What are the 34 symptoms of perimenopause? The list, checked

On this page

In brief The 34 symptoms: the full list, checked The 21 symptoms the NHS and HSE list The 5 that are partly listed The 8 that aren't on the lists Symptoms that need a doctor soon What helps What NHS, HSE and NICE say Check your own symptoms Questions people ask About this page Sources

In brief

No health service publishes a list of 34 symptoms: NICE, the NHS, the HSE and WHO each describe a shorter list.^1,2,3,4
A change in your periods is usually one of the first signs of perimenopause.²
Symptoms can start 7 to 10 years before your periods stop, and most last around 4 years after your last period, the HSE says.³
The NHS says symptoms usually last 7 to 9 years, sometimes longer, and can change over that time.²
Any bleeding after your periods have stopped for 12 months needs checking by a doctor.⁵
Palpitations with chest pain, breathlessness or fainting need emergency help: call 112.⁶

The 34 symptoms: the full list, checked

This is the list of 34 that circulates online, in its usual order. For each symptom we checked whether the NHS or the HSE, Ireland's health service, lists it as a symptom of perimenopause or menopause.^2,3 Partly means they list something closely related, such as anxiety for panic attacks.

The 34 symptoms, checked against the NHS and HSE symptom lists
#	Symptom	On the NHS or HSE list?	What the sources say
1	Hot flushes	Yes	Sudden heat in the face, neck and chest.²
2	Night sweats	Yes	Listed with hot flushes.²
3	Irregular periods	Yes	Usually one of the first signs.²
4	Loss of libido	Yes	A lower sex drive.^2,3
5	Vaginal dryness	Yes	Often with burning, irritation or itching.²
6	Mood swings	Yes	On both lists.^2,3
7	Fatigue	Partly	Poor sleep is listed, and the NHS names menopause among causes of tiredness.^2,7
8	Hair loss	Yes	Hair thinning or hair loss.²
9	Sleep problems	Yes	Trouble getting to sleep or staying asleep.^2,3
10	Difficulty concentrating	Yes	Often called brain fog.³
11	Memory lapses	Yes	On both lists.^2,3
12	Dizziness	Partly	Not on its own, but the NHS says a hot flush can make you feel dizzy.²
13	Weight gain	Yes	Common in perimenopause and menopause.²
14	Incontinence	Yes	Needing to pee more, or not being able to control it.²
15	Bloating	No	If it's persistent, a doctor should check it.⁸
16	Allergies	No	Not on either list.^2,3
17	Brittle nails	No	Not listed; the NHS lists dry, itchy skin.²
18	Changes in body odour	No	Not listed; hot flushes often come with sweating.⁴
19	Irritability	Yes	On the HSE list.³
20	Depression	Yes	Low mood or depression.²
21	Anxiety	Yes	On the HSE list.³
22	Panic disorder	Partly	Anxiety is listed; panic attacks are not.³
23	Breast pain	No	Not on either list, though the NHS names menopause hormone changes among its causes.⁹
24	Headaches	Yes	Headaches and migraines that are worse than usual.²
25	Joint pain	Yes	Joint aches and pains.^2,3
26	Burning tongue	Partly	The NHS lists mouth problems; burning mouth is mostly seen after menopause.^2,10
27	Electric shocks	No	Not on either list.^2,3
28	Digestive problems	No	Not on either list.^2,3
29	Gum problems	Yes	Sensitive teeth, painful gums or other mouth problems.²
30	Muscle tension	Partly	The NHS lists muscle aches.²
31	Itchy skin	Yes	Dry and itchy skin.²
32	Tingling extremities	No	See a GP if pins and needles keep coming back.¹¹
33	Osteoporosis	Yes	Bone loss that isn't usually painful until a bone breaks.^2,12
34	Irregular heartbeat	Yes	Palpitations: a faster, slower or more noticeable heartbeat.^2,3

That makes 21 listed, 5 partly listed and 8 not listed. The sections below explain each group, and which symptoms need a doctor soon.

