Symptoms and diagnosis

Changes to your periods

The first sign of perimenopause is usually, but not always, a change in the usual pattern of periods, for example, they become irregular. Eventually, your periods stop completely.

Mental health symptoms

• Mood changes, such as feeling down, anxiety, mood swings and low self-esteem
• Problems with memory or concentration (brain fog: ‘I can’t think clearly’)

Physical symptoms

• Hot flushes, characterised by sudden sensations of heat or cold in the face, neck and chest, which may cause dizziness
• Difficulty sleeping, often linked to sweating at night, which can lead to fatigue, irritability and drowsiness during the day, potentially affecting daily activities, particularly at work
• Palpitations, characterised by a sudden, more noticeable heartbeat
• Headaches and migraines that are more severe than usual
• Muscle and joint pain
• Changes in body shape and weight gain
• Skin changes, particularly dry, itchy skin
• A decrease in libido
• Vaginal dryness, as well as pain, itching or discomfort during sexual intercourse
• Recurrent urinary tract infections
• Urinary leakage (urinary incontinence), particularly during physical exertion (coughing, laughing, exercise) or associated with a sudden, uncontrollable urge to urinate
• Sensitive teeth, sore gums or other oral health problems

Duration of symptoms

Symptoms can last for months or years and change over time.

For example, hot flushes and sweating at night may improve, whilst mood disorders (feeling down, irritability) or anxiety may develop.

Some symptoms, such as joint pain and vaginal dryness, may persist after periods stop.

How is a diagnosis made if hormonal contraception is being used?

It is not possible to determine with certainty whether a person is in perimenopause or menopause if they are using hormonal contraception, such as the pill, a hormonal intrauterine device (IUD), a contraceptive implant or injectable contraception.