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For some women, perimenopause symptoms are mild. For others, it can feel like your mind and body are doing things you didn’t sign up for.
In a ThisIsMenopause poll of more than 2,000 women in perimenopause or menopause, respondents often described perimenopause as confusing, exhausting, and surprisingly emotional.
Below are some of the most common ways women said perimenopause affects them — in their own words.
One of the biggest themes women shared is how quickly their emotions can shift and how hard that is to live with day to day.
“It takes you out of your element. You’re not yourself anymore,” one respondent said. “You’re always angry or cold or hot, and everything gets on your nerves.”
Another said they experienced “mood swings and crying a great deal.”
When your mood changes like a switch has been flipped, it can be scary — especially if you’ve always felt emotionally steady. If you’re noticing mood changes, it can help to track when they happen (and what else is going on, like sleep loss or hot flashes). Bring that information to your doctor. They can help you sort out whether your symptoms line up with perimenopause, another health issue, or both.
If appropriate, your doctor can prescribe medications to help with mood, including antidepressants or menopause hormone therapy (also known as hormone replacement therapy or HRT).
Some women described anxiety that feels new, stronger, or harder to control than anything they’ve had before. Others mentioned panic attacks.
“My anxiety has been so bad,” said one respondent.
Another said they’ve been “experiencing panic attacks” alongside “trouble concentrating.”
If anxiety is interfering with your daily life, you deserve support. Consider telling your healthcare provider exactly what you’re experiencing. Include any physical symptoms that come with it, like racing heart, shortness of breath, or dizziness. It may also help to share whether these feelings are tied to certain times of day, sleep disruption, or hot flashes. Your doctor can tell you whether medications like hormone therapy or antianxiety medications may be appropriate.
Sleep loss came up again and again, and it makes sense. When you’re not sleeping, everything feels harder: mood, concentration, patience, and energy.
More than one respondent specifically mentioned “trouble sleeping.” “Bad sleep due to hot flashes,” another specified.
Some women connect sleep disruption directly to night sweats and temperature changes. If your sleep is getting wrecked, you might consider tracking patterns (like waking up drenched, waking at the same time nightly, or struggling to fall asleep). Your doctor can help you review your options and rule out other common causes of sleep problems. There are a number of options to treat sleep disruptions, including hormone therapy and cognitive behavior therapy for insomnia.
For many women, hot flashes and night sweats aren’t occasional; they’re constant, uncomfortable, and disruptive.
“I can’t wear sweaters or sweatshirts because I’m always having hot flashes. I can’t sleep with a blanket because of night sweats,” one respondent said.
“The night sweats I have 24 hours a day. Miserable!” said another respondent.
Temperature swings can affect what you wear, how you sleep, and whether you feel comfortable in public. If hot flashes or night sweats are frequent or severe, talk with your healthcare provider. They may recommend lifestyle changes, such as dressing in layers, using a fan, and avoiding triggers like hot drinks, spicy foods, and alcohol.
There are also effective treatment options. These include hormone therapy and newer nonhormonal prescription medicines. You and your provider can choose what works best for you.
Fatigue is more than being tired. Respondents described it as feeling like you’re running on empty, even if you’re not any busier than usual.
“I’m exhausted, moody, and confused by what my body is feeling,” said one respondent.
When energy drops, you might be tempted to grab some caffeine or just try to “push through” — but fatigue is a real symptom. If you’re exhausted most days, consider checking in with a doctor to discuss sleep quality, stress, mood, and other health issues that can overlap with perimenopause (like anemia, thyroid problems, or depression). You’re not “lazy” or simply tired. You’re dealing with something. Treating factors like mood disruption and insomnia may help improve your energy levels.
Changes in bleeding patterns are another common experience, including heavy flow and longer periods.
“My periods are so heavy and long,” one respondent said. “Heavy flow periods,” said another.
Heavier or longer periods can affect your work, social plans, and confidence. If you’re soaking through pads or tampons, bleeding for much longer than usual, or noticing big changes in your cycle, it’s important to let your healthcare provider know. Heavy bleeding can sometimes lead to iron deficiency, and it’s always worth getting checked.
New heavy or irregular bleeding during perimenopause may need evaluation to rule out causes like uterine polyps or fibroids. In some cases, doctors may also check for endometrial hyperplasia or cancer. There are several options to help manage heavy and irregular bleeding, including birth control pills, hormonal IUDs, and hormone therapy.
Some women described feeling mentally “off” — forgetful, scattered, or unable to focus the way they used to.
“My stress level is through the roof, mood swings, depression, brain fog,” a respondent shared. Another listed, among many other symptoms, “trouble concentrating.”
When concentration dips, it can be tempting to assume the worst about yourself. But brain fog can be connected to sleep loss, stress, anxiety, and mood changes — all things women mention alongside perimenopause. Tracking what you’re experiencing (and when it’s worse) can help you and your doctor spot patterns and identify ways to feel better. This might include hormone therapy, strategies and treatment to improve sleep, and more.
Many women described feeling like they don’t recognize themselves. That can affect relationships, intimacy, and self-esteem.
“Changes in my body are confusing and make me feel like a freak. I don’t recognize my own self anymore,” said one respondent.
“My sex life basically is on hold,” said another. “With my mood swings, I’m surprised I haven’t pushed everyone out of my life. Mostly though, it’s really impacted my relationships.”
“It makes me feel old and ugly,” a third respondent shared.
When symptoms change how you feel about your body or how you show up with people you love, it can be deeply painful. If you feel comfortable, consider telling a trusted partner or friend what you’re going through — not as an apology, but as context. And if your symptoms are affecting intimacy, mood, or relationships, a healthcare provider can help you explore what support might look like.
Perimenopause can affect sleep, mood, energy, periods, memory, and relationships — sometimes all at once. If any of these experiences feel familiar, consider writing down what you’re noticing and bringing it to a healthcare provider. You deserve to be taken seriously, and you deserve relief.
If you don’t feel your healthcare provider is listening to you or appropriately considering how perimenopause could be affecting you, consider finding a healthcare provider who is a menopause specialist. The Menopause Society provides a tool to help you find a certified menopause practitioner in your area.
It can also help to connect with others who get it. Sometimes the most powerful first step is hearing, “I know just what you’re feeling.”
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