Full list of perimenopause symptoms

Menstrual changes often appear first: periods may become irregular, lighter, heavier, shorter, or more widely spaced. Some cycles may be missed. Temperature changes can cause hot flushes or night sweats, sometimes disturbing sleep.

Other changes include tiredness, headaches, palpitations, joint or muscle aches, vaginal dryness, discomfort with sex, urinary symptoms, lower sexual desire, irritability, anxiety, low mood, and difficulty concentrating. Symptoms can come and go, and not everyone experiences the same combination. A symptom may have another cause, so a new or troublesome change deserves an individual assessment.

Keep a simple record of bleeding, temperature episodes, sleep, mood, medicines, and possible triggers. Light layers, a cool bedroom, regular movement, balanced meals, and a consistent sleep routine may make daily symptoms easier to manage. Use a suitable lubricant or vaginal moisturiser for dryness if appropriate.

A clinician can discuss hormone treatment and non-hormonal choices, taking account of your health history. Bring your symptom record and mention contraception needs, because pregnancy can still occur while periods are changing.

Arrange a medical review for bleeding that is very heavy, prolonged, or disruptive, bleeding after sex, bleeding after periods have stopped, new pelvic pain, or symptoms that interfere with sleep, work, or relationships. Seek urgent help for severe pain, fainting, or bleeding that makes you feel weak or unwell.

Ask whether your pattern fits perimenopause, whether another test or examination is needed, which contraception remains suitable, what can help hot flushes or sleep, and how to manage vaginal or mood symptoms safely.