Common signs of perimenopause

Common signs of perimenopause

Struggling to sleep, getting frequent vaginal infections, more headaches, feeling nauseous, or feeling like your body odour is changing? These are just some of the signs that you may be perimenopausal. Our research of 1,526 women revealed the most well-known signs of perimenopause, the lesser-known symptoms, and the debilitating impact perimenopause can have on mental health as women transition into menopause.

Perimenopause is the transition period before menopause, when oestrogen levels begin to decline, and it can start up to 10 years before menopause. 

Here we share the common and less common symptoms of perimenopause, the impact of perimenopause on gut health, physical and mental health. We also share the best remedies to relieve symptoms, including PeriMenoFriend®, the uniquely comprehensive plant-based supplement to naturally regulate and balance hormones through perimenopause and relieve symptoms. 

The 10 most common symptoms of perimenopause

More than 80% of women going through perimenopause will experience one or more of the following: brain fog, anxiety, mood swings, and fatigue. More than two-thirds will experience worsening sleep or insomnia, joint aches and pains, bloating, hot flushes and night sweats. 

 10 most common symptoms of perimenopause Proportion affected
Brain fog 84%
Anxiety / mood swings 81%
Fatigue 80%
Poor sleep or insomnia 71%
Joint pain 71%
Bloating 69%
Hot flushes or night sweats 66%
Weight gain 65%
Low libido 60%
Low self-esteem 56%


Research shows that while the symptoms of perimenopause and menopause are very similar, women are more likely to experience certain symptoms through perimenopause when compared to menopause, or for these symptoms to be more severe during perimenopause. These include: 

Unusual symptoms of perimenopause

There are also some less common symptoms of menopause that are more likely to be felt more during perimenopause than menopause. These include:

  • Changes in body odour
  • Tinnitus
  • Electric Shocks
  • Nausea

Changes in periods are a common sign of perimenopause. Women going through perimenopause may still experience PMS symptoms, while also experiencing menopause symptoms. There are a number of common changes in periods women can expect during perimenopause - learn more in 'Understanding perimenopause periods', and you may also be interested in reading about 'period poo'.

The impact of gut health during perimenopause

Our hormones play a vital role in the health and balance of our gut microbiome, which in turn affects our whole body. As hormone levels fluctuate and then decline during perimenopause and menopause, this can disrupt the balance of the gut microbiome, leading to bloating and weight gain, worsening sleep, fatigue, difficulty focusing and concentrating, poorer skin health, weaker and thinner hair, and other symptoms. Likewise, a change in the gut microbiome, for example, through a change in diet or a course of antibiotics, can impact oestrogen levels, which in turn can exaggerate the symptoms of perimenopause and menopause. 

Breakthrough research by DR.VEGAN® into the impact of menopause on gut health found that women are twice as likely to first notice changes in gut health during perimenopause compared to menopause. Symptoms including bloating, mild or severe IBS, stomach cramps, diarrhoea, a change in the smell of your farts or stools, and constipation or not feeling relieved from bowel movements are all more likely to first present during perimenopause. 

You may be interested in learning more about the common and unusual symptoms of IBS. and Gut Works®, the multi award-winning prebiotic and probiotic with 6 clinically studied strains of healthy bacteria and 50bn CFU, which has been shown in research to be the most effective probiotic for optimal gut health during perimenopause.

Changes in gut health can also have a domino effect on vaginal health, leading to vaginal infections including yeast infectionsbacterial vaginosis (BV), and urinary tract infections (UTIs). Learn more about the link between your gut and vagina or discover our award-winning vaginal health formula, pH Hero®, formulated to maintain a balanced and healthy vaginal flora, protecting against harmful bacteria, bugs and UTIs.

Mental health during perimenopause

As women begin the transition to menopause, feelings of loneliness are very common. As oestrogen levels deplete, up to 40% of women will experience mild depression, and some may experience severe depression or even suicidal thoughts. This is why, unfortunately, too many women are prescribed anti-depression medication when going through menopause, which in many cases is unnecessary. Instead, by naturally regulating hormones through this natural phase in a women's life, women can experience a better mood and improve their resistance to anxiety and stress

The combination of physical symptoms, including vaginal dryness, low libido, weight gain, and hot flushes, with debilitating mental symptoms including brain fog, anxiety, feeling inadequate sexually, and feelings of worthlessness or being invisible, can become overwhelming, exacerbating feelings of loneliness and depression. If you're experiencing any of these symptoms, it's important to remember you're not alone, and there are remedies available, including PeriMenoFriend® and MenoFriend®, that naturally regulate and balance hormones to relieve symptoms so you can thrive. If you're at all uncertain, you can email the team of expert nutritionists at DR.VEGAN® at, or consult your GP. 

Recommended for perimenopause

GP and hormone health expert, Dr. Katie Hodgkinson, recommends a combination of a healthy diet, regular physical activity, and managing stress to help reduce perimenopausal symptoms. Read Dr Hodgkinson's 8 lifestyle tips to help you prepare for the perimenopause.

We also recommend PeriMenoFriend®, a uniquely comprehensive natural supplement, developed by practitioners, that supports the changing health needs of women through perimenopause. PeriMenoFriend® regulates and balances hormones to relieve symptoms of perimenopause, including brain fog, mood swings, hot flushes and night sweats, poor sleep, joint aches, bloating and weight gain, PMS symptoms, and more.

Discover The Menopause Hub with extensive resources and support for a smooth transition through menopause.

View our range of award-winning vegan supplements and probiotics.

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*UK survey based on responses from 1,526 women, nationally representative, during January 2024.

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