Signs of Perimenopause


The years leading up to a woman’s last period, called perimenopause, are filled with many changes. Some, like hot flashes, are well-known. Others may surprise you. Learn how to manage these lesser-known symptoms and embrace this new chapter of life!
Do you race to the restroom? Feel a little leak when laughing with friends? You are not alone. During perimenopause, estrogen levels begin to drop, weakening the bladder area and leading to urinary incontinence in some women.
Self-care: To combat leakage, strengthen your pelvic floor muscles, which support your bladder and uterus. Start by performing Kegel exercises – squeezing and relaxing the muscles you use to stop the urine stream. In addition, avoid food and drinks high in caffeine and acid (coffee, oranges, tomatoes, etc.), which can irritate the bladder. If you are struggling with leakage, a physical therapist specializing in the pelvic floor can help.

Whether you wake up in the middle of the night or struggle to fall asleep, sleep issues are common in menopausal years. Yes, the stress and responsibilities of aging can sideline slumber. But shifting hormones also play a role. Other menopause symptoms (hello, hot flashes!) can interrupt sleep, too.
Self-care:  To increase your ZZZs, take a walk or bike ride during the day. Exercise is one of the best things you can do to improve sleep. Bonus: It also helps curb hot flashes. Then, focus on good sleep hygiene. Make sure your bedroom is dark and cool. Avoid looking at your phone or other screens close to bedtime. And create a relaxing nighttime routine, such as taking a bath or reading.

Feeling bloated or crampy? Hormone changes related to menopause may be the cause. Shifting hormone levels can result in excess gas, constipation, nausea, abdominal pain, and indigestion.
Self-care:  Take steps to reduce your stress. Work with your healthcare provider to identify foods that trigger your digestive issues, keeping a food journal may help. See your provider right away if you experience unexplained weight loss or rectal bleeding. See page 10 for more about gut health. 

Whether it is ringing, roaring, hissing, or buzzing, if you hear a constant noise in one or both ears, you may have tinnitus. The condition is often associated with hearing loss or exposure to loud noises, but menopause also raises risk. Some experts point to changes in reproductive hormones that can affect the inner ear. Sleep issues common during menopause might also contribute.
Self-care:  While ringing in your ear usually does not pose a danger to your health, it can be distressing. To help, focus on good sleep habits and talk to your provider about low-dose hormone replacement therapy, which can improve symptoms.

Studies show that three out of every four women deal with cognitive and emotional issues during perimenopause such as mood changes, anxiety, forgetfulness, difficulty concentrating, and more. These symptoms, brought on by hormone fluctuations, are especially prevalent in women who struggled with strong premenstrual symptoms (PMS).
Self-care:  Focus on self-care. In addition to eating a healthy diet, getting quality sleep, and exercising regularly, engaging in activities like mindfulness, yoga, meditation, or listening to music can reduce stress. Stay connected with family and friends.
Most importantly, share any new or troubling symptoms with your healthcare provider. They may share additional self-care strategies, recommend treatments, or identify signs of a more serious problem. Do not worry alone – contact your primary care provider with any questions.


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