Beyond Hot Flashes: The Other Signs of Perimenopause and Menopause

When you hear the word “menopause,” most people think of hot flashes and night sweats. And yes, those can definitely happen… but they’re only one part of the story.

Perimenopause (the transition years leading up to menopause) and menopause itself can bring changes in so many areas of the body. Why? Because hormones like estrogen and progesterone don’t just control your period, they play a role in your brain, skin, sleep, digestion, bones, and even your mood.

That means when those hormone levels shift, you may notice changes that don’t seem obviously connected to menopause at first. Let’s walk through some of the most common ones, in plain language.

Period Changes

Often, one of the first signs of perimenopause is noticing that your cycles are different. Periods may come closer together, be farther apart, get lighter, or feel heavier. Spotting between periods can also happen. These changes are normal, but sometimes they can feel frustrating or surprising.

Mood Ups and Downs

Have you noticed yourself feeling more irritable, anxious, or weepy than usual? Maybe your moods swing faster than they used to. This is very common. Hormones influence brain chemicals like serotonin, so when they’re shifting, your emotions can feel like they’re along for the ride.

Sleep Troubles

Even without night sweats, many women say their sleep changes. You might find it harder to fall asleep, wake up more often in the night, or wake up earlier than you’d like. When sleep isn’t great, everything else (mood, focus, energy) feels harder too.

Brain Fog

Misplacing your keys, forgetting words, or just feeling a little “off” mentally? That’s perimenopause brain fog. It doesn’t mean anything is wrong with you, it’s a normal (and temporary) part of this stage of life.

Vaginal and Bladder Changes

Lower estrogen affects the tissues in the pelvic area. You might notice:

• Vaginal dryness

• More frequent urinary tract infections

• Leaking when you laugh, sneeze, or work out

These are so common, but they don’t always get talked about. And they can absolutely be helped.

Skin, Hair, and Nail Shifts

Estrogen helps keep skin hydrated and hair strong. Without as much of it, some women notice:

• Drier skin

• Thinning hair or new shedding

• Nails that break more easily
  Sometimes there’s also new acne or facial hair growth. Not fun, but all connected.

Aches and Pains

More stiffness in the morning? Joints feeling sore for no clear reason? Declining estrogen can make inflammation more noticeable, which is why achiness is a very real menopause symptom.

Weight and Metabolism Changes

Many women notice their weight redistributing, especially around the middle. This isn’t just about “eating less and moving more”, hormones shift how your body stores fat and builds muscle.

Heart Palpitations

Some women feel their heart flutter, skip a beat, or race briefly. While it can feel unsettling, it’s often related to hormone changes and poor sleep.

Digestive Surprises

Bloating, new food sensitivities, or changes in bowel habits sometimes pop up in this stage. Hormones affect your gut more than most people realize.

Bone Health

You can’t feel this right away, but estrogen protects bone strength. As it declines, bone loss speeds up and this is why bone health becomes extra important after menopause.

Shifts in Sexual Desire

Libido can change during this stage, sometimes it goes down, sometimes up. Vaginal dryness, fatigue, or mood shifts can all play a role too.

Feeling Less Resilient to Stress

Do you feel like things that never used to bother you suddenly do? Hormone changes can make stress feel heavier. This is one reason many women say they feel less “buffered” during perimenopause.

Perimenopause and menopause aren’t illnesses, they’re natural life stages. But just because they’re normal doesn’t mean you have to put up with symptoms that make you feel lousy.

Hot flashes and night sweats may get the most attention, but as you can see, they’re only a small part of the picture. If you’re noticing these changes, know that you’re not alone and that there are many options to help you feel better.

This is exactly what I support women with every day. If you’re curious about what’s going on in your body or want strategies that actually make a difference, I would love to help.