I’ve just turned 40 but could my symptoms be signs of perimenopause?
Navigating your 40s can bring about many exciting changes, but it can also leave you wondering why your body isn’t behaving quite like it used to. If you’ve been experiencing new symptoms lately you might be wondering, "Could this be perimenopause?"
Understanding these changes, and what you can do to alleviate them, can help you navigate this transition with greater ease.
Signs and Symptoms of Early Perimenopause
The average age of menopause in the UK is 51 years old1 and perimenopause is the transition phase leading up to it. During this time, your ovaries begin producing fewer sex hormones – your oestrogen levels change unpredictably, and your progesterone and testosterone levels steadily decline, which can lead to a range of mental, physical and emotional changes.
Some of the more commonly known perimenopausal symptoms include irregular periods, hot flushes and night sweats, mood swings and sleep disturbances. But did you know there are lesser-known symptoms that women may experience as their hormone levels begin to fluctuate, that are not commonly associated with the perimenopause. Here five that might surprise you:
5 Lesser-Known Symptoms of Perimenopause
• Tinnitus: Ringing or buzzing in the ears is a symptom many don't associate with perimenopause. It is thought that declining oestrogen levels causes alterations in blood flow to the inner ear tube (the cochlear) which affects the regulation of electrochemical impulses and in turn alters auditory signals.
Reducing stress levels and getting enough sleep can often improve tinnitus, as can the right dose and type of hormone replacement therapy (HRT). In some cases, tinnitus may be relieved with the use of sound therapy or cognitive behavioural therapy. More information is available from the British Tinnitus Association.
• Dry Eyes: Reduced oestrogen levels can affect tear film production leading to dry, gritty eyes, blurry vision, or even very watery eyes2. You might notice discomfort while reading or using screens, or in cold or windy weather.
Using a warm compress or eye mask applied to closed eyelids can help to loosen oil from blocked glands along the eyelid that supply oil to your tears, protecting your eyes with wrap-around eye wear, and regular use of preservative-free dry eye drops can all be helpful to ease dry eye symptoms.
• Brittle Nails: Your nails are made of a protein called keratin, which gives them structure and helps keep them hard and strong. Oestrogen helps the body to produce keratin, so when levels are lower, your nails may start to crack, flake and break.
Tips to help with brittle nails during perimenopause include:
• Moisturise often to maintain hydration
• Use rubber gloves if you’re washing up or putting your hands in water regularly
• Avoid smoking as it lowers oestrogen levels further, causes dehydration and can affect your circulation
• Massage vitamin E oil drops directly into your nails and cuticles
• Altered Sex Drive: Altered sex drive is commonly discussed as one of the challenges of perimenopause. Many women experience a decreased sex drive due to fluctuating hormone levels, particularly the decline in oestrogen and testosterone. These changes can lead to vaginal dryness, discomfort during sex, and reduced libido. Stress, mood swings, and poor sleep—common during perimenopause—can also negatively impact desire. To address this, women should focus on maintaining hormonal balance through a nutritious diet rich in omega-3s, managing stress with relaxation techniques, and staying active.
• Heart Palpitations: Heart palpitations can result from fluctuating oestrogen levels4 and feel like your heart is beating harder or with an irregular rhythm. They can last from a few seconds to a couple of minutes and may occur on their own or alongside hot flushes or dizziness. While palpitations can be alarming, especially if they’re your first noticeable perimenopausal symptom, they are often not linked to serious heart issues.
To reduce palpitations, aim to lower stress, maintain healthy sleep habits, and stay well-hydrated. Avoid alcohol, caffeine, and sugary or high-carb foods, which can trigger palpitations by spiking blood sugar levels. Lastly, maintaining a healthy weight, quitting smoking, and engaging in regular exercise will help support overall heart health.
See your doctor if your palpitations start to happen more often, last for more than a few minutes or get worse over time and get emergency medical help straight away if you have shortness of breath, chest pain, dizziness or fainting along with palpitations.
Nutrition to Support Perimenopausal Symptoms
While these perimenopausal symptoms can be challenging, nutrition plays a key role in managing them. Incorporating specific hormone-balancing foods into your diet can support your body during perimenopause:
• Leafy Greens: Spinach, kale, and Swiss chard are rich in magnesium and calcium, which help regulate mood, improve sleep, and support bone health.
• Berries: Blueberries, strawberries, and raspberries are packed with antioxidants, which help reduce oxidative stress and inflammation.
• Seeds: Incorporate seeds like flaxseeds and pumpkin seeds for their phytoestrogens and essential fatty acids, which can help balance hormones naturally.
• Nuts: Almonds and walnuts are high in healthy fats and magnesium, which can support hormone production.
• Fatty Fish: Salmon, mackerel, and sardines are rich in omega-3 fatty acids that support brain health and can reduce the severity of symptoms like hot flushes and mood swings.
Final Thoughts
While the perimenopause transition can bring its challenges, understanding what’s happening in your body and how to support it can make a significant difference. Incorporating hormone-balancing foods, staying hydrated, and focusing on a nutrient-rich diet can help you manage symptoms more effectively and support your overall well-being.
If you're experiencing discomfort or are unsure about your symptoms, consider consulting a Nutritional Therapist for personalised guidance and support.
Amber Cotton Nutrition BSc., Dip.ION, mBANT, mCNHC
Registered Nutritional Therapist
W: www.ambercotton.co.uk
E: amber@ambercotton.co.uk
Bibliography
1. NHS Inform. (2024). Menopause. NHS Inform
2. Peck T, Olsakovsky L, Aggarwal S. Dry Eye Syndrome in Menopause and Perimenopausal Age Group. J Midlife Health. 2017 Apr-Jun;8(2):51-54
3. El Khoudary SR, Greendale G, Crawford SL, Avis NE, Brooks MM, Thurston RC, Karvonen-Gutierrez C, Waetjen LE, Matthews K. The menopause transition and women's health at midlife: a progress report from the Study of Women's Health Across the Nation (SWAN). Menopause. 2019 Oct;26(10):1213-1227
4. Carpenter, J.S., Sheng, Y., Elomba, C.D. et al. A Systematic Review of Palpitations Prevalence by Menopausal Status. Curr Obstet Gynecol Rep 10, 7–13 (2021)
5. Costa S, Saguner AM, Gasperetti A, Akdis D, Brunckhorst C, Duru F. The Link Between Sex Hormones and Susceptibility to Cardiac Arrhythmias: From Molecular Basis to Clinical Implications. Front Cardiovasc Med. 2021 Feb 17;8:644279