In this episode we talk about the sneaky perimenopause symptoms you must know about, including perimenopause symptoms you haven’t heard of, never expected, never knew existed, the less-known symptoms, and the perimenopause symptoms you shouldn’t ignore.

There are 34 officially recognised symptoms of perimenopause, but probably many more.

Estrogen, progesterone and testosterone optimise the function of every cell, tissue and organ in the body, so when they start to fluctuate and fall during perimenopause, the body & brain can go haywire.

Sign up for my free masterclass: Reset Your Body & Brain and Feel Like Yourself Again here!


Episode Transcript


Perimenopause awareness could be the difference between you feeling fit, strong and healthy for the rest of your life, or wondering “who is that woman in the mirror?!” and fading out of your own life. No joke, this might be, as a woman in your thirties and forties, the best 21 minutes you invest all year. Now, if you are a woman in your thirties or forties, DO NOT automatically put down any of these symptoms into that “work-life stress” bucket because if they are caused by hormonal fluctuations of perimenopause, then I have fantastic news for you. You CAN reset your body and brain and feel like yourself again. Hello, I’m Stephanie Holland, the creator of The Body:Brain Reset, the 14-day micro course that helps you reset your body and brain and feel like yourself again. And in this video we’re gonna talk about the 34+, because there are more than 34 symptoms, the 34 sneaky perimenopause symptoms that you must know about.


Now, please listen to the whole list and if you have any of the symptoms, I’m gonna tell you the next essential step to resetting your body and brain and feeling like yourself again, because listen, just because you have some or many of these symptoms doesn’t actually mean you’re in perimenopause, but you do have to find out if you are and we are gonna cover that at the end of the list of symptoms. Now, just a quick recap of my video: “What is perimenopause?” Listen your sex hormones, estrogen, progesterone, and testosterone, what they do in your body is that they optimize the function of every single cell tissue and organ in your body and brain. So when levels start to fluctuate and fall during perimenopause, the body and brain can go haywire. So the following symptoms can be caused by fluctuating and falling hormones.


Let’s get started with the five sneaky perimenopause symptoms that you must know about. Now these are the ones that can be really hard to articulate and can leave you wondering if it’s all in your mind, 1: feeling flat and off your game. Now, I’ve done a whole video about this. You can click to watch it now and I’ll put link in the description below. 2: you don’t recognize yourself in the mirror. You’ve lost your glow, you don’t feel like you, something is off, something is up. You just don’t know what 3: you feel exhausted by exercise when it used to energize you. it leaves you feeling knackered and it takes you ages to recover. 4: and this is so powerful to realize this, your usual health and wellbeing toolkit doesn’t work. Nothing you do alleviates your symptoms. Your usual wellbeing toolkit doesn’t work. Exercising more, eating less dieting, detoxing supplements, super foods, doing more yoga, your symptoms seem sudden and intractable.


And 5: feeling overwhelmed and finding it hard to cope with daily life. Now, fluctuating hormones during fluctuating hormone levels during perimenopause impact your resilience, your confidence, your sense of identity, your brain function leaving you feeling more emotional than usual, as well as indecisive, flat, foggy and blunted. So you can just feel generally overwhelmed with daily life and really exhausted by it as well. And it’s really important to note that during perimenopause right up until the end of the perimenopause runway, which can last up to 15 years, your periods might be completely normal and regular. so we’re gonna talk about perimenopause sorry, periods during perimenopause in a minute. Obviously that is a symptom, but you’ve got to realize that you can’t just look at your periods to see if you are in perimenopause. Okay, so next up the 10 symptoms of perimenopause that you put down to work and life stress.


So number 6 is mood swings. You may experience sudden changes in your mood such as irritability, anxiety, and depression. And of course this impacts every relationship in your life as well as your work and your career. Number 7, depression. So this might present as feelings of sadness, hopelessness, and worthlessness, worthlessness, <laugh> hard to say worthlessness. You may be actually diagnosed with clinical depression, but antidepressants might not work for you because…, they don’t actually work for depression caused by hormonal fluctuations. Number 8 is anxiety. So these include feelings of worry, fear, and panic. And sometimes the panic is so bad that it’s number 9: panic disorder can be your diagnosis. So these can be sudden and intense feelings of fear and panic. Now these four: mood swings, depression and anxiety and panic can, can occur because estrogen levels drop. And when that happens, the mood-boosting hormone serotonin also drops and the stress hormone cortisol rises.


