The 34 Symptoms of Perimenopause and Menopause

For me it started with heavy, unpredictable periods, then came the hot flashes, the mood swings I couldn't explain and a burning feeling on my tongue that no one could account for. I was hot one minute and freezing the next, and the belly fat wouldn't budge no matter what I ate. I found out I was in menopause from a two-line message in a patient portal, read in an airplane seat as the plane taxied out. I cried the whole flight.

What I wish I'd had that day was a clear map: what was happening to my body, why, and what I could actually do about it. So I put on my journalist's hat, changed doctors and spent years asking the world's leading menopause experts the questions I couldn't get answered. This page is that map.

Here are the 34 symptoms of perimenopause and menopause, why they happen and what helps each one. You may recognize three of them or thirty. Either way, you're not imagining it, and you're not alone.

By Tamsen Fadal, Emmy-winning journalist and author of the New York Times bestseller How to Menopause, reported from her interviews with 42 experts · Updated November 2026

Track what you're feeling as you read: download the free Menopause Symptom Tracker and bring it to your next appointment.

All 34 symptoms, A to Z

Tap any symptom to jump to it. Not everyone gets every symptom, and you aren't destined to experience all 34.

• Acne
• Allergies
• Anxiety
• Bloating and constipation
• Body odor
• Breast soreness
• Brittle nails
• Cholesterol changes
• Depression
• Difficulty concentrating
• Dizzy spells
• Fatigue
• Gum problems
• Hair loss
• Headaches and migraines
• Heart palpitations
• Hot flashes
• Irregular periods
• Irritability and rage
• Itchy skin
• Joint and muscle pain
• Libido changes
• Loss of breast fullness
• Memory lapses
• Mood swings
• Nausea
• Night sweats
• Osteopenia and osteoporosis
• Pain during sex
• Panic disorder
• Sleep issues
• Urinary incontinence
• Vaginal dryness
• Weight gain

Plus three odd but not uncommon ones: burning mouth, electric shock sensations and itchy ears.

The symptoms, one by one

There are estrogen receptors on every organ in the body, which is why so many of these symptoms trace back to estrogen withdrawal. Progesterone, the calming hormone that helps with sleep and mood, drops too. Learning to recognize your symptoms as menopause gives you agency, and it's better to be validated than to feel lost.

Acne

When estrogen drops while testosterone and other androgens stay comparatively high, breakouts can come back, sometimes decades after your teenage years. Adult acne needs different treatment than the teenage kind.

What helps: A good dermatologist who can tailor treatment to midlife skin.

Go deeper: Hair Loss, Dry Skin and Sagging Skin: The #1 Dermatologist Explains

Allergies

When progesterone falls, asthma, allergies and hay fever can get worse or show up for the first time. Lower estrogen weakens the skin's moisture barrier, which can bring on eczema, and stress, along with hot flashes and night sweats, can trigger hives.

What helps: Identifying triggers, gentle fragrance-free products and talking to your doctor or an allergist about treatment.

See a doctor if: reactions are new or severe. Get emergency care for swelling of the lips, tongue or throat, or trouble breathing.

Go deeper: Perimenopause 101: The Symptoms, Tests and Fixes No One Tells You About

Anxiety

Anxiety is one of the biggest complaints of this stage, even among women with no history of it. Dealing with so many symptoms at once also leaves us less resilient to the pressures of home, work, children, parents and money that we might have handled just fine before.

What helps: Therapy, breathing practices, regular movement, less caffeine and alcohol, and for many women, hormone therapy or other medication.

See a doctor if: anxiety is getting in the way of daily life.

Go deeper: Anxiety 101: What I Wish I Knew Before I Hit Perimenopause

Bloating and constipation

As estrogen declines, the stress hormone cortisol rises, and stress slows digestion. The longer food takes to move through you, the harder and drier your stool becomes. Weak pelvic floor muscles can add to constipation.

