Although Hormonally cannot give you an exact run down of what will happen to you individually, during perimenopause and menopause, we can provide you with an overview of what the majority of women will experience.

Equipping yourself with this knowledge will allow you to better prepare for the possible symptoms you may experience and mean you know how to manage them when they arise.

Did you know, in the US, there are more than 34 recognized symptoms of menopause and that 80% of women will experience some of them in their lifetime?

Symptoms of perimenopause and menopause happen because your body is reacting to your ovarian production changing. Over time, your ovaries stop producing eggs and the amount of hormones needed to support a pregnancy. This is usually a subtle process that lasts for several years, so it’s not always easy to spot perimenopause initially.

If you have surgery or undergo medical treatment that affects your ovaries, this can cause you to enter menopause immediately and symptoms can usually happen suddenly and be more severe than if you were to go through ‘naturally’.

Symptoms of perimenopause and menopause can be physical, like feeling fatigued, having achy joints, getting headaches or experiencing vaginal dryness, as well as psychological, like experiencing mood changes, increased anxiety, a lack of motivation or feeling more forgetful.


Perimenopause is the period of time before menopause. Perimenopause can last for a few years and can cause symptoms along with changes to your periods.

Menopause is when your periods stop. After you have experienced 12 months in a row without a period, you will be able to say you have ‘gone through’ menopause.

Post-menopause describes the period of time after you have gone through menopause. It lasts from the end of menopause for the rest of your life.

Symptoms of perimenopause and menopause can start slowly. They can also come and go as your hormone levels change, particularly during perimenopause. Your symptoms may be subtle at first. Many women actually don’t realize it’s their changing hormones that are causing them issues.

Perimenopause is especially difficult to recognize if you don’t have periods because of the birth control you use, or your periods haven’t changed yet. It’s often not until symptoms become more severe, or begin to involve things like hot flashes, that women put two and two together and think: could this be menopause?

Every person will have a unique experience of perimenopause and menopause and although the average age of menopause in the US is 52, symptoms can start a decade before this. Read our ‘Perimenopause and Menopause’ resource for more information on the stages of menopause.

A ‘natural’ menopause:

  • symptoms usually start in your mid-40s but can happen in your late 30s or even earlier

A medical or surgical menopause:

  • if you have surgery where both of your ovaries are removed, or you undergo medical treatments that suppress your ovarian function (for example, when treating certain types of cancer), you will enter menopause at this time.
  • symptoms can be sudden and more severe with a medical or surgical menopause and you will most likely need to use hormone therapy (HT) to help you with these symptoms.

How long will symptoms last for?

This is different for everyone, but on average:

  • perimenopause lasts for between 4-10 years
  • after your menopause you may continue to get symptoms for an additional 5 years or so
  • some women continue to experience symptoms for many years beyond this.

The cognitive, emotional and psychological symptoms of menopause often (but not always) appear first. These symptoms are often the ones that have the most impact on our relationships and our performance at work. They’re also the ones that are easily put down to other factors such as stress or burnout.

Psychological symptoms of menopause can be grouped further into cognitive and mood-based symptoms.

Cognitive changes

Could include:

  • changes to your speed of thinking
  • changes to your clarity of thought
  • changes to your ability to focus or pay attention
  • issues with ‘brain fog’ including forgetfulness, problems finding words and increased mental fatigue.

How this looks in real life: losing your train of thought when you’re talking, forgetting people’s names, or certain things that need doing including appointments. You might find yourself getting distracted easily, lose items like your keys or phone, or generally just feel like you are not as mentally sharp.

Changes to your mood and emotions

Could include:

  • feeling more anxious than usual
  • experiencing low mood or feeling depressed
  • feeling more tearful than usual
  • having less motivation
  • experiencing a lack of pleasure doing things you usually enjoy
  • having quick mood changes, especially feeling angry or irritated
  • feeling a drop in self confidence and self esteem.

How this looks in real life: you may find yourself struggling to sleep because you are worrying about things that wouldn’t normally bother you.

You may find yourself feeling unsure about your abilities at work when you used to feel on top of your game.

Rather than attending social events, you might find yourself preferring to stay in or feeling like you’ve got little to offer when you do see friends.

A hot flash is a sudden feeling of warmth in the upper body, usually all over your face, neck and chest area. Your skin might go red, as if you were blushing and you may start to sweat.

Your sex hormones are connected to virtually every area of your body, so, when your hormone levels are low, it can impact more of your bodily functions than you may think.

Here are some of the most common physical symptoms you may notice during perimenopause and menopause:

  • fatigue or tiredness
  • difficulty sleeping (including both falling asleep and staying asleep)
  • headaches
  • urinary tract infections (UTI)
  • discomfort including itching, soreness or pain around your vulva and/or vagina
  • migraine attacks
  • dry skin, or changes to your skin
  • urinary urgency or incontinence
  • weight changes
  • sweating at night
  • breast tenderness
  • bloating
  • numbness and tingling
  • hot flashes
  • heart palpitations
  • changes to your hair including hair loss
  • tinnitus (ringing in the ears)
  • joint pains and muscle aches

You may experience only one of these symptoms or you could find you suffer with several. Remember, during perimenopause, symptoms can completely come and go.

If this information has rung true for you and you think you may be experiencing perimenopausal or menopausal symptoms, fill out our menopause symptom checker and learn more about what treatment options are available.

Menopause doesn’t need to be dreaded – there’s plenty that can be done to ease symptoms and make sure you stay feeling like yourself during this transitional period.

Hormonal mood changes can be difficult to differentiate from conditions such as generalized anxiety disorders, or clinical depression. This being said, there are some subtle characteristics that are useful when it comes to spotting the differences between mood changes associated with your hormones, and more serious mental health issues.

During perimenopause and menopause, you may experience symptoms in which:

  • your mood shifts quickly. You may experience more irritability, rage and anger as opposed to sadness.
  • you have more intrusive thoughts that are unsettling. This could include thoughts of harming yourself which can be upsetting.

If no one has realized your moods may be related to your hormones changing, it’s easy to assume the psychological symptoms you are experiencing are because of a mental health condition. This is particularly the case if you have suffered with your mental health in the past. Many women who experience menopause related mood changes will be diagnosed as having anxiety and/or depression first when they seek help from a healthcare professional.

Antidepressants could be offered to you. These may help but equally, they may not. If mood changes are connected to your hormone levels changing, antidepressants are unlikely to bring you the relief you’re looking for. This is because the underlying cause (your changing hormone levels) are not being addressed by this medication. You may also experience unpleasant side effects from antidepressants, such as nausea and a lowering of your sex drive. These side effects tend to subside after a few weeks, but if after this time your mood is still low, it’s important to go back to talk to your doctor about your continuing symptoms.

Many women who struggle with psychological and emotional symptoms at perimenopause and menopause find that using hormone therapy (HT) will help to stabilize their mood and help them to feel more like themselves again.

For further information about managing your mental health during perimenopause and menopause, see our mental health life hacks.