Many women know the common signs of perimenopause, such as hot flashes, changes in periods, and weight gain. But there are many other symptoms that are less well known.
Menopause specialist Dr. Zubina Mawji explains, “During the menopause transition, your body makes less estrogen. Since estrogen receptors exist throughout the body, menopause can affect almost every organ.”
What Are Some Uncommon Menopause Symptoms?
The National Menopause Foundation lists 36 symptoms related to perimenopause and menopause. While some may seem unusual, they are normal signs of low estrogen.
Dr. Mawji says, “Women usually notice the obvious signs like irregular periods. But as we explore other symptoms, it becomes clear they may all be connected. It’s a journey of self-awareness.”
Not every woman will experience all these symptoms, but many could be linked to perimenopause.
Changes in Skin, Hair, and Nails
Menopause can cause surprising changes to skin, hair, and nails.
Acne: As estrogen drops, androgens (which increase oil production) become more active. This can cause adult acne or rosacea to flare up again.
Hair Changes: Estrogen supports hair growth and fullness. When it falls, you may notice thinning hair, more hair loss, drier hair, or even new chin hair.
Brittle Nails: Hormone changes can reduce keratin production, leading to nails that crack or peel.
Dry and Itchy Skin: Lower estrogen reduces collagen and moisture in the skin, causing dryness and itching.
Body Odor: Hot flashes and night sweats increase sweating, which can lead to stronger body odor due to bacteria on the skin.
Mood and Mental Health Effects
A 2023 study found that 15% to 50% of women during perimenopause or menopause experienced emotional symptoms such as:
Anxiety: New or worsening anxiety can occur due to hormone swings.
Depression: About 20% to 30% of women face depression during menopause, especially if they have a history of depression or severe hot flashes.
Panic Disorder: Around 10% of women may develop panic disorder or have more frequent panic attacks.
Digestive Issues
Your gut also responds to estrogen changes, leading to:
Constipation or Diarrhea: Hormonal shifts affect gut movement, causing irregular bowel habits.
Bloating: Common during perimenopause due to changes in digestion.
Heartburn: Weight gain and fat distribution changes can increase acid reflux.
Sleep and Energy Problems
Menopause can disrupt sleep and energy levels.
Sleep Problems: Hot flashes and hormone changes can interfere with your sleep cycle.
Fatigue: Low estrogen causes tiredness, worsened by poor sleep, stress, or diet.
Sensory Symptoms
Some women notice odd sensations:
Difficulty Concentrating: Many women find it hard to focus or pay attention.
Dizziness: Balance issues and vertigo can happen, possibly linked to hormone effects on the inner ear.
Electric Shocks (“Body Zaps”): Brief buzzing or tingling sensations may occur.
Tingling in Hands and Feet: Changes in estrogen affect nerve function, causing “pins and needles.”
Dry Eyes and Vision Changes: Lower estrogen can cause dry, itchy eyes, blurred vision, or light sensitivity.
Pain Symptoms
Menopause may cause various aches:
Breast Pain: Hormonal fluctuations can make breasts feel sore or tender.
Burning Mouth Syndrome: Some women feel a tingling or burning in the mouth, often with dry mouth.
Headaches: Hormone swings can trigger headaches or worsen migraines.
Joint Pain: Estrogen protects joints, so its decline can cause aches and soreness.
Muscle Tension: Some women feel more muscle tightness during menopause.
Heart Health Changes
Menopause increases risks to your heart.
Irregular Heartbeat: Up to 42% of women report palpitations or fluttering due to hormone changes.
Cholesterol Changes: Estrogen loss can raise cholesterol levels, increasing heart disease risk.
Other Symptoms to Watch For
Allergies: Hormone shifts can worsen existing allergies or cause new symptoms like congestion.
Urinary and Bladder Changes: Thinning tissues and weaker muscles may cause urgency, leakage, or infections.
Loss of Libido: Decreased estrogen, fatigue, and vaginal dryness can reduce sexual desire.
Osteoporosis: Bone loss speeds up after menopause, raising fracture risks.
Common Perimenopause Symptoms
These well-known signs often appear alongside less obvious ones:
- Brain fog
- Hot flashes
- Irregular periods
- Irritability
- Mood swings
- Night sweats
- Vaginal dryness
- Weight gain
Dr. Mawji says about 80% of women have typical symptoms, while 20% show unusual signs that only make sense when viewed through a menopause lens.
What Should You Do?
Perimenopause shouldn’t cause ongoing distress. If symptoms affect your life, see a healthcare provider trained in menopause care.
Your doctor will check for other causes before confirming menopause. Treatments vary, and hormone replacement therapy (HRT) may help moderate to severe symptoms.
“Many women feel relieved to learn their symptoms are real and treatable,” Dr. Mawji notes.