The 21 symptoms the NHS and HSE list

Periods

One of the first signs of perimenopause is usually a change to your periods: they may come more or less often, and bleeding may get heavier or lighter.² Very heavy bleeding, bleeding between periods or after sex, and any bleeding after your periods have stopped for 12 months need a doctor.^13,14,5

Hot flushes, night sweats and sleep

Hot flushes are when your face, neck and chest suddenly feel very hot or cold, and night sweats are listed with them.² A hot flush often comes with flushed skin, sweating and palpitations.⁴ Trouble getting to sleep or staying asleep is on both lists.³

Mood and mind

Mood swings, low mood or depression, anxiety, irritability and low self-esteem are all listed. So are problems with memory or concentration, often called brain fog.^2,3

Body

The NHS lists headaches and migraines that are worse than usual, muscle aches and joint pains, a faster, slower or more noticeable heartbeat (palpitations), hair thinning or hair loss, and skin changes, including dry and itchy skin.² It also lists sensitive teeth, painful gums and other mouth problems. Weight gain is common, and the HSE also lists loss of muscle.³

Intimate and bladder

Vaginal dryness, burning, irritation or itching, discomfort during sex and a lower sex drive are listed.^2,3 So are needing to pee more, not being able to control when you pee, and more urine infections or symptoms that feel like one.

Bones

The NHS lists weakening bones (loss of bone density), which can lead to osteoporosis.² Osteoporosis isn't usually painful until a bone breaks, and women lose bone quickly in the first few years after menopause.¹²

The 5 that are partly listed

Fatigue

Tiredness isn't on the menopause symptom lists, but poor sleep is.² The NHS names hormone changes during the menopause among the causes of tiredness, alongside others such as iron deficiency anaemia, and advises seeing a GP if you've felt tired for a few weeks and don't know why.⁷

Dizziness

Dizziness isn't on the lists as a symptom of its own, but the NHS says a hot flush can make you feel dizzy.² Other common causes include an ear infection, migraine, dehydration or heat exhaustion, and stress or anxiety. See a GP if it won't go away or keeps coming back.¹⁵

Panic attacks

Anxiety is on the HSE and WHO lists; panic attacks as such are not.^3,4 The HSE says to talk to your GP if you're finding your symptoms difficult. For low mood that isn't clinical depression and started around the same time as other menopause symptoms, NICE suggests considering HRT, and CBT (a talking therapy) when it comes with hot flushes.¹

Burning tongue

The NHS lists sensitive teeth, painful gums and other mouth problems.² Burning mouth syndrome is mostly seen in women after menopause, though a 2026 review found no single proven cause.¹⁰

Muscle tension

The NHS lists muscle aches and joint pains.²

The 8 that aren't on the lists

Breast pain, bloating, digestive problems, allergies, brittle nails, changes in body odour, electric-shock feelings and tingling hands or feet are not on the NHS or HSE menopause symptom lists.^2,3 That doesn't mean you're imagining them, but it does mean other causes are worth checking.

Breast pain

Breast pain is usually linked to periods, and the NHS lists hormone changes during the menopause among its causes.⁹ Breast pain by itself is unlikely to be a sign of cancer, but ask for an urgent GP appointment if there's a hard lump that doesn't move, a breast changes shape, the skin looks dimpled like orange peel, or there's a rash on or around a nipple or a nipple has sunk in.

Bloating and digestive problems

When bloating, feeling full quickly or losing your appetite, tummy or pelvic pain, or needing to pee more urgently or more often happen persistently or frequently, particularly more than 12 times a month, UK guidance asks GPs to test for ovarian cancer, especially at 50 or over.⁸ So don't put them down to perimenopause without a check.

Tingling and electric-shock feelings

See a GP if pins and needles keep coming back or last a long time.¹¹

Body odour, nails and allergies

Hot flushes often come with sweating.⁴ The NHS lists dry and itchy skin, but not nail changes or allergies.²

Symptoms that need a doctor soon

Bleeding after menopause: any bleeding after your periods have stopped for 12 months, even a little or only once. It's usually not serious, but it can be a sign of cancer.⁵
Bleeding between periods or after sex.¹⁴
Very heavy periods: changing a pad or tampon every 1 to 2 hours, periods lasting more than 7 days, or clots bigger than about 2.5 cm.¹³
Bloating, feeling full quickly or losing your appetite, tummy or pelvic pain, or needing to pee more urgently or more often, if it happens persistently or frequently (particularly more than 12 times a month), especially at 50 or over.⁸
Palpitations with chest pain, breathlessness or fainting: call 112.⁶
A headache that starts suddenly and is extremely painful: call 112.¹⁶
A hard breast lump that doesn't move, a breast that changes shape, dimpled skin, or a rash on or around a nipple or a nipple that has sunk in: ask for an urgent GP appointment.⁹

Changes to your periods or menopause symptoms before 40 need a doctor's assessment, including blood tests, to check for premature ovarian insufficiency.^1,17

If your mood is very low or you're thinking about harming yourself, call Samaritans free on 116 123 in Ireland or the Mental Health Helpline on 1579 in Malta, both day or night.^18,19 In an emergency, call 112.

