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Comprehensive Checklist of Perimenopause Symptoms


Published June 4, 2025

Perimenopause, the transitional phase before menopause, typically begins in a woman’s 40s but can start earlier. It is characterized by fluctuating hormone levels, particularly estrogen and progesterone, leading to a wide range of physical, emotional, and cognitive symptoms. Understanding these symptoms is essential for managing health and well-being during this phase. Below is a comprehensive checklist of perimenopause symptoms to help women identify changes and seek appropriate care.

Menstrual Changes

  1. Irregular Periods – Cycles may become shorter, longer, heavier, or lighter.
  2. Skipped Periods – Menstrual cycles may become unpredictable with missed periods.
  3. Shorter Cycles – Periods occurring more frequently than usual.
  4. Longer Cycles – Increased time between periods.
  5. Heavy Bleeding – Menstruation that is heavier than usual, sometimes with clotting.
  6. Light Bleeding – Periods that become lighter than usual.
  7. Spotting Between Periods – Unexplained bleeding between cycles.
  8. Increased Menstrual Cramping – More intense pain before or during menstruation.

Vasomotor Symptoms (Hot Flashes and Night Sweats)

  1. Hot Flashes – Sudden warmth, often in the upper body, face, and neck.
  2. Night Sweats – Excessive sweating during sleep.
  3. Chills After Hot Flashes – A sudden drop in body temperature following a hot flash.
  4. Flushing of the Skin – Redness in the face or chest.
  5. Increased Sensitivity to Temperature Changes – Difficulty tolerating heat or cold.

Sleep Disturbances

  1. Insomnia – Difficulty falling or staying asleep.
  2. Frequent Night Wakings – Waking up multiple times at night.
  3. Restless Sleep – Feeling unrefreshed upon waking.
  4. Early Morning Wakings – Waking up too early and being unable to go back to sleep.
  5. Increased Fatigue – Persistent exhaustion despite adequate rest.

Mood and Emotional Symptoms

  1. Mood Swings – Rapid changes in emotions.
  2. Irritability – Increased sensitivity to stress or frustration.
  3. Anxiety – Feelings of worry or panic without a clear cause.
  4. Depression – Persistent sadness, low energy, and loss of interest in activities.
  5. Increased Stress Levels – Feeling overwhelmed more easily.
  6. Loss of Motivation – Lack of enthusiasm or drive.
  7. Frequent Crying Spells – Emotional sensitivity leading to crying easily.
  8. Feelings of Hopelessness – A sense of despair or lack of purpose.
  9. Reduced Self-Esteem – Feeling less confident in oneself.

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Cognitive Changes

  1. Brain Fog – Difficulty concentrating and thinking clearly.
  2. Memory Issues – Forgetfulness or trouble recalling information.
  3. Difficulty Finding Words – Struggling to remember common words.
  4. Reduced Mental Clarity – Feeling mentally sluggish.
  5. Decreased Problem-Solving Abilities – Challenges in processing complex information.
  6. Shortened Attention Span – Trouble focusing for long periods.

Physical Changes

  1. Weight Gain – Particularly around the abdomen.
  2. Slowed Metabolism – Increased difficulty in losing weight.
  3. Increased Belly Fat – Changes in fat distribution.
  4. Loss of Muscle Mass – Decreased strength and muscle tone.
  5. Joint Pain & Stiffness – Aches and stiffness in joints.
  6. Muscle Aches – Soreness without obvious cause.
  7. Increased Fatigue – Persistent low energy levels.
  8. Headaches or Migraines – More frequent or severe headaches.
  9. Breast Tenderness – Soreness or discomfort in the breasts.
  10. Bloating – Feeling full or swollen in the abdomen.
  11. Water Retention – Puffiness, especially in hands and feet.
  12. Changes in Body Odor – Increased or altered sweat odor.
  13. Increased Hair Shedding – Hair loss or thinning.
  14. Dry Skin – Reduced skin moisture and elasticity.
  15. Acne or Breakouts – Hormonal fluctuations leading to adult acne.
  16. Increased Facial Hair Growth – Thicker or darker hair on the face.
  17. Thinning Eyebrows – Especially on the outer edges.

Sexual and Urinary Symptoms

  1. Decreased Libido – Reduced interest in sexual activity.
  2. Vaginal Dryness – Lack of natural lubrication leading to discomfort.
  3. Painful Intercourse – Discomfort or pain during sex.
  4. Vaginal Atrophy – Thinning and weakening of vaginal tissue.
  5. Increased UTIs – More frequent urinary tract infections.
  6. Urinary Urgency – Feeling a sudden, intense need to urinate.
  7. Urinary Incontinence – Leakage of urine when coughing, sneezing, or laughing.

Heart and Circulatory Symptoms

  1. Palpitations – Rapid or irregular heartbeats.
  2. Increased Blood Pressure – Higher-than-normal blood pressure.
  3. Dizziness or Lightheadedness – Feeling faint or unsteady.
  4. Cold Hands and Feet – Poor circulation leading to temperature changes.
  5. Increased Risk of Varicose Veins – Appearance of bulging veins in legs.

The post Comprehensive Checklist of Perimenopause Symptoms appeared first on BodyLogicMD.

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  • My wife and I starting coming to BodyLogicMD a few years ago as were both feeling the effects of our aging. She was pre-menopausal with slight weight gain and night sweats and low energy and I was suffering from very low testosterone as most men over 40 do and had low energy. My wife read about hormone treatment in a book by Susanne Somers and we searched out doctors in Atlanta that offered it and found BodylogicMD. After being on our treatment programs for about 90 days we both felt great and our symptoms went away and we have maintained...Read More
  • "At 44 I was tired of feeling tired. I wasn't sleeping through the night, waking up with the sweats and just not able to turn my brain off. During the day, I had no energy. The 3 pm slump would hit me like a ton of bricks everyday - no matter how well I had slept the night before. My libido was pretty much zilch and I was seriously moody. Worst of all, don't tell my husband the no libido wasn't the worst, I couldn't lose weight to save my life. After hearing about BodyLogicMD, I decided that something needed...Read More

  • "I was unable to find a provider who specializes in female hormones through my OBGYN – they just give you the pill which I didn’t want. And, my endocrinologist fell short in this area. Then I found BodyLogicMD of Atlanta and Dr. Karen Weldon. At my first appointment, the office staff was great, and Dr. Weldon was very thorough in reviewing my lab results. During the course of my treatment, Dr. Weldon has been very quick in responding to all my questions via email which is very convenient. I can write to her when an issue is happening and...Read More

  • "Dr. Donohue has been treating me for several years now and the change in my health has been incredible.  I no longer have that “foggy” feeling, my thoughts are now clear and concise.  I have more energy and look healthier than I have ever looked before, and my friends and family have noticed and commented favorably.  With the boost in energy I’m able to exercise more and that has resulted in a better looking body and a lower number on the scale!  I completely trust Dr. Donohue, he’s knowledgeable and takes the time to explain things, is compassionate and is...Read More
  • "My husband I have been Dr. Donohue’ patients for the past several years and we can honestly say it has been a life changing experience for us….., as we grow “younger”, we have been faced with many age related deteriorations physically and mentally…., Dr. Donohue’ precise HRT therapy and supplements have made us feel and look as young as we feel at our hearts…, plus I love the fact Dr. Donohue is prompt and we never have to wait more than 5 mins!!!!!!!! The staff at his office is wonderful as well; professional, friendly and very caring; we are just...Read More

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