And of course all the other symptoms that you experience as a result of the fluctuating hormones during perimenopause can also make you feel anxious and depressed as well. So it just kind of has this compounding ripple effect. Number 10 is irritability. So again, you may just feel easily annoyed and frustrated by silly things that before you would’ve just taken in your stride. Number 11 is fatigue. So this is feeling tired and sluggish even after a good night’s sleep. Like it’s almost like you never feel awake and you wake up feeling groggy even if you’ve had the perfect eight hours, which I know is the holy grail. <laugh> number 12 is insomia. So you may have trouble falling asleep or staying asleep, now progesterone


plays a particular role in feeling calm, which helps you fall asleep. So when levels drop might be harder to feel calm so that you can fall asleep. Number 13, heart palpitations. You may feel your heart pounding or racing race racing racing, which can be worsened by caffeine, alcohol and other stimulants. Number 14 is high blood pressure. Number 15 is high cholesterol. Now the decrease in estrogen levels can lead to an increase in LDL, which is supposedly the bad cholesterol. There are no symptoms per se for for bad cholesterol itself, but it might show up on a routine blood test. Now if you are already saying yes, yes, yes to any of these symptoms, you are going to love my course, The Body Brain Reset. It’s not available yet, but it does launch in four 14 days and it’s a 14 day micro experience to help you reset your body and brain and feel like yourself again.


You can sign up for the wait list or stephanie And when you get there, you see my beautiful hot pink and neon yellow website <laugh>, and you can sign up and get on the list anywhere where there’s a pink button. okay. But it’s all about the fact that you can reset your body and brain and feel like yourself again when you’re going through perimenopause. All right, so let’s keep going. The five symptoms down there that you don’t need to suffer through. Number 16, vaginal dryness or itching and burning in the vaginal area is caused by a decrease in estrogen levels during perimenopause, which leads to the thinning and the drying of the vaginal tissues. Estrogen usually would be this natural protective lubricant that keeps everything down there, there, and of course everything in your body and bra brain as well, but it keeps everything down there in your vagina and vulva area, lubricated, hydrated, protected, and healthy.


Number 17, obviously this might lead to painful or uncomfortable sex and avoiding sex altogether and creating a bit of distance and tension and discomfort between you and your partner. Number 18 is recurrent UTI symptoms and u actual UTIs. Now because estrogen keeps the vaginal walls healthy and lubricated and also the bladder and the urethra healthy and lubricated, and at the right pH usually it would protect it from bacterial infection. But when estrogen is low everything down there is left a little bit vulnerable to bacterial infection. So that’s why recurrent UTI and recurrent UTI symptoms can happen. Number 19 is an overactive bladder and the the sort of like need or the urge to pee all the time. So this is also called urge incontinence. sometimes this can happen all the way through the night as well, which can also keep you awake and lead you to not getting enough sleep.


Number 20 is stress incontinence. So that’s when you pee when you sneeze or cough or during exercise totally by accident and totally out of control. And it’s because the pelvic floor muscles need adequate levels of estrogen to stay strong. Now, everything in this area of our body down there, vulva vagina, is referred to all issues down there are referred to genital urinary syndrome of the menopause. GSM for short. I mean, seriously who comes up with these names? But when you’re talking with your doctor about these kind of symptoms, drop in genital urinary syndrome of the menopause and GSM into the conversation and also ask about fluctuating hormones as the cause of your symptoms down there. Now these symptoms are still so taboo and many women suffer for three or four years with them unnecessarily because there are solutions, but it’s still so taboo, so stigmatized, please talk to your doctor.


Your doctor will know about it and will know how to help you solve it. There is no reason to suffer with symptoms down there. Now, if you are getting value from this episode so far, hit the like button and subscribe. I am creating a ton of content about hormone balance and how to turn perimenopause into a portal to a whole new universe, right? Swiftly. Moving on to the three peral perimenopause symptoms you haven’t heard of and probably would never even connect to fluctuating hormones, right? Number 21 is tinnitus. Now this is described as a sensation or awareness of sound that is not caused by a real external sound source resulting in a kind of humming buzzing sensation that can drive you nuts. It’s not in your mind. Low estrogen could be the cause because estrogen plays an important role in helping nerves conduct messages across neural pathways.


