21 Signs Perimenopause Has Begun (And What You Can Do About It)

Posted on 13th June 2025 at 16:12

Have you noticed some unexpected changes in your body or mood lately? You’re not alone—and you’re certainly not imagining things. Perimenopause, the phase leading up to menopause, can be a wild hormonal rollercoaster with a wide range of symptoms.

In fact, 75% of women experience noticeable changes during this transition, and many don’t initially connect them to perimenopause. So let’s demystify it. Below are 21 of the most recognised signs, based on the Greene Climacteric Scale—a globally used tool for tracking menopause-related symptoms.

Let’s break them down by category: Psychological, Physical, and Vasomotor (related to blood flow like hot flushes).

Psychological Symptoms

These are often the first to show up—and the most misunderstood.

Feeling Tense or Nervous Sudden anxiety or nervousness that feels out of the blue? Hormonal shifts could be to blame.

Difficulty Sleeping Not just the occasional restless night—this is regular trouble falling or staying asleep.

Feeling "Excitable" Overstimulation or an emotional edginess that feels unfamiliar can be linked to hormone fluctuations.

Difficulty Concentrating Many women report brain fog, trouble focusing, or forgetting why they walked into a room.

Feeling Depressed or Unhappy Low mood or unexplained sadness can sneak in, sometimes even showing up as silent tears.

Crying Spells You might cry more easily or for no clear reason. This emotional sensitivity is common.

Irritability Short fuse? Perimenopause can heighten feelings of frustration or impatience, often without warning.

Physical Symptoms

Hormones don’t just affect your mood—they touch nearly every system in your body.

Heart Palpitations Your heart may feel like it’s racing or pounding unexpectedly, which can be alarming but is often hormone-related.

Dizziness or Faintness Sudden bouts of lightheadedness or unsteadiness may come and go.

Pressure or Tightness in the Head/Body That odd “headband” feeling or a sense of tightness across your chest or limbs can pop up.

Muscle or Joint Pain Aches that seem to come out of nowhere, even in previously pain-free joints, are common.

Low Energy or Fatigue Even after a good night’s sleep, you might still feel drained.

Breathing Difficulties Some women report shallow breathing or the sensation of not getting enough air.

Headaches These may be more frequent or intense than what you’re used to, especially around your period.

Numbness or Tingling in Hands/Feet Pins and needles or temporary numbness can be surprising symptoms of perimenopause.

Irregular Periods Your cycle may become longer, shorter, heavier, or lighter as oestrogen begins to fluctuate.

Changes in Libido Some women notice a drop, while others experience an unexpected spike in sexual desire.

Vaginal Dryness This symptom can affect comfort during intimacy and may even show up as general discomfort.

Bladder Issues Increased urgency or frequency, or even mild incontinence, can be part of the hormonal shift.

Vasomotor Symptoms

These relate to blood vessel and temperature regulation—hot flushes are the classic hallmark here.

Hot Flushes That sudden wave of heat, often followed by sweating or redness, usaully at the most inconvenient moment? Yep, that’s a hot flush.

Night Sweats Waking up drenched in sweat—even if your room is cool—is another tell-tale sign.

What to Do Next

If you’re nodding along to several of these signs, it may be time to speak with your healthcare provider. The Greene Climacteric Scale is a great self-assessment tool to help track and communicate what you’re experiencing.

Remember, you’re not broken, and you’re not alone. This is a powerful time of transition—and knowledge is power.

Disclaimer: This post is for informational purposes only and is not intended to substitute professional medical advice. Always consult with a healthcare provider for diagnosis and treatment options.

Download our free Perimenopause Symptom Tracker to take to your next doctor’s appointment—your future self will thank you.