Are you perimenopausal?

shutterstock_103185746The classic signs of the menopause are well known; hot flushes, night sweats and irregular periods. But there are other symptoms in the preceding so-called perimenopausal years – that are not so well known and if you’re  a woman in your late forties (like me) you might want to know about them….

Palpitations, joint pain, dizzy spells, depression, memory problems, thinning hair, panic attacks, changes in taste, indigestion, itchy skin conditions and receding gums are just some of the seemingly unrelated symptoms that can start to affect women in the two-to-three year window before their menopause. Yet many symptoms  are investigated and treated individually in isolation and not recognised as being connected to hormone changes.

Professor John Studd, a consultant gynaecologist at the London PMS and Menopause Clinic, says there are stacks of symptoms that can be attributed to hormone changes in the perimenopause. One of the symptoms is skin formication – an itchy sensation like crawling insects. Not everyone gets them of course – that depends on how sensitive you are to the hormones oestrogen and progesterone. If you’ve  been badly affected by premenstrual syndrome (PMS) or postnatal depression in the past, though, you’re more likely to suffer from depression in the perimenopausal years.

Mandy Flynn, a 49 year old bank cashier from Kenley , Surrey, whom I interviewed for this piece  for Daily Mail Good Health started suffering from a string of seemingly unrelated health problems  as she hit her mid 40s. These included dizzy spells, hyperventilation, heavy aching joints, an itchy skin condition on her neck , indigestion, memory problems and anxiety. Mandy dismissed her symptoms as minor ailments and put up with them for 18 months before seeing her GP – but wondered why she was suddenly falling apart . She was shocked when her GP suggested all the symptoms were related and part of the perimenopause – as at the time she was still having periods and had none of the classic menopause symptoms such as  hot flushes and night sweats.

shutterstock_31102336 CAPTION: Hot flushes are a classic sign of the menopause < IMAGE > SHUTTERSTOCK

What causes perimenopausal symptoms?

There are cells called oestrogen receptors all over the body that are targets for the female sex hormone  oestrogen. As the levels of the hormone fluctuate in the perimenopause, the cells react and cause symptoms . For instance – muscles have oestrogen receptors  and falling levels can trigger pain. Changes in oestrogen levels can also affect levels of collagen ( a naturally occurring protein)  found in the skin, joints, hair, nails,bladder and vagina. Professor Studd says  loss of collagen causes muscle pain and skin formication – a creeping itching sensation similar to insects crawling under the skin.  Too often these symptoms are not recognised  as signs of the perimenopause – and instead women often undergo unnecessary investigations and are prescribed treatments that are ineffective – because the underlying problem is hormonal.

Miss Claudine Domoney , consultant obstetrician and gynaecologist at the Chelsea and Westminster Hospital, says women can often undergo more tests and treatment that end up doing more harm than good. For instance , she says joint and muscle pain in perimenopausal women are much more likely to be due to hormone changes rather than an auto immune condition such as rheumatoid arthritis, which is what might be diagnosed.’ The treatment is much easier and more acceptable than other treatments for musculo-skeletal disorders , such as steroids.’

These symptoms often resolve within a week when women try hormone replacement therapy.


CAPTION:  Anxiety and depression are common signs of hormone imbalances  in the perimenopause


Equally though, some experts argue that not all medical conditions that appear in the perimenopause years  can be attributed to hormones. Endocrinologist Dr Mark Vanderpump from the Royal Free Hospital says that thyroid problems are very common in the years before the menopause but these symptoms will not respond to HRT because the thyroid problem needs treating first. He says:  ‘ Symptoms of the menopause and thyroid disorder can overlap and one can mask the other.’

On balance though – if you’ve noticed a string of weird symptoms  as you hit your mid forties it might be worth asking your doctor if she thinks they are connected to the perimenopause and considering a trial of HRT. It might  just save you an awful lot of other investigations and complicated treatments with side effects  – and you won’t feel like you’re suddenly falling apart either.

PS: If you are struggling with classic menopausal night sweats – take a peek at the  The Fine Bedding Company’s range of Perfect Balance TM pillows, mattress toppers and duvets ( from £30) – they’re covered and filled with a special fibre blend called  Lysoft –  don’t ask me how but somehow it keeps you warm and cool at the same time helping regulate your body temperature and keeping moisture  away from your body so you don’t wake up bathed in sweat. Even if you’re not menopausal  the duvets are  great for  coping with the  ever-changing British climate.


  1. Jo – this is a subject that has been on my mind a lot recently. Did your experts say that often you may have some of the weirder symptoms without any of the usual hot flushes and night sweats you’d expect? Did anyone also mention electric shocks and twitches? (I have come across these elsewhere but they seem less well known). Karen

    1. Yes! They said these less well known symptoms appear in the years running up to the menopause before the classic signs such as hot flushes appear – I definitely saw electric shocks mentioned somewhere too. In some women all the symptoms disappear if they are prescribed HRT – but instead some end up on multiple meds for everything from joint pain to minor heart palpitations – when its really just their hormones that need a top up.

      1. I think it might have been Heather Curry? The problem is going to your GP and sounding like a know it all – when they are likely to say, “Ooh, I’ve never heard of that before!”

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