Top 3 Most Commonly Reported Perimenopause Symptoms: Not What Everyone Thinks

It goes without saying that perimenopause comes with a LOT of changes as our bodies adjust to lower estrogen levels.

When we think about peri it’s easy to get caught up in all the common stories we hear and read everywhere about hot flashes and night sweats. I was one of those people who immediately thought of hot flashes when thinking about peri- or menopause. But when my journey started I was surprised to recognize that my symptoms were NOT in fact hot flashes and night sweats, but I had an absolutely different set of symptoms. These symptoms made me anxious until I was able to connect them to perimenopause transition.

I was recently doing research on what actually are the most common initial symptoms in perimenopause. I stress here that we are talking about perimenopause. I came across an article in https://www.forthwithlife.co.uk/ about most commonly reported symptoms by women and learned that they conducted multiple surveys of total over 11,000 perimenopausal women. They did it in a span of 2 years: 2022 & 2023. I was very surprised to find out that it painted a very different picture! It turns out, perimenopause isn’t all about what we thought. Let’s break down the most commonly reported 3 symptoms, the real ones women are dealing with, and how you can manage them.

1. Mood Changes: More Than Just Hormones

The number one perimenopause symptom reported by women? Mood changes. Anxiety, bursts of anger, and unexplained sadness—these are incredibly common. I was definitely affected… In fact, 87% of women surveyed reported their moods had been affected often or all the time.

Here is what other women on forums say about this symptom and what it meant for them:

“I had shocking anxiety, hot flashes, mood swings and shocking crying fits, regularly walked out of jobs because of all of this.”

“Just wanted to chime in here for all you brutally suffering with peri… That was me… for over 10 years. Extreme anxiety / depression, etc. etc. I know everyone is different, but I just want to say that there is hope, well for some of us. I’m now just over a year without a period. I don’t have any medical explanation as to why I feel so much better. Although I do have the mid weight gain, but I will take that over the emotional roller coaster I was on.”

“Talk to me about dizziness, lightheaded off balance feelings not anaemic! Oh the joys of peri peri and health anxiety does me no favors that alongside the reflux gives me no peace…”

“Been having bad anxiety/panic the past couple days but trying to deal. Dizziness, faint feeling, numbness/tingling in hands/feet, lower back and knees ache, and no energy at all.”

“Does anyone have stomach problems with anxiety as their symptom of menopause? My stomach always feels like it’s in knots and I am nauseous and cannot hardly eat anything. Especially my upper tummy.”

And here’s the thing – these mood changes are natural. The shifting hormones definitely exaggerate those changes, but there’s strength in accepting them. Rather than resisting or fearing the feelings, know that they’re part of the process. When you approach these emotions with curiosity and / or calm acceptance instead of fear, you know that they will pass. Knowing that they will pass, will help you to reduce the stress they bring. You aren’t losing control, you’re adapting.

There are activities that are known to boost mood and calm anxiety down. I’d like to think of them as lifestyle tools. Among them are gentle exercise, meditation, or even just connecting with someone who understands. Pick the ones that fit your lifestyle and preferences and start doing them, even if it is just for a few minutes a day. For example, you can start with a 30-min walk each day, and then maybe adding some meditation. I built up my walking from 2,000 steps a day to 10,000 steps and I now walk minimum 10,000 steps a day. During my walk I enjoy listening to my favorite podcasts. I personally can attest to the fact that walking is calming for anxiety and swirling thoughts. For relaxation and meditation I discovered Yoga Nidra. It is a a guided meditation practice which is powerful in slowing down body and mind. It works great for me when I practice it to fall asleep. It is super easy to do: you just listen to a pleasant voice and follow the directions. Here is a great example of one such practice session that helps you to calm your nervous system.

2. Poor Sleep: It’s Not Just About Night Sweats

Sleep problems are another top symptom, and not just because of hot flashes. Nearly 80% of women reported having trouble sleeping. It might be difficulty falling asleep, staying asleep, or simply waking up feeling unrested.

