Perimenopause Symptoms Explained: What’s Normal, What’s Not, and Why You Feel So Off.
Perimenopause symptoms happen because your hormones are no longer steady, they’re fluctuating. And those shifts can affect far more than just your period.
Let’s break it down in a way that actually makes sense.
What is perimenopause?
Perimenopause is the transition phase leading up to menopause, and for many women it starts in their late 30s to mid-40s sometimes earlier than expected.
During this time, estrogen and progesterone don’t gradually decline in a straight line. Instead, they rise and fall unpredictably, which is why symptoms can feel random, confusing, or even unrelated at first.
This phase can last several years, and symptoms often come and go before periods become irregular.
What are the most common perimenopause symptoms?
Here’s the part most women are searching for and often not getting clearly answered.
The most common perimenopause symptoms include:
Fatigue or low energy
Sleep problems (trouble falling or staying asleep)
Mood changes, anxiety, or irritability
Brain fog or difficulty concentrating
Weight gain, especially around the midsection
Changes in menstrual cycles
Low motivation or feeling “flat”
Hot flashes or night sweats
Some women experience just a few of these. Others experience many and that doesn’t mean something is “wrong” with you.
Can perimenopause cause anxiety or mood changes?
Yes - very commonly.
Estrogen plays a role in serotonin and other brain chemicals that influence mood. When estrogen fluctuates, it can affect how calm, resilient, or emotionally balanced you feel.
Many women describe:
increased anxiety
feeling overwhelmed more easily
irritability they don’t recognize in themselves
These symptoms are often dismissed as “stress” but for many women, hormones are a significant contributor.
Why do perimenopause symptoms feel so unpredictable?
Because hormone levels during perimenopause don’t decline smoothly.
One month estrogen may be high. The next month it may drop suddenly. Progesterone often declines earlier and more consistently, which can affect sleep and anxiety.
This is why:
symptoms can change month to month
labs can look “normal”
and you may feel fine one week and completely off the next
Perimenopause is less about a single number and more about patterns over time.
What are unusual or unexpected symptoms of perimenopause?
This is where many women say, “No one ever told me this.”
Less talked about perimenopause symptoms include:
Headaches or migraines
Heart palpitations
Joint pain or muscle aches
Digestive changes or bloating
Skin changes
Increased sensitivity to stress
Feeling disconnected from your body
These symptoms can feel alarming, especially when no one connects them back to hormonal shifts.
How do I know if my symptoms are perimenopause or something else?
This is one of the most important questions.
Perimenopause symptoms often:
show up gradually
fluctuate
cluster together
don’t respond to things that “used to work”
That said, symptoms should never be automatically dismissed. Other health conditions can coexist with perimenopause, which is why tracking symptoms and advocating for yourself matters.
Understanding what your body is experiencing helps you ask better questions and seek appropriate support.
Is there one “right” way to support your body in perimenopause?
No — and this is where many women get stuck.
Perimenopause is not one-size-fits-all. What supports one woman’s energy, sleep, or mood may not support another’s.
That’s why generic advice can feel frustrating or ineffective.
The goal isn’t to do everything.
The goal is to understand what your body needs right now.
Feeling overwhelmed or unsure where to start?
If you’ve read this and thought, “This explains so much… but I still don’t know what to do next,” you’re not alone.
Perimenopause can feel confusing because it’s a transition and transitions require clarity, not guesswork.
That’s why I created a short, science-informed quiz to help you connect your symptoms to what your body may be asking for right now, whether that’s better energy support, hormone balance, stress regulation, or sleep support.
👉 Take the free quiz below to get clarity on your next best step in perimenopause.
Because you deserve to understand what’s happening in your body and feel supported through it.
Hi, I’m Dr. Jaime Lynne
A women’s health advocate and educator passionate about helping women navigating the confusing and often overlooked journey of perimenopause. Through my work and resources, I empower women to recognize their symptoms, speak up, and get the care they deserve.
Download the free Perimenopause Action Plan