Now, it’s been found that the right dose and type of hormone replacement therapy can often improve tinnitus. Now, not enough research has been done just yet, but a study published in 2019 found a positive association between menstrual cycle irregularity and tinnitus suggesting that hormones and their levels and their fluctuating levels might play a role in tinnitus. All right, number 22 is allergies. Our bodies become more sensitive and less able to process histamine, okay, which is our natural response to inflammation. So hay fever, asthma, prickly heat can start or worsen. Now for me, suddenly a couple of years ago, I developed this life-threatening allergy to grass, pollen and cement dust. And I had no idea why I kept needing to go to emergency with breathing difficulties. And it’s because this was one of the clues leading up to or letting me know I was on the perimenopause runway that I had no idea about and no idea I was in perimenopause.


So it all made sense. Everything, the penny always drops in hindsight, unfortunately, which is why I am giving you this information now. number 23 is an altered sense of smell and taste. Crazy, right? So this includes you not being able to smell things as well as you used to, but also a heightened sense of smell to things that really drive you nuts. And it can be anything, but it’s often things like perfume or detergents. And this happens because flu fluctuating levels of estrogen affect the pathways in your brain that control your sense of smell and taste. Therefore, it can also affect your sense of taste. I think I mentioned that in a minute. All right, moving on to the 10 unusual perimenopause symptoms that you never expected. Expected. Number 24 is the loss of libido. So a decrease in sexual desire and arousal is caused by decreasing levels of testosterone because testosterone regulates arousal and sexual pleasure.


And well, also, estrogen plays a role in keeping your vagina, nice and lubricated. So all of these factors kind of influence, you know, you know, your sex drive number 25 is hair loss. Your hair might be thinning and falling out. This is caused by decreasing estrogen levels. Number 26 is dry skin. Oh my goodness, I had crocodile skin and no amount of moisturizer or hydration would do anything about it. And I was so confused by this. So you may experience dry, itchy, and flaky skin. This is caused by decreasing levels of estrogen because it caused like estrogen is responsible for the production of collagen, ceramides, sebum, and hyaluronic acid, which is basically all these four things are the skin’s, natural, protective, hydrating, and waterproofing mechanisms that keep the skin glowy, plump and high hydrated. So as levels of estrogen drop, you kind of lose those like glowy plumpy hydrating qualities and your skin can become very dry.


And as a result, itchy and inflamed. Number 27 is brittle nails. Now you may notice that your nails become brittle and break easily, and now this is caused again by decreasing estrogen levels because estrogen is responsible for, of course, collagen and those other things, but also keratin production, which keeps your nails lovely, beautiful and strong. Number 28 is acne, particularly around the jawline. This is caused by fluctuating hormones in general, particularly testosterone, and for some people it can feel like puberty all over again. I actually explained the beautiful synchronicity of puberty and perimenopause in another video. You can click the to watch that now, and I’ll put a link in the description. Number 29 changes in body odor. This is so strange, like you can really notice that your, your, your smell, your natural armpit smell becomes much more pungent, pungent and sour, and you can smell yourself.


And that is the weirdest thing. Number 30, electric shock sensations in your head and body. Number 31, tingling and numbness in your extremities, your fingers and toes. I had a lot of tingling and numb numbness on my thighs and my sides as I’m a side sleeper, and that totally weirded me out. I thought I was gonna lose sensation in my body. Nope, it was just perimenopause. <laugh> Number 32 is dental issues. So you might experience gum problems, dry mouth bleeding, swollen gums toothache a burning sensation in your mouth, halitosis, which is bad breath. And generally sort of like an increased issues, oral and dental issues. Now estrogen plays a huge role in oral health particularly because it protects all of our delicate mucus membranes. And again here it also, you know, it’s responsible for your, your sense of taste. So anything in the mouth area might be affected, but also your sense of taste, which is really, really a shame if you’re a food person.


And totally weird, right? <laugh> number 33 is dry eyes. Estrogen plays an extraordinary role in creating tear film so that as levels of estrogen fluctuate it stops lubricating the eye area and you can experience dry eyes and because they’re dry, you can feel like the, it’s a, kind of, feels a little bit gritty and maybe you have blurry vision. So, dry eyes, blurry vision, that gritty feeling can be a result of perimenopause. All right, so now five perimenopause symptoms you shouldn’t ignore because it’s probably perimenopause is #34 irregular periods. I was so confused and so were so many of my girlfriends at, at a similar age. What is going on with my period? They’re really heavy or they’re really short and they change from month to month, what is going on with me? So you may start to notice changes in your menstrual cycle.


