From Hot Flashes to Brain Fog: 34 Symptoms of Perimenopause

Reviewed by Dr. Kenton Bruice, MD

Reading time: four minutes

Perimenopause is the stage before menopause when hormone levels start to shift. For some women, it begins in their 40s, while others notice changes earlier. What makes this time so confusing is that the symptoms are unpredictable, and not always the ones you expect.

Why Symptoms Vary So Much

Estrogen and progesterone are powerful messengers that influence nearly every system in the body. When their levels rise and fall unevenly, the effects can show up in surprising ways. That is why one woman may only struggle with hot flashes while another feels joint pain, brain fog, or new food sensitivities.

No two experiences are alike, and there is no single checklist that applies to everyone.

The 34 Symptoms of Perimenopause

If you have ever searched “symptoms of perimenopause,” you may have seen a list that tries to capture the wide range of changes. Think of it less as a guaranteed roadmap and more as a reminder of how many areas of the body can be affected.

The 34 symptoms often linked to perimenopause include:

  1. Hot flashes
  2. Night sweats
  3. Irregular menstrual cycle
  4. Heavy periods
  5. Light periods
  6. Vaginal dryness
  7. Lower sex drive
  8. Mood swings
  9. Irritability
  10. Anxiety
  11. Depression
  12. Panic attacks
  13. Fatigue
  14. Brain fog
  15. Poor concentration
  16. Memory lapses
  17. Insomnia
  1. Weight gain
  2. Bloating
  3. Breast tenderness
  4. Headaches or migraines
  5. Dizziness
  6. Tingling skin
  7. Burning tongue or mouth
  8. Changes in body odor
  9. Hair thinning
  10. Brittle nails
  11. Joint pain
  12. Muscle aches
  13. New or worsening allergies
  14. Heart palpitations
  15. Dry or itchy skin
  16. Dry eyes
  17. Urinary tract infections

Remember: Not everyone will experience these symptoms, and some may notice only a few mild changes.

How Perimenopause Affects Mind and Body

The changes of perimenopause are not just physical. Sleep disruptions, fluctuating hormones, and daily stress can all interact, leading to mood swings, anxiety, or a general feeling of not being yourself. These shifts are just as real as hot flashes or joint pain, and they deserve attention.

How Hormone Therapy Can Help

Bioidentical Hormone Replacement Therapy (BHRT) is one option for women whose symptoms are interfering with daily life. At Centennial Hormone Institute of Colorado, Dr. Kenton Bruice uses advanced testing and personalized treatment plans to help women restore balance.

BHRT may help with:

  • Reducing perimenopausal symptoms
  • Improving sleep and mood stability
  • Supporting memory and focus
  • Relieving vaginal dryness
  • Making weight management more achievable

Why Work With Dr. Kenton Bruice

Dr. Kenton Bruice is an experienced OB/GYN who has specialized exclusively in hormone replacement therapy since 2005. Hormone care is his sole focus, which means every consultation and treatment plan benefits from two decades of dedicated expertise. 

At Centennial Hormone Institute of Colorado, his goal is to help women feel understood, supported, and empowered to take charge of their health during perimenopause and beyond.

Take the Next Step Toward Relief

The conversations around menopause are changing. It is no longer a taboo subject or a phase of life that women just have to endure in silence. More women are speaking openly about their experiences, and more treatment options are available than ever before.

With personalized hormone care from Dr. Kenton Bruice in Centennial, CO, you can find real solutions for perimenopausal symptoms and move forward with confidence.

To book an appointment at the Centennial Hormone Institute of Colorado, call (303) 957-6686 or visit 7009 South Potomac St, Suite 111, Centennial, CO 80112.

📍Other locations:

Denver Hormone Institute of Colorado

90 Madison Street Suite 704 Denver, Colorado 80206

📞(303) 957-6686

St.Louis Hormone Institute of Missouri

9909 Clayton Rd, Suite 225 , St. Louis, MO.

📞(314) 222-7567

FAQs

How long does perimenopause usually last?

On average, perimenopause lasts four to eight years, but the length can vary widely from woman to woman.

What age do perimenopausal symptoms start?
Perimenopause often begins in the early to mid-40s, though some women notice subtle changes in their late 30s. The exact timing depends on genetics, overall health, and individual hormone patterns.
Can perimenopause cause weight gain?

Yes. Hormonal shifts can slow metabolism and change the way your body stores fat, making weight gain—especially around the midsection—more common during perimenopause.

Where can I get treatment for perimenopausal symptoms in Centennial, CO?

At Centennial Hormone Institute of Colorado, Dr. Kenton Bruice offers personalized BHRT plans to help women manage symptoms and improve quality of life.

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