Signs of Perimenopause: Common and Unexpected Symptoms
Have you been wondering whether the changes you're experiencing could be related to perimenopause? Many Australian women experience a wide range of physical and emotional symptoms during perimenopause, often without realising they're connected.
The challenge is that the signs of perimenopause can vary significantly from woman to woman. While some women experience well-known symptoms such as hot flushes and irregular periods, others develop symptoms that seem completely unrelated to hormones.
Understanding the common and unexpected symptoms of perimenopause can help you identify patterns, seek support from your GP, and explore practical strategies for managing symptoms through nutrition and lifestyle changes.
What is Perimenopause?
Perimenopause is the transition phase leading up to menopause. During this time, hormone levels, particularly oestrogen and progesterone, begin to fluctuate.
For most women, perimenopause starts in their 40s, although some women experience symptoms earlier. This transition can last several years before menopause, which is defined as 12 consecutive months without a menstrual period.
While menopause marks a single point in time, perimenopause can be a long and often confusing stage where women experience a range of symptoms that come and go as hormone levels fluctuate.
How Do You Know If You're in Perimenopause?
One of the most common questions women ask is "Can my GP do a test to confirm perimenopause?" In most cases, there is no single test that can definitively diagnose perimenopause.
This is because hormone levels can fluctuate significantly from one day to the next during the perimenopausal years. A blood test that appears "normal" one week may be completely different a few weeks later.
Instead, healthcare professionals typically assess:
Your age
Changes to your menstrual cycle
Your symptoms
Your medical history
This is why recognising the signs of perimenopause and tracking your symptoms can be so valuable.
Common Signs of Perimenopause
Many women are familiar with some of the more well-known symptoms of perimenopause.
Common signs of perimenopause include:
Changes to your menstrual cycle
Fatigue
Brain fog
Hot flushes
Night sweats
Insomnia or disrupted sleep
Mood changes
Irritability or rage
Anxiety
Reduced libido
Weight gain
Changes to body composition, particularly around your middle
For some women, sleep disturbances, fatigue and mood changes may appear before hot flushes or cycle changes become obvious.
Unexpected Signs of Perimenopause You May Not Realise Are Hormone Related
Many women are surprised to discover that symptoms they've been experiencing for months, or even years, can be linked to perimenopause.
Some of the lesser-known signs of perimenopause include:
Dizziness
Heart palpitations
Loss of lean muscle mass
Heartburn or reflux
Memory issues
Vaginal dryness
Changes to taste and smell
Dry mouth
Breast tenderness
Brittle nails
Bad breath
Tinnitus
Joint pain
Muscle aches and pains
Shoulder pain
Pelvic pain
Thinning hair
Bloating
Because these symptoms aren't commonly discussed, many women don't realise they may be connected to hormonal changes.
Why Every Woman Should Track Her Perimenopause Symptoms
Because there isn't a single diagnostic test for perimenopause, tracking symptoms can provide valuable information for both you and your GP.
Keeping a record of of the following can help you identify patterns over time and support more productive conversations with healthcare professionals:
Menstrual cycle changes
Sleep patterns
Mood fluctuations
Energy levels
Hot flushes
Body changes
Physical symptoms
A tool we often recommend is the Balance App.
The Balance App is free and allows women to track the many different symptoms that may be related to perimenopause. It can also generate a PDF report that can be shared with your GP, helping paint a clearer picture of what's been happening over time.
For additional evidence-based information about perimenopause and menopause, we also recommend visiting the Jean Hailes' website.
Jean Hailes is Australia's leading women's health organisation and provides trusted information, resources and support.
Can a Dietitian Help With Perimenopause?
Many women are surprised to learn that nutrition can play an important role in managing perimenopause symptoms.
While food cannot stop hormonal changes, nutrition can support:
Energy levels
Muscle maintenance
Appetite regulation
Bone health
Heart health
Blood sugar management
Overall wellbeing
During perimenopause, many women notice that eating patterns that worked for them in their 20s and 30s no longer seem as effective. Changes in hormones, sleep, stress levels and body composition can all influence how you feel and function day to day. This is where personalised nutrition support can help.