You may not notice any changes in your menstrual cycle right up until the end of your perimenopause runway, but you might such as shorter cycles, longer cycles, heavier or lighter periods missed period periods and just changing from month to month, whatever is happening. this was quite scary and we had no clue what was going on. Well, we, we, we knew the word perimenopause, but the word didn’t come up in our conversation and we had no awareness of how perimenopause applied to us in our late thirties and early forties. So you, you know what, this just should be known like we should know about this. Anyway, I’m just gonna get on cause I could get into a whole rant about that. Number 35 is unusual bleeding between periods. So this could be spotting or brown discharge. Any kind of color that seems weird to you could be as heavy as a period and it could last several days and it could be triggered by all sorts of things.


But during perimenopause it can be the result of fluctuating hormone levels. Number 36 is breast tenderness and soreness. So low estrogen can also make your breasts shrink and appear droopy. But ultimately estrogen and testosterone also play a role in helping build muscle. And of course, breast tissue is a muscle, so your breast might feel tender and sore and they also might just start to look like they’re sagging and drooping, which is, you know, equally depressing and anxiety inducing, especially in your thirties. Number 37 is weight gain. So this includes a pot bellya change in your body shapebecause of a decrease in muscle mass due to low estrogen andtestosterone. And also then an increase in fat mass as the body tries to produce more estrogen from fat stores, which is actually very clever of your body as your body’s, as your ovariesslowly produce less and less estrogen.


Your body tries to produce a different type of estrogen from your fat stores, so this is just your miraculous body in survival mode in SOS mode trying to keep you functioning. And I think it’s extraordinary, but it is a result of perimenopause and weight gain can have a massive impact on how you feel about yourself on your body image and your identity. Sojust so you know, that’s one of the reasons of weight gain that you can’t shift no matter how much exercise or dieting you do, because it’s because of fluctuating hormones. Number 38, as you know, part of the same thing, a slowed metabolism, making it harder to lose weight despite any amount of exercising and dieting that you might do. Okay, moving on to the less known perimenopause symptoms. Number 39 is difficulty concentrating. So you might have trouble focusing and remembering things.


This is just caused by hormone fluctuations, particularly estrogen and progesterone. Number 40 is memory problems. So you may experience memory lapses and forgetfulness. This is caused by the fluctuation of hormones, particularly estrogen and progesterone. Now, both of these come under the umbrella of what’s kind of cause called brain fog. So it’s kind of that sense of walking into a room only to forget why, or that just general feeling of fuzziness and not being able to think clearly or focus or concentrate. For me, I just couldn’t read books. I just didn’t have the focus and concentration to read a book. And I love reading. I’m a voracious reader. I, before perimenopause, I was reading three or four books a week, and all of a sudden I just couldn’t concentrate. That was heartbreaking to me. So this can have an effect on so many areas of your life, your passions, your work, your relationships, conversations.


You can kind, yeah. Anyway, yeah, I mean there’s a whole episode in that on its own <laugh>, but many women worry they have early onset Alzheimer’s when they start to get these issues with memory and concentration, but the cause is fluctuating levels of estrogen and testosterone. Now, testosterone I’ve mentioned already a couple times in this episode it’s responsible for cognitive function in both men and women. It’s a human hormone, it’s not just a male hormone. We might have roughly 10% of the levels that men do, but we actually have three to four times more testosterone than estrogen during our reproductive years. So it’s a really, really critical hormone for your body as well. It’s not just a male hormone. Number 41 is the loss of confidence because testosterone is also a confidence booster. and when levels of testosterone fluctuate, so can our confidence.


We have roughly half the levels of testosterone at 40 than we did at 20. So we can have half the level of confidence and of course diminishing confidence. So if you feel like there are things that used to be super confident about before, like giving pres presentations or driving in crazy la highway freeway, six lane traffic, and all of a sudden you’ve lost confidence to do that. This could be a reason why perimenopause could be a reason why number 42 is headaches. So you may experience headaches and migraines regularly with more intensity than you did before. This is caused particularly by the fluctuations in estrogen and progesterone. Number 43 is digestive problems. This hit me particularly hard. So you may experience bloating, gas, constipation, diarrhea, similar symptoms to what is discussed around irritable bowel syndrome (IBS). Now this is caused particularly by fluctuating levels of estrogen and progesterone, and there are a ton of of fixes for this, including dietary changes if this is a result of hormone fluctuations of perimenopause.