What helps: Enough fiber and water to keep things moving, and magnesium, which acts as a mild laxative and also helps with sleep, which lowers stress, which helps with bloating. A virtuous circle.

See a doctor if: you notice blood in your stool, unexplained weight loss, or bloating that doesn't go away.

Go deeper: The Menopause Gut: How to Beat Bloating and Belly Fat

Body odor

I can't pinpoint exactly when it happened to me, but it was clear it had. This isn't the smell you get after a hard workout. It's a new, stronger odor that gets through just about any deodorant, and I've tried more than my share. More sweating from hot flashes and shifting hormones both play a part.

What helps: Breathable fabrics, showering after you sweat and clinical-strength antiperspirant. I share what I use in How to Menopause.

Go deeper: Dr. Mary Claire Haver: The Perimenopause Symptoms No One Warned You About

Breast soreness

About 40 percent of women have breast tenderness at some point during the transition. For some it's tenderness, burning or soreness; for others, a sharp, stabbing pain in one or both breasts.

What helps: A supportive, well-fitted bra and keeping up with regular mammograms.

See a doctor if: the pain persists, or you notice a lump, skin changes or nipple discharge. Breast pain is rarely a sign of cancer, but it should be checked.

Go deeper: The Truth About Mammograms, Hormones and Dense Breasts

Brittle nails

With less estrogen, the body holds on to less water, which leaves nails dry, fragile, peeling or flaking. Estrogen also drives the production of keratin, the protein that keeps nails hard.

What helps: Keeping nails short, wearing gloves for dishes and cleaning, and moisturizing nails and cuticles.

Go deeper: Hair Loss, Dry Skin and Sagging Skin: The #1 Dermatologist Explains

Cholesterol changes

When estrogen goes down, LDL (bad) cholesterol and triglycerides tend to go up. You can't feel it, which is why it matters to check.

What helps: Exercise lowers cholesterol, so it pays to get moving. Colorful fruits and vegetables help too, since their antioxidants and fiber help clear cholesterol.

See a doctor if: you haven't had a lipid panel recently. Ask about your overall heart health, including blood pressure and blood sugar.

Go deeper: The Menopause Heart Doctor Reveals the 3 Warning Signs Doctors Dismiss

Depression

There's no question that menopause can affect your mental health. Falling estrogen is linked to lower serotonin, and progesterone drops too, and both help protect against depression. Women with a history of depression, postpartum depression, PMS or PMDD have a higher risk of clinical depression in menopause.

This is tricky territory, because the most common thing women walk out of a doctor's office with is a prescription for antidepressants. Many of us aren't technically depressed; we're dealing with the physical effects of losing estrogen. Still, an antidepressant can be a useful tool to stabilize you while you find the right care. One of the many doctors I saw prescribed one, and it helped me cope until I finally got my hormone therapy figured out.

See a doctor if: low mood lasts more than two weeks. If you're having thoughts of harming yourself, call or text 988 (the Suicide and Crisis Lifeline in the US) right away.

Go deeper: Top Psychiatrist Reveals What Women Are Getting Wrong

Difficulty concentrating

Up to two-thirds of women go through cognitive changes during menopause, and they can be severe enough to mimic ADHD or even dementia. This has been a particular challenge for me. The good news: these issues are usually at their worst in perimenopause, and for the vast majority of women they get significantly better after menopause.

What helps: Protecting your sleep, regular exercise, lists and routines that take the pressure off. I cover my strategies in the brain chapter of How to Menopause.

Go deeper: The ADHD Psychiatrist: How to Get Your Focus Back After 40

Dizzy spells

Up to a quarter of women experience dizziness at some point in menopause. Fluctuating hormones affect blood sugar and the inner ear, which controls balance, and can also bring on fatigue and migraines.

What helps: Sit or lie down until it passes, stay hydrated and eat regularly.

