged bleeding
• Spotting between periods
• Decreased fertility
• Vaginal dryness
• Decreased lubrication during intercourse
• Pain or discomfort during intercourse
• Changes in libido (sex drive)
• Difficulty feeling aroused (hypoarousal)
• Hot flashes
• Night sweats
• Mood swings
• Irritability
• Anxiety
• Depression
• Fatigue
• Insomnia
• Difficulty concentrating
• Memory problems
• Decreased stress tolerance
• Joint pain or stiffness
• Muscle aches
• Osteoporosis (in later stages)
• Skin dryness
• Itchy ears
• Dry eyes
• Changes in skin texture or elasticity
• Acne
• Hair thinning or loss
• Changes in hair growth patterns
• Brittle nails
• Palpitations (sensation of rapid or irregular heartbeat)
• Changes in heart rate
• Fluctuations in blood pressure
• Increased risk of heart disease (in later stages)
• Bloating
• Digestive issues (e.g., constipation, diarrhea, indigestion)
• New dietary sensitivities e.g. gluten, dairy
• Changes in appetite
• Cravings
• Reduced tolerance to alcohol or allergy to alcohol
• Urinary frequency or urgency
• Urinary incontinence
• Needing to pass urine at night
• Urinary tract infections
• Recurrent urinary tract infections
• Pelvic floor weakness
• Brain fog (difficulty concentrating or remembering and word-finding)
• Headaches or migraines
• Dizziness or light-headedness
• Tingling sensations (paraesthesia)
• Formication – the sensation of insects beneath the skin
• Vertigo
• Tinnitus
• Sensory sensitivities
• Shortness of breath
• New or worsening respiratory allergies
• Mood swings
• Anxiety
• Depression
• Irritability
• Rage
• Emotional instability
• Loss of confidence or self-esteem
• Changes in body image
• Insomnia
• Difficulty falling asleep
• Waking up frequently during the night
• Restless sleep
• Night sweats

Every Journey is Unique

This list shows the diverse range of symptoms that women may experience during perimenopause and menopause. It's important to note that not all women will experience all these symptoms. Individual experiences will vary: no two journeys will be the same.

Therefore it is important not to compare your experience to those of others around you, or to blame yourself in any way for symptoms that are extreme.

Equally there is no “one-size fits all” approach to managing symptoms. Everyone will need a unique set of tools in their toolkit. This often involve a large dose of trial and error to find what is right for you, but ultimately this journey of exploration is a worthwhile one. As part of this series, I'll be sharing advice on the steps you can take to determine what's right for you.