Want to talk your symptoms through with a doctor?

Mobi Doctor connects you with a licensed EU-registered doctor over video, usually within 15 minutes, daily 7am–11pm CET.

See available times Menopause: what we treat

What helps

HRT is the most effective treatment for hot flushes and night sweats. If HRT isn't right for you, there are non-hormonal medicines and menopause-specific CBT.^20,1 Vaginal oestrogen treats vaginal dryness, irritation, pain during sex and discomfort when peeing, and very little of it reaches the bloodstream.²¹ CBT can also help you manage hot flushes and sleep problems.²²

Read HRT in Ireland for how the free HRT scheme works, or the treatment section of the perimenopause test for the options a doctor can discuss.

What NHS, HSE and NICE say

The symptom lists this page is checked against, and the version we read on 6 November 2026.

Official symptom lists, as read on 6 November 2026
Source	What it lists	Version read
NHS: menopause and perimenopause symptoms	Changes to periods; hot flushes and night sweats; sleep problems; mood changes, anxiety and low self-esteem; brain fog; palpitations; headaches and migraines; muscle aches and joint pains; weight gain; skin and hair changes; mouth problems; vaginal dryness, discomfort during sex and a lower sex drive; urinary symptoms; weakening bones.²	Reviewed 19 May 2026
HSE Ireland: menopause symptoms	Symptoms can start 7 to 10 years before periods stop and most last around 4 years after the last period; the list includes hot flushes, sleep problems, mood changes and anxiety, brain fog, muscle loss, vaginal dryness and lower sex drive; talk to your GP if you find your symptoms difficult.³	Reviewed 28 July 2025
NICE guideline NG23	Describes symptom groups rather than a numbered list: vasomotor symptoms (hot flushes and night sweats), sleep problems, mood changes, joint and muscle pain, urogenital symptoms and altered sexual function; at 45 or over, perimenopause is identified from these symptoms and cycle changes without blood tests.¹	Updated 15 April 2026
WHO	Irregular periods, hot flushes, sleep disturbance, mood changes, and vaginal and urinary symptoms; perimenopause runs from the first signs until a year after the final period.⁴	Fact sheet of 16 October 2024

Check your own symptoms

The free perimenopause test asks about 12 symptoms from the NICE, NHS and WHO lists, rated by how much each one bothers you, and reads what your periods show. It takes about 2 minutes, your answers stay on your device, and you get a one-page summary to take to any doctor. It's our own checklist, not a validated questionnaire, and it doesn't diagnose you.

Questions people ask

Is there an official list of 34 perimenopause symptoms?

No. Lists of 34 symptoms circulate online, but NICE, the NHS, the HSE and WHO each describe a shorter list, and none of them uses the number 34.^1,2,3,4

What are the 34 recognised symptoms of perimenopause?

No health service recognises a list of 34. The list that circulates online is checked above: 21 of its 34 items are on the NHS or HSE symptom lists, 5 are partly listed (such as panic attacks, where anxiety is listed) and 8 are not, such as allergies, brittle nails and body odour.^2,3

What are the first signs of perimenopause?

Usually a change in your periods: they come more or less often, or bleeding gets heavier or lighter.² Hot flushes, night sweats, poor sleep and mood changes often follow, and in some women hot flushes start while periods are still regular.^4,23

What are 7 signs of perimenopause?

There is no official list of 7 either, but the signs the NHS, NICE and WHO describe most often are: changes in your periods, hot flushes, night sweats, sleep problems, low mood or anxiety, brain fog, and vaginal dryness or a lower sex drive.^2,1,4

What age does perimenopause start?

There is no set age. Menopause usually happens between 45 and 55, and the HSE says symptoms can start 7 to 10 years before your periods stop.^24,3 Symptoms before 40 need a doctor's assessment, with blood tests, for premature ovarian insufficiency.¹

What is the difference between premenopause and perimenopause?

Premenopause has no agreed medical meaning: in research it describes the years when periods are still regular, and in everyday use it is often another word for perimenopause.²³ Perimenopause is the transition itself, from the first changes until a year after the final period; menopause is confirmed after 12 months without a period.⁴

Can perimenopause cause itchy skin?

Yes. The NHS lists skin changes, including dry and itchy skin, among the symptoms of menopause and perimenopause.² Itching in and around the vagina is listed separately.