See a doctor if: it keeps happening, so you can rule out anything more serious. Dizziness with chest pain, fainting, numbness or trouble speaking needs emergency care.

Go deeper: Perimenopause 101: The Symptoms, Tests and Fixes No One Tells You About

Fatigue

Up to 85 percent of women report low energy, motivation and drive. There's a big difference between fatigue and sleepiness: if you're sleepy, you need sleep, and if you're fatigued, you need rest. Knowing which one you're dealing with helps you give your body what it actually needs.

See a doctor if: fatigue is persistent. Ask about checking your thyroid and iron levels, since both can cause it too.

Go deeper: Exhausted, Gaining Weight and Feeling Off? This Is What's Happening

Gum problems

Six in ten women report gum problems during menopause. One culprit is dry mouth: with less saliva, your mouth can't wash bacteria off your teeth as well. The other is more serious: lower estrogen can lead to bone loss in the jaw, which can cause receding gums and even tooth loss.

What helps: Be extra careful with your dental health starting in perimenopause: brush, floss, stay hydrated and keep up with cleanings.

Go deeper: Dr. Mary Claire Haver: The Perimenopause Symptoms No One Warned You About

Hair loss

Many women don't connect midlife hair loss with menopause, but it's a very typical symptom. Thinning is especially common, along with dryness and changes in texture.

What helps: For minor changes, try new hair care products, since the ones you've always used may not work as well as your hormones change. Serious cases may need medical treatment from a dermatologist.

See a doctor if: hair loss is sudden or comes out in patches.

Go deeper: The Hair Loss Doctor: What Works and What's a Waste

Headaches and migraines

Migraines and other headaches often get worse in perimenopause, and some women get them for the first time. A drop in estrogen can set them off, and they tend to be more severe after surgical menopause. Hormone therapy may help, or it may not. The good news is that many women find their headaches disappear in postmenopause.

See a doctor if: you have a sudden, severe headache, or a headache with weakness, confusion, vision changes or trouble speaking. Get emergency care.

Go deeper: The #1 Neurologist: What Actually Works for Migraines and the free Migraine Action Guide

Heart palpitations

It's common to feel your heart fluttering, pounding or skipping a beat, often along with hot flashes. Fluctuating hormones can raise your heart rate by up to 16 beats a minute. Palpitations usually pass on their own, but they can signal something serious.

See a doctor if: you have palpitations, and urgently if they come with chest pain, pain in your left arm, neck or jaw, shortness of breath or lightheadedness.

Go deeper: The Heart Doctor: 5 Warning Signs Your Heart Is in Trouble

Hot flashes

Doctors call hot flashes and night sweats vasomotor symptoms, or VMS. (When I see those letters, I think Very Moist and Sweaty.) A hot flash feels like a smoldering fire that suddenly breaks out all over your body. It creeps up your neck, makes your armpits drip and sets your face on fire. And it isn't as funny as TV makes it look.

Hot flashes can also point to long-term risks. The SWAN study, which has followed a diverse group of midlife women since 1996, linked them to cardiovascular disease and bone loss, and the more severe the symptoms, the greater the risk.

What helps: Hormone therapy is the first-line treatment. There's also a nonhormonal prescription option, and cooling clothing and wearables can help. For a while I kept a glass of cold water nearby to press against my wrist when I felt one coming. Even on hormone therapy I still get the occasional hot flash, and my neck fan is never more than an arm's length away.

Go deeper: Estrogen 101: What I Learned From the World's Top Menopause Doctors

Irregular periods

Irregular periods are usually the first sign your hormones are in transition. Cycles can come closer together, last ten days or more, and be extremely heavy, or you might skip a period entirely. In perimenopause I bled so heavily that I went through super maxi pads and tampons, ruined more outfits than I can count, and checked the back of my dress every time I stood up.

