Journal / Menopause

6 Annoying Perimenopause Symptoms and How to Deal With Them

Dr. Green

Medically reviewed by Dr. Green OB/GYN

Written by Winona Editorial Team

Last updated April 01, 2022

6 Annoying Perimenopause Symptoms and How to Deal With Them

The first step in dealing with annoying perimenopause symptoms is recognizing that you are in perimenopause. Perimenopause is the period of time before menopause and usually starts around that 40th birthday. By definition, menopause occurs when you have gone 12 months without a period, and is due to the drop in the hormones estrogen and progesterone. Because perimenopause can last up to 10 years, these symptoms can take a serious toll on your quality of life if not recognized and dealt with.

Perimenopause can be fraught with uncomfortable symptoms that many women don’t recognize as hormone-related. Once we recognize that those achy joints, headaches, and mood changes are hormone-based and treatable, we can start to live our best life again. Let’s not talk about hot flashes for a minute - everybody talks about them, most women get them and they are super easy to treat. Instead, let’s focus on the lesser-known symptoms of perimenopause.

This article will provide a snapshot into 6 annoying perimenopause symptoms and how to manage them. At Winona, we strive to help you make the second half of your life even better than the first.

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Say goodbye to dryness. For Good.

The Stages of Perimenopause:

Early perimenopause usually occurs in your late 30s to early 40s. Your progesterone and estrogen levels start to fluctuate more than ever. Your periods will change - shorter span between them, heavy period, light period, no period and spotting. During this time, you may start to notice changes in your temperature regulation, memory lapses, and vaginal dryness.

Late perimenopause is where both progesterone and estrogen start to plummet and you are skipping your periods more often. You might now start to feel the hot flashes, mood changes, achiness, and sleep disruptions.

Menopause occurs after you’ve gone 12 consecutive months without a period (for no other biological cause). The average age for menopause is 51 but it can occur in women in their 40s or younger. 

Postmenopause is the rest of your life! Making sure you have balanced hormones for the duration is key to leading a wonderful second chapter. Vaginal changes and osteoporosis typically get worse without treatment. The risk of heart conditions also increases postmenopause. So, postmenopause is not the time to assume that your menopause journey is over. Rather, maintaining your hormone levels for ideal health is critical for the rest of your life.  

6 Annoying Perimenopause Symptoms & Solutions

Gaining weight, but only around the waist

While many doctors might discount this weight gain as simply part of aging, it is not necessary, nor is it healthy. The type of weight gain at perimenopause (belly weight) increases the chances of many diseases including cardiovascular disease, stroke, type 2 diabetes, and some forms of cancer. 

As your hormones start to drop, so does your metabolism. By readjusting your decreasing hormones you can stop the weight gain and get your familiar, youthful curves back. 

Of course, with age, we need to be aware of a balanced diet, consume fewer calories and ensure that we get at least 30 minutes of exercise a day including strength training. While all of that is good, it won’t be enough to combat the ever-decreasing hormones. Hormone replacement therapy (HRT), in combination with these lifestyle changes, can make all the difference in your weight gain and distribution. 

So much anxiety, moodiness and can we talk about memory lapses?

Perimenopause impacts both a woman’s mind and her body. The dramatic decrease in estrogen and progesterone during perimenopause is often overwhelming. Persistent sleep disturbances can contribute to the development of and worsening of anxiety symptoms, moodiness and memory lapses. Unfortunately, many women do not correlate their anxiety, moodiness, and sleep disorders with perimenopause,

It is critically important for women experiencing anxiety and memory lapses in their late 30s to mid-40s to recognize that they may be in perimenopause. These decades often mark significant life changes that can adversely impact a woman’s mental health. 

During this time, women may be helping aging/ailing parents, saying goodbye to children who are leaving home, facing increased career demands, and possibly dealing with other personal health concerns. This combination of physical and environmental changes causes stress and anxiety which also affects a woman’s ability to function. 

The good news is that there are effective treatments. If a woman’s medical history allows, anxiety, mood disorders, and ‘brain fog’ can be abated with hormone replacement therapy (HRT).

Achy Joints and Headaches

Perimenopause is a time when the hormones that help with inflammation are dropping. Because they are dropping, you may start to notice joint pain that can affect the knees, shoulders, neck, elbows, or hands. Old joint injuries may begin to ache anew. Many will say that these aches and pains are due to aging - and they are - sort of. As we age, our hormone levels decrease and you may start to notice that you feel more aches and pains in certain areas than you used to. That’s because estrogen helps to reduce inflammation. As its levels decline, inflammation may increase, causing discomfort and even menopause-related arthritis2

Beyond the pains in your joints, fluctuations in estrogen are also linked to migraine headaches. You may get migraines for the first time or see an increase in severity or frequency during perimenopause. It’s unclear why, but some women have the reverse reaction, and see a reduction in migraine occurrence as they enter menopause. This may be because high levels of estrogen can trigger headaches and when those levels are diminishing during perimenopause that can cause a decrease, but that is rare.

Sleepless in Seattle, Sacramento, and Sarasota

Let’s not underestimate the value of a good night’s sleep. Falling levels of the hormone progesterone — characteristic of early perimenopause — can make falling and staying asleep a struggle.  

When our hormones drop, especially estrogen and progesterone, insomnia becomes all too familiar. Progesterone is a calming hormone, sometimes called the ‘feel-good hormone,’ so when you have less of it you may feel more restless. Replacing those dropping hormones can get you back on track for a good night's sleep - how fantastic does that sound? 

Beyond HRT, maybe start to create a relaxing nightly routine. That will mean something different for every person but a few examples include no electronics an hour before bedtime, a bath, and settling down in a cool dark room to help trigger rest and peacefulness. 

Sexual Dysfunction

As the hormones are decreased and depleted during perimenopause many women notice a decrease in their libido and problems reaching climax. Painful sex is another common concern in perimenopause.

Hormones are a necessary part of maintaining vaginal tissue health. Low hormones can result in vaginal tissues that are dry and thin leading to painful intercourse. It makes sense then that if hormone levels are too low there can be arousal problems and pain. HRT can improve the vaginal dryness that can lead to painful sex almost immediately in the form of vaginal estrogen creams.

Feel like yourself again.

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Feel like yourself again.

Skin, Eyes and Hair Changes

When your estrogen, progesterone, and testosterone levels decrease during perimenopause, collagen production also decreases. Collagen is a protein your body produces that strengthens your skin and hair and progesterone keeps your skin and eyes moist. When it drops, your skin becomes dry, wrinkly, and itchy. 

The lighter your skin, the more prone you are to these symptoms. Many women experience flare-ups or new cases of allergies, acne and eczema in perimenopause.

Strangely, the eyes may be one of the first places that hormonal changes start to manifest. Dry eyes and changes in your vision (like going from near-sighted to far-sighted) are common symptoms of women in perimenopause.7

Summary: Safe, natural, bio-identical HRT is available with Winona, if prescribed. Winona was created by perimenopausal and menopausal women, for menopausal women – and their partners and families. 

A simple question, “When does menopause start” can lead to so many answers. We all have a unique story to tell. Winona is working hard to prevent other women from unnecessarily suffering from these symptoms. Reach out to our Winona physicians for your free consultation today at





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