Can perimenopause cause dizziness?

It can be part of a hot flush: the NHS says a hot flush can make you feel dizzy, though dizziness isn't on the NHS or HSE lists as a symptom of its own.^2,3 Other common causes include an ear infection, migraine, dehydration and anxiety, and the NHS advises seeing a GP if it won't go away or keeps coming back.¹⁵

Can perimenopause cause breast pain?

It can. Breast pain is usually linked to periods, and the NHS lists hormone changes during the menopause among its causes.⁹ On its own it's unlikely to be a sign of cancer, but ask for an urgent GP appointment if there's a hard lump that doesn't move, a breast changes shape, the skin looks dimpled like orange peel, or there's a rash on or around a nipple or a nipple has sunk in.

Can perimenopause cause anxiety or panic attacks?

Anxiety is on the HSE and WHO lists of menopause symptoms; panic attacks as such are not.^3,4 The HSE says to talk to your GP if you're finding your symptoms difficult. If your mood is very low or you're thinking about harming yourself, call Samaritans free on 116 123 in Ireland or the Mental Health Helpline on 1579 in Malta, both day or night.^18,19 In an emergency, call 112.

Can perimenopause cause heart palpitations?

Yes. A faster, slower or more noticeable heartbeat is on the NHS and HSE lists.^2,3 Call 112 if palpitations come with chest pain, breathlessness or fainting, and see a GP if they keep coming back, happen more often or last longer.⁶

How long do perimenopause symptoms last?

The NHS says symptoms usually last 7 to 9 years, sometimes longer, and can change over that time.² The HSE says they can start 7 to 10 years before your periods stop, and that most last around 4 years from your last period, though around 1 in 10 people have symptoms for up to 12 years.³

Want to talk your symptoms through with a doctor?

Mobi Doctor connects you with a licensed EU-registered doctor over video, usually within 15 minutes, daily 7am–11pm CET.

See available times Take the free test

About this page

Medical review pending

Written by the Mobi Doctor medical content team. Every medical statement on this page is traced to a source listed under Sources, mostly guidelines and health-service pages, and was checked against it before publication.

The list of 34 is the one that circulates online. We checked each item against the NHS and HSE symptom pages on 3 October 2026 and read them again on 6 November 2026.

Found something out of date? Use the contact page and we will check it against the source. Contact us

Sources

Menopause: identification and management (NG23) — NICE (updated 15 Apr 2026)
Menopause and perimenopause: symptoms — NHS (reviewed 19 May 2026)
Menopause symptoms — HSE (reviewed 28 Jul 2025)
Menopause (fact sheet) — WHO (16 Oct 2024)
Postmenopausal bleeding — NHS (reviewed 24 Sep 2026)
Heart palpitations — NHS (reviewed 17 Mar 2026)
Tiredness and fatigue — NHS (reviewed 2 Jun 2023)
Suspected cancer: recognition and referral (NG12) — NICE (updated 15 Apr 2026)
Breast pain — NHS (reviewed 3 May 2023)
Exploring the association between menopause and burning mouth syndrome: an updated review — Qaderi et al., BMC Oral Health (2026)
Pins and needles — NHS (reviewed 4 Jan 2024)
Osteoporosis — NHS (reviewed 13 Oct 2022)
Heavy periods — NHS (reviewed 19 Sep 2024)
What causes bleeding between periods? — NHS (reviewed 13 Aug 2024)
Dizziness — NHS (reviewed 21 Apr 2023)
Headaches — NHS (reviewed 17 Apr 2024)
Evidence-based guideline: premature ovarian insufficiency (Hum Reprod Open 2024;hoae065) — ESHRE, ASRM, CRE, IMS (9 Dec 2024)
Contact a Samaritan (Ireland) — Samaritans
National Suicide Prevention Strategy for Malta 2025–2030 — Ministry for Health, Malta (Mar 2025)
Updated menopause guidance includes discussion aid to support conversations about HRT — NICE (Nov 2024)
Types of hormone replacement therapy (HRT) — NHS (reviewed 9 Mar 2023)
Menopause treatment — HSE (reviewed 28 Jul 2025)
Duration of menopausal vasomotor symptoms over the menopause transition (JAMA Intern Med 2015;175(4):531–539) — Avis NE et al. (SWAN) (2015)
Early or premature menopause — NHS (reviewed 11 Mar 2025)

This page gives general information based on published guidance. It does not diagnose you and does not replace advice from a doctor who knows your situation.

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