Dr. Nanette Santoro, a leading menopause researcher, explains it this way: think of your uterine lining as a lawn. Estrogen is the fertilizer that makes it grow, and progesterone is the lawn mower. In perimenopause the lawn service skips a few months, the lawn gets overgrown, and the result is a heavier period after a skipped one.

See a doctor if: your bleeding is very heavy, lasts longer than usual or comes between periods. Irregular bleeding can also be a sign of something else. In my case it was endometrial polyps. Keep seeing a menopause-informed doctor even after treatment.

Go deeper: Perimenopause 101: The Symptoms, Tests and Fixes No One Tells You About

Irritability and rage

Irritability is one of the top complaints of perimenopause, and I relate to every woman who says she could chew through steel. I said "I'm sorry" a lot over those years, not because I can't apologize, but because I wasn't myself. When estrogen drops off a cliff, serotonin falls with it, and progesterone, the calming hormone, declines too. The small things that set you off feel very big. It's not your fault.

What helps: Sleep, movement, naming what's happening to the people around you, and treating the hormonal root with your doctor.

Go deeper: Is It the Relationship, or Is It Menopause? Here's How to Tell

Itchy skin

Here's an alarming fact: we lose nearly a third of our skin's collagen in the first five years of menopause. Skin cell turnover slows, and the outer barrier loses its ability to hold moisture. The result is skin that's itchy and as parched as a desert.

What helps: Changing up your routine with richer, fragrance-free moisturizers applied to damp skin, lukewarm showers and daily sunscreen.

See a doctor if: itching is severe, keeps you up at night or comes with a rash.

Go deeper: Hair Loss, Dry Skin and Sagging Skin: The #1 Dermatologist Explains

Joint and muscle pain

Almost three-quarters of women have muscle and joint pain in perimenopause, yet it has only recently started getting the attention it deserves. Estrogen helps maintain cartilage and other joint tissue, so its decline is likely part of the cause. Joint pain is more common in Asian women, and in Japan it's the number one menopause symptom, ahead of hot flashes.

Frozen shoulder is another common complaint. Orthopedic surgeon Dr. Vonda Wright explains that it's really a hot fire of inflammation, and while our instinct is to hold the shoulder still, that lets it get tighter. Keep it moving: walk your fingers up a wall, to the front and then out to the side.

What helps: Reducing inflammation through diet, exercise and better sleep. A physical therapist can help with frozen shoulder.

See a doctor if: a joint is red, hot or swollen, or the pain is severe.

Go deeper: What Your Joints Are Trying to Tell You

Libido changes

When estrogen declines, the vaginal lining can thin and make sex painful, and if sex hurts, you're not going to want it. But desire can also fade for reasons that have nothing to do with hormones, including fatigue, irritability and the stress of living with all these symptoms.

What helps: Talk to your doctor. Many of the OB-GYNs I respect prefer testosterone gel or cream over injections or pellets. There's no FDA-approved testosterone treatment for women yet, but it can be prescribed off-label. And remember that the brain is the largest sex organ: a lot of intimacy begins outside the bedroom.

Go deeper: The Testosterone Doctor: The Truth About Women's Libido

Loss of breast fullness

By our forties, our breasts are already losing the fight with gravity. When estrogen drops sharply in menopause, the mammary glands shrink and are replaced by fat, which can lead to sagging.

What helps: A well-fitted bra, and keeping up with mammograms as breast tissue changes.

Go deeper: The Truth About Mammograms, Hormones and Dense Breasts

Memory lapses

Estrogen supports verbal memory, and when it goes, so does some of our ability to find words. The good news is that most women bounce back, or at least plateau, and memory can be trained.

What helps: Sleep, exercise, stress management and memory practice. The brain chapter of How to Menopause walks through all of it.

See a doctor if: memory problems are getting steadily worse.