Number 44 is joint pain. So you may experience pain, stiffness in your joints. This is caused by decreasing levels of estrogen and testosterone levels which can lead to inflammation and pain in your joints. Number 45, muscle tension. You may experience muscle tension and stiffness. You may experience like stiff and achy joints and muscles, which is the worst, but again, caused particularly by fluctuating levels of estrogen and progesterone. All right, so the two most famous symptoms of perimenopause that don’t happen to everyone, and that’s why I left them till last 46, is hot flashes or hot flushes depending on whether you speak American or British English. Now this is a sensation of warmth, heat, sweating, flushing anxiety and chills. That that’s a terrible combination, right? That can last for around one to five minutes, maybe longer. They’re triggered by a variety of factors including stresscaffeine, alcohol, spicy foods, as well as thyroid issues, diabetes and tuberculosis.


So not necessarilycaused by the hormone fluctuations of perimenopause, could be caused by perimenopause, could be caused by other things. 47 is night sweats. So night sweats are hot flashes or hot flushes that occur at nighttime and they can be so severe that they wake you up, disrupt your sleep. You can wake up with soaked clothes, soaked bedsheets, a soaked partner! I haven’t experienced this, but I’ve spoken to many women who have, and it’s really quite disturbing for them. Quite, quite worrying. Now scientists aren’t sure why hot flashes, hot flushes and night sweats occur exactly, but ap it appears that falling estrogen levels affect the hypothalamus, which regulates body temperature. Now, it’s also thought that, and sort of preliminary research is kind of indicating that women who smoke or are overweight or obese are more likely to have hot flashes, hot flashes and night sweats.


And race is also an important factor in research done in Britain. It showed that British Asian womenare less likely to have hot flashes and black women in Britain, British black women are more likely to have hot flashes, flushes and night sweats. And actually research indicates that there are significant differences in the experience of menopause across race in general. And I’m wondering if it’s the half Indian in me, which is is the reason that I didn’t have hot flashes and flushes when the perimenopause hit me. And yes, it felt like an unsurpassable wall. I had 31 of these symptoms my friend, and it was just crazy. So you are experiencing any of the above? Oh my goodness, I feel you right now. I absolutely feel you. But that’s 47 symptoms, my beautiful friend and I didn’t even actually mention dizziness or heartburn.


So that’s actually 49 that I’ve come across in the last 18 months of studying like a mofo. So tell me in the comments below, which symptoms surprise you the most, let me know, but also, okay, just quickly before we continue, share this with all of your girlfriends so that every woman is aware of and prepared to reset her body and brain during perimenopause. But heads up, as I hinted at the beginningyou, you don’t have to suffer through fatigue and exhaustion and irritability and brain fog and weight gain and depression and anxiety and loss of confidence or any of the other 47 symptoms, okay? When you know what the symptoms are, you can look out for them, you can just be aware of them, you can notice them when they start and even when they’re subtle, you can start picking up on them and you can very quickly adapt your self-care, health, healthcare, and lifestyle so that you can reset your body and brain and feel like yourself again all the way through your perimenopause runway.


And maybe like my experience was that I actually feel better than I did before perimenopause started because it gave me a chance to reassess my self-care, healthcare and lifestyle on every single level right from scratch. So I actually feel more fantastic than I did before. But also just because you’re experiencing these symptoms of perimenopause doesn’t actually mean you are in perimenopause because these symptoms could be caused by other conditions. So the most important thing you can do next is to start tracking your symptoms. Perimenopause symptoms mimic other conditions and vice versa. I mean, you know, as well as I do from looking at Dr. Google trying to like diagnose any problem in the past, right? When you look up something like headaches or migraines, it could be, you know, caused by a dozen things from PMS to I don’t know high altitude <laugh> dehydration.


You know, your symptoms could be caused by many underlying factors. So start tracking your symptoms so that it’s easier for your doctor and you together collaboratively to diagnose perimenopause and as well simultaneously to rule out other conditions as a cause of your symptoms. Now this is the key to feeling great right now and future proofing your health and wellbeing. The key to feeling great is tackling the underlying cause of your symptoms, whether it’s perimenopause or something else. So whatever’s causing your symptoms, dedicate yourself to being the best Sherlock, and Sherlock the hell out of your symptoms and figure it out because I mean, ultimately perimenopause is a clinical diagnosis. When you know you’re in perimenopause, you can reset your body and brain and feel like yourself again. You can implement solutions and lifestyle strategies that align with your health and wellbeing values. So how do you track your symptoms most effectively, most efficiently? That doesn’t like make you go crazy every day trying to figure out what you did, you know, like trying to keep a food journal! Oh my goodness, that can be just so maddening sometimes. But listen, tracking your symptoms is so simple. I made a whole video about how to track your symptoms. So click to watch that next, subscribe to catch the latest episodes and I will see you, my beautiful friend in the next episode.