How Sage Dietitians Can Help During Perimenopause
At Sage Dietitians, we help women navigate perimenopause with practical, evidence-based nutrition advice that fits real life.
We can help you:
Manage perimenopause symptoms more effectively through consistent nutrition and lifestyle habits.
Work towards a comfortable weight range in a steady, sustainable way using a weight-neutral approach.
Understand and meet your protein needs during perimenopause, aiming for an even spread of protein across the day to support energy, muscle health and appetite regulation.
Maintain muscle mass and support healthy ageing.
Build sustainable eating habits that support long-term health and wellbeing.
Cut through nutrition misinformation and focus on realistic strategies that work for you.
Understanding the Signs of Perimenopause is the First Step
The signs of perimenopause can be surprisingly varied.
While many women expect symptoms such as hot flushes and irregular periods, they are often surprised to learn that joint pain, heart palpitations, bloating, dizziness, sleep disturbances and memory changes can also be linked to hormonal changes.
There is no single test that can confirm perimenopause for most women. That's why understanding your symptoms and tracking changes over time can be so valuable.
If you're noticing changes that don't feel like your normal, consider keeping a symptom diary and making an appointment with your GP. Tools like the Balance App can help you identify patterns and provide useful information to discuss during your appointment.
Nutrition is another important piece of the puzzle. While food won't stop the hormonal changes associated with perimenopause, it can play a significant role in supporting energy levels, muscle health, appetite regulation, bone health and overall wellbeing.
At Sage Dietitians, we're here to support you with practical, evidence-based nutrition advice so you can feel more confident navigating this stage of life.
Read about how we support people in perimenopause and menopause.
You can also book an appointment by clicking here.
Frequently Asked Questions About Perimenopause
What age does perimenopause usually start?
Perimenopause most commonly starts in your 40s, but some women notice symptoms in their late 30s. Every woman is different, and symptoms can start gradually
What are the first signs of perimenopause?
The first signs can vary, but common early symptoms include:
Changes to your menstrual cycle
Poor sleep
Fatigue
Mood changes
Brain fog
Hot flushes
Some women notice mood or sleep changes before they notice changes to their periods.
Can a blood test confirm perimenopause?
For most women, there is no single blood test that can confirm perimenopause. Hormone levels can change from day to day, which makes testing unreliable. GPs usually look at your symptoms, age and menstrual history.
Can perimenopause cause weight gain?
Perimenopause can be associated with changes in body composition, including increased fat storage around the abdomen. Sleep, stress, reduced muscle mass and hormonal changes can all play a role.
Can perimenopause cause anxiety or mood swings?
Yes. Fluctuating hormone levels can affect mood and emotional wellbeing. Some women experience anxiety, irritability, low mood or feelings of rage, even if they have never had these symptoms before.
What are some lesser-known signs of perimenopause?
Some symptoms that are often overlooked include:
Heart palpitations
Joint pain
Dizziness
Bloating
Tinnitus
Dry mouth
Thinning hair
Changes to taste and smell
Many women are surprised to learn these symptoms may be related to perimenopause.
Should I track my symptoms?
Yes. Tracking symptoms can help you identify patterns and provide useful information for your GP. Many women find symptom tracking helpful when discussing concerns and treatment options
Can a dietitian help with perimenopause?
Absolutely. A dietitian can help you:
Manage symptoms through practical nutrition and lifestyle strategies.
Meet your protein needs to support muscle health.
Improve energy levels and appetite regulation.
Support bone and heart health.
Work towards a comfortable weight range using a sustainable, weight-neutral approach.
At Sage Dietitians, we help women navigate perimenopause with evidence-based nutrition advice that fits real life.
This article provides general nutrition information and is not a substitute for individualised advice from an Accredited Practising Dietitian or your GP. Please consult an Accredited Practising Dietitian before making changes to your diet, especially if you have an existing health condition.
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