Go deeper: The Menopause Brain: Top Neuroscientist Shares New Data on Brain Fog and Alzheimer's

Mood swings

Almost a quarter of women have mood changes during the transition. Roller-coaster moods in perimenopause are essentially our old friend PMS, except now it isn't always clear when, or if, the period is coming. One of the true silver linings of postmenopause is that moods settle for most women once periods stop for good.

What helps: Sleep, exercise, therapy and, for some women, hormone therapy.

Go deeper: Progesterone 101: The Hormone Behind Your 3 a.m. Wake-Ups, Your Anxiety and Your Worst PMS

Nausea

Nausea is relatively uncommon, but it's awful enough to mention. It's thought to be linked to low progesterone and is often worse in the morning. It can also come with hot flashes, which happens to me, and for some women it's a side effect of hormone therapy.

What helps: Talk to your doctor to figure out the cause so you can find the right fix.

Go deeper: Perimenopause 101: The Symptoms, Tests and Fixes No One Tells You About

Night sweats

Night sweats are hot flashes that happen at night. Estrogen affects the hypothalamus, the body's thermostat, leaving us more sensitive to temperature changes. Up to 80 percent of women have hot flashes, often as night sweats. Drenched sheets and nightclothes follow, and after you change them yet again, you give up and look for anything on Netflix you haven't seen.

What helps: Blanket on, blanket off. I learned early to sleep with one foot outside the covers. A cool room and breathable bedding help, and so do the treatments for hot flashes.

See a doctor if: night sweats come with fever or unexplained weight loss.

Go deeper: The Sleep Doctor: The 4 Hormones Wrecking Your Sleep

Osteopenia and osteoporosis

This is so serious I hesitate to call it a symptom. Your bones have estrogen receptors, and when estrogen declines they no longer get the same signals to rebuild. Osteopenia is a decrease in bone density; osteoporosis is a serious decline that puts you at much greater risk of fracture. You can't feel either one until a bone breaks.

What helps: Strength training and weight-bearing exercise, enough protein, calcium and vitamin D, and hormone therapy, which helps protect bone.

See a doctor if: you've broken a bone in a minor fall, or have early menopause or a family history. Ask when you should have a bone density scan.

Go deeper: Longevity Doctor: How Women Can Burn Fat, Build Muscle and Age Strong

Pain during sex

The trifecta of thinning, smoothing and drying of the vagina can cause pain and even bleeding during sex.

What helps: There are plenty of great lubricants, plus vaginal moisturizers made with hyaluronic acid that you can use a few times a week. Estrogen applied directly to the vagina as a cream, suppository or ring can help, as can pelvic floor physical therapy.

See a doctor if: sex is painful or you have bleeding afterward.

Go deeper: Estrogen Down There: Here's Everything You Need to Know

Panic disorder

I know what this one feels like. It was a panic attack combined with a hot flash that took me down on set one night in 2019, and that night is the reason How to Menopause exists. My heart was pounding, my breathing went shallow and sweat poured down my sides, and I couldn't tell the two apart. When estrogen dips, mood goes with it, and losing progesterone, the calming hormone, matters just as much. It's no wonder women are twice as likely as men to have panic disorder.

What helps: Therapy, breathing techniques and talking to your doctor about the hormonal piece.

See a doctor if: you're having panic attacks. Chest pain or trouble breathing always deserves urgent care.

Go deeper: The Anxiety Scientist: Feeling Overwhelmed? Rewire Your Brain With This Science-Backed Method

Sleep issues

About 80 percent of menopausal women have disrupted sleep, whether that's trouble falling asleep, trouble staying asleep or both. It isn't always clear whether night sweats wake us up or the two happen independently. Sleep is foundational to your overall health, and it can get better.

What helps: A consistent schedule, a cool, dark room, less alcohol and caffeine late in the day, and treating hot flashes.

See a doctor if: you snore loudly, wake gasping or feel exhausted after a full night.