It’s tempting to think this is just an inevitable part of perimenopause, and I succumbed to this temptation myself as I am struggling with sleep as I am writing this! But I tell myself there are ways to work with my body to improve sleep. I set my bedtime routine that feels calming. For me it is taking warm/cold shower. I keep room very cool, but I use warm water bottle to warm up my feet. I listen to Yoga Nidra (mentioned above) and fall asleep. My biggest problem now is staying asleep, as i wake up 2-3 times each night and I finally wake up at 6am, sometimes not feeling rested, but unable to fall back to sleep. I am currently experimenting with natural calming herbs and magnesium. Most importantly, I think we should not let these sleep problems get to us and cause extra stress. I guess my mantra here is that I am aware that the reason I am having all these unpleasant sleep issues because of shifting hormones, but I am not letting myself to be stressed out by it. Instead, I try to observe my body and work with it to see what will have positive effect. I officially let go of the struggle!

Here is what other women on forums say about their struggles with sleeping:

“What can I take or do to get a decent night’s sleep? I’ve never really been one to sleep through the night ever but as I’ve gotten older its gotten far worse. I fall asleep with no problems but literally never sleep through the night. I’m lucky if I get 2 hours before I’m awake again. Literally, I wake up about every 2 hours.”

“Suffering from chronic sleep problems. Can fall asleep no problems – just don’t stay asleep for long (2-3 hours) and then that’s it for the night.”

“I’m also having trouble sleeping bought every type of over the counter sleep aid and their all crap takes me ages to get to sleep then I’m wide awake about 3 or 4 in the morning…”

“I’m working with 2-3 hours per sleep myself. I must go to bed early because I wake at 2:30am and cannot fall back asleep.”

3. Digestive Issues: An Overlooked Reality

It’s not something we talk about when we discuss perimenopause, but digestive issues were among the top three symptoms women reported! Nearly 78% of women said they experienced bloating, constipation, or other digestive discomfort during perimenopause. This is due to fluctuating hormone levels that impact gut health. We also notice how being stressed out or anxious causes unpleasant intestinal symptoms, or gastric symptoms such as excessive stomach acid or diarrhea. Considering that number one reported symptom is being extra moody, anxious or stressed out, no wonder that it could contribute to appearance or exacerbation of digestive problems.

Supporting digestion with the right foods can make a world of difference. I started experimenting with incorporating more fiber, fermented foods, and plenty of water. I learned that one can also use mindfulness techniques to help ease digestion, so now I try to slow down when eating and savor each bite. Finally, taking a warm bath and gently massaging your stomach in a clockwise motion can help relax soft tissue and soothe your digestive system.

There are also various supplements that help easing or improving digestive symptoms. Here are some that worked for me. They improved motility and also calmed my stomach acidity.

• Pre- and Probiotics
• Apple Pectin
• Chamomile Tea
• Apple Cider Vinegar

Here is what other women on forums say about their digestion:

“I get stomach aches when I eat now because I don’t eat as much as I used to and my stomach seems to be sensitive and digestive issues. I get full faster and things stick on top and then when it goes down to stomachaches. My metabolism obviously has slowed it down and my weight has been put on so this is just crazy. Anyone else with digestive and stomach issues at this time of life?”

“Yes I cant eat pasta too much anymore”

“Yes, I have found that I have small windows where my hormones are just right and I can eat what I want for several days then it’s back to stomach pain, reflux and slow digestion. It’s off and on with more on lately. I’ve had tons of tests. Nothing wrong with me that they can find. I’m sure it’s hormone related.”

“Is anyone else having serious constipation issues? If I poo once a week naturally it’s a miracle. & if I drink any more water I’ll start leaking. I take a mild laxative every now & again but it tears my stomach up. Help!”

“The acid in my stomach is really bad. I’ve always been a worrier but its got worse while going through this journey.”

“I know its made worse by anxiety and even seeing a therapist to help with that but it feels like my stomach is on fire and I can literally feel it burning and bubbling.”

“I’ve been experiencing some big time bloating the last couple weeks. I feel like my stomach is about to explode. I’ve tried gas pills and yogurt but nothing seems to help.”

“I drink warm water with lemon juice and a pinch of acv with honey and it helps my bloating go away drink it every morning and it also stabilize’s my weight!”

As you can see these 3 symptoms are reported very often in early stages of perimenopause. For many women, noticing these symptoms in their late 30s or early 40s can be a gentle nudge to consider that their hormones are starting to shift. If we recognize these early signals and explore practical ways to manage them, we can navigate this transition with more confidence and less fear. I always remind myself: this is a phase, not a permanent state, and there’s strength in seeking solutions and support.

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