“I wish I had known some of the obscure symptoms that aren’t widely discussed,” a woman in perimenopause told ThisIsMenopause. “For example, when I experienced frozen shoulder, I thought I had been seriously injured. Later I found out it was a symptom of menopause. I wish I had been better prepared.”

So many women feel unprepared for perimenopause and shocked by the wide range of symptoms they experience. Perimenopause goes way beyond hot flashes and an irritable mood. Whatever you’re experiencing, it’s not your imagination.

Here are some of the very real, and very invisible ways, perimenopause may be affecting you from head to toe. This list isn’t exhaustive, so be sure to talk to a healthcare professional about any unusual symptoms you’re experiencing.

Are there symptoms you would add, based on your own experience?