Go deeper: Sleep Expert Reveals What's Ruining Your Sleep

Urinary incontinence

Roughly half of women over 50 deal with urinary incontinence. There's stress incontinence, or "peezing," when a sneeze, cough or laugh makes you leak. There's urge incontinence, or overactive bladder, when you feel you have to go all the time but not much comes out. And there's overflow incontinence, when the bladder doesn't fully empty. All three share a cause: losing estrogen weakens the muscles of the bladder, urethra and pelvic floor.

I didn't have a personal story for this one until the start of 2024, when my whole family came to visit and passed around the flu. A week of coughing later, I was mid-spasm and felt pee running down my leg. Two years married, my husband looked at me and said, "Well, I guess no more secrets." I started these exercises that day:

• Kegels: tighten your pelvic floor, hold for 3 to 5 seconds, relax for 3 to 5 seconds. 10 reps, 3 times a day.
• Glute bridge: lie on your back, feet flat, and lift your pelvis, inhaling on the way up and exhaling on the way down. 10 to 12 reps, once or twice a day.
• Ball squeeze: lie on your back with a soccer-size ball between your knees, squeeze and hold for 5 to 10 seconds, then relax. Work up to 10 reps, once or twice a day.

See a doctor if: leaking affects your daily life. Ask about pelvic floor physical therapy.

Go deeper: Peeing When You Sneeze? Pelvic Floor Specialist Explains Why

Vaginal dryness

This is one symptom that doesn't improve after perimenopause. The body keeps making a little estrogen for a while after menopause, but eventually the supply dwindles, taking natural lubrication and the strength of the vaginal walls with it. It also changes the vagina's pH and microbiome, which can mean discomfort during sex and everyday activities, plus more urinary tract and vaginal infections.

What helps: The great news is that there are many excellent remedies, from moisturizers and lubricants to vaginal estrogen.

See a doctor if: you have pain, bleeding or repeated infections.

Go deeper: Estrogen Down There: Here's Everything You Need to Know

Weight gain

After hot flashes, this is what I'm asked about most. I was shocked when my body started changing in my late forties even though my diet and exercise hadn't. It's a big part of why I became certified as an integrative wellness coach specializing in menopause. What I learned is that without estrogen, the body uses starches and blood sugar less efficiently, which increases fat storage, especially around the middle, and reduces muscle mass.

What helps: Strength training to protect muscle, protein and fiber at every meal, less alcohol and better sleep.

Go deeper: Why Your Belly Fat Won't Budge Even When You're Doing Everything Right and the free Belly Fat Reset Guide

Bonus round: odd but not uncommon symptoms

Researcher Andrea Donsky has documented 103 symptoms of menopause and counting. Here are three of the stranger ones.

Burning mouth

Sometimes called menopause mouth, burning mouth syndrome can bring tingling, numbness or cutting sensations along with the burning, plus dry mouth, a metallic or bitter taste and a distorted sense of taste. It was one of my first symptoms. It's diagnosed by ruling everything else out, and it isn't clear whether hormone therapy helps, but for most women it disappears or improves once hormones level out.

Electric shock sensations

It feels like something is pulsing or moving under your skin, and you can't find it, stop it or see it. Essentially, hormones go haywire and nerves misfire. I have it in the palm of my hand, and I was convinced something had burrowed under my skin until I realized it was another reminder of menopause. It's said to pass once hormones level out. In the meantime, magnesium might help, and some women find relief from massage, yoga or acupuncture.

Itchy ears

It's not only you. When you lose estrogen you lose water too, and skin and mucous membranes dry out, including the inner ear. Itchy ears can come with hot ears and ringing in the ears.

Go deeper: Dr. Mary Claire Haver: The Perimenopause Symptoms No One Warned You About

Perimenopause vs. menopause: the stages

Menopause itself is a single day: the point when you've gone 12 months in a row without a period. Everything before it is perimenopause, and everything after is postmenopause. In the US the average age of menopause is 51 for white women and 49 for Black and Hispanic women. The "pause" in menopause makes it sound temporary, but postmenopause is forever.

Stage	When	What's happening	What you may notice
Perimenopause	Usually starts in the 40s, sometimes the late 30s; lasts about 4 years on average, and up to 8	Estrogen and progesterone rise and fall unpredictably	Cycle changes, hot flashes, sleep problems, mood shifts, brain fog
Menopause	One day, 12 months after your last period; average age about 51	Ovaries have stopped releasing eggs	Symptoms often peak in the year or two around this point
Postmenopause	Every day after menopause	Estrogen stays low	Hot flashes often ease over time; vaginal, bone and heart changes need ongoing attention

Menopause before 45 is called early menopause and affects 5 to 7 percent of women. Before 40, it's primary ovarian insufficiency, or POI. Surgery that removes both ovaries causes immediate menopause. In any of these cases, talk to a doctor about your options, because the health effects of losing estrogen early are greater.

Where to go from here

Find a doctor who gets it. Many doctors receive little training in menopause care. Our Menopause Support Provider Directory lists practitioners who specialize in it.

Track your symptoms. The free Menopause Symptom Tracker helps you spot patterns and walk into your appointment with specifics instead of a vague sense that something is off.

Get the full story. How to Menopause is the book I wish I'd had on that plane, with every symptom, every treatment option and the questions to ask your doctor.

Keep learning. Browse all the free guides, including How to Perimenopause and Hormone Therapy 101, or listen to The Tamsen Show.

Frequently asked questions

What are the first signs of perimenopause?

For most women it's a change in their cycle: periods that come closer together, further apart, heavier or lighter. Sleep problems, new anxiety, hot flashes and brain fog are also common early signs, and some women notice these before their periods change at all.

At what age does perimenopause start?

Most women notice the first changes in their mid-40s, but it can begin in the late 30s. The age your mother or sisters went through menopause is one of the better clues to your own timing.

How long does menopause last?

Perimenopause lasts about four years on average and can run up to eight. Hot flashes and night sweats often last longer than people expect: in the large SWAN study, frequent symptoms lasted a median of 7.4 years. Symptoms like vaginal dryness can continue without treatment.

How do I know if I'm in perimenopause or menopause?

If you're still having periods, even irregular ones, and noticing symptoms, you're likely in perimenopause. Once you've gone 12 months without a period, you've reached menopause. There's no definitive test for perimenopause. It's a clinical diagnosis, and a single hormone blood test can mislead because levels swing from day to day. As Dr. Sharon Malone told me, if you're between 40 and 50 and having any of the 34 symptoms, you're in perimenopause. That's why tracking your symptoms matters so much.

Can you get pregnant during perimenopause?

Yes. You can still ovulate, even if your periods are irregular. If you don't want to get pregnant, keep using contraception until your doctor confirms you've reached menopause.

How many symptoms of menopause are there?

How to Menopause covers the 34 most common symptoms, and researcher Andrea Donsky has documented 103 and counting. Every woman's experience is different: some have a few mild symptoms, others have many.

What helps menopause symptoms the most?

Hormone therapy is the most effective treatment for hot flashes and night sweats and helps several other symptoms, and it's appropriate for many women. Non-hormonal medications, strength training, sleep habits, nutrition and cognitive behavioral therapy all help too. A menopause-informed doctor can help you find the right mix.

Sources

Primary source: Tamsen Fadal, How to Menopause, Chapters 1 and 2. Additional sources:

• Avis NE et al. Duration of Menopausal Vasomotor Symptoms Over the Menopause Transition, JAMA Internal Medicine, 2015 (the SWAN study)
• Cleveland Clinic, Perimenopause and Your Fertility: What to Know
• Cleveland Clinic, Perimenopause (how long perimenopause lasts)

Medical disclaimer

The information on this page is for educational purposes only and is not medical advice. Always talk with a qualified healthcare professional about your symptoms and treatment options.