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Perimenopause

Why Do I Have Horrible Perimenopause Symptoms? (Plus, 30+ Ways to Find Relief)

Zoe Kaplan
Zoe Kaplan

Dealing with horrible perimenopause symptoms? You’re not alone. Here’s why—and how to get relief.

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Dealing with horrible perimenopause symptoms? You’re not alone. Here’s why—and how to get relief.

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Dealing with horrible perimenopause symptoms? You’re not alone. Here’s why—and how to get relief.

Perimenopause is a phase of life that can sneak up on you, bringing with it a host of conflicting emotions and unwelcome, sometimes even unbearable, perimenopause symptoms.

If you’re experiencing this transitional period before the end of your period—and not feeling your best—you’re not alone.

The journey through perimenopause can be a rollercoaster ride of physical, emotional, and psychological changes. Hot flashes, mood swings, sleep disturbances, and irregular periods are just a few of the symptoms that can make you feel like you're navigating uncharted territory.

Understanding what’s happening in your body—and why— is the first step toward finding relief. In this guide, we’ll explore why you might be experiencing horrible perimenopause symptoms and how to find relief.

Perimenopause symptoms

Perimenopause is often marked by a diverse array of symptoms that can range from mildly inconvenient to seriously disruptive. While every woman's experience is unique, here are some of the most common and, at times, horrible perimenopause symptoms:

  • Hot flashes and night sweats: also known as vasomotor symptoms, these are sudden waves of intense heat, often accompanied by sweating
  • Irregular periods: more sporadic menstrual cycles, with periods becoming heavier, lighter, more frequent or more infrequent
  • Mood swings: quick mood changes, irritability, anxiety, and even depression
  • Sleep disturbances: difficulty staying or falling asleep
  • Vaginal dryness and discomfort: dryness, itching, and discomfort during intercourse
  • Decreased libido: decrease in sexual desire and satisfaction
  • Weight gain: especially around the abdomen
  • Memory and concentration issues: often referred to as “brain fog,” affecting cognitive function
  • Breast tenderness: more sensitivity in your breasts
  • Hair changes: changes in hair texture, including thinning, or increased facial hair
  • Bone health: bone fragility and being more prone to incidents
  • Digestive problems: bloating and indigestion
  • Joint pain: stiffness in your joints
  • Headaches: increased head pain, including migraines
  • Skin changes: drier skin or more prone to acne

These are just a few of the challenging symptoms that women may encounter during perimenopause. It's essential to remember that the severity and combination of symptoms can vary widely from person to person.

When is perimenopause at its worst?

Unfortunately, there’s no one day, month, or year to expect the worst of horrible perimenopause symptoms. This is because perimenopause varies so greatly from one person to another. Some women might experience a year of perimenopause, while others experience closer to a decade. In general, the average length of perimenopause is three to four years, with symptoms getting worse closer to menopause.

Why are my perimenopause symptoms so bad?

If you’re experiencing any of these horrible perimenopause symptoms, you might be wondering: why me? Why such extremes? Severe perimenopause symptoms can be due to a range of factors, including drastic hormonal changes, lifestyle factors, genetic factors, and preexisting health conditions.

Hormonal changes

Hormone fluctuations, especially when drastic, can be to blame. One of the most significant hormonal changes during perimenopause is the decline in estrogen levels. This decline can be erratic, causing irregularities in the menstrual cycle and triggering various symptoms.

Progesterone levels also fluctuate during perimenopause, affecting the menstrual cycle and contributing to symptoms like mood swings and sleep disturbances.

Hormonal changes during perimenopause don't occur in a linear or predictable fashion. Instead, they often fluctuate unpredictably, leading to inconsistent symptoms. The more dramatic or erratic the changes are, the most intense your symptoms might be.

Lifestyle factors

Lifestyle factors can also exacerbate perimenopause symptoms. High levels of stress, for example, can make symptoms go from bad to worse. Poor dietary choices and weight gain can intensify symptoms like hot flashes and joint pain.

Genetic factors

Unfortunately, some women may have a genetic predisposition to horrible perimenopause symptoms. Women with a family history of severe perimenopausal symptoms, such as intense hot flashes, mood swings, or early perimenopause onset, may be genetically predisposed to experience similar challenges.

Genetic traits related to hormone regulation and sensitivity to hormonal changes can also be inherited. Some individuals may have hormone receptors that are more or less sensitive to estrogen and progesterone, influencing the severity of symptoms.

Further, research has shown that women from different ethnic and racial backgrounds may have varying experiences of perimenopause. Specifically, the Study of Women’s Health Across the Nation (SWAN) found that women of color enter perimenopause earlier than their white peers, have longer transition periods to menopause, and can experience more intense symptoms.

Preexisting health conditions

Certain preexisting health conditions can interact with perimenopause and potentially exacerbate the severity of symptoms, including:

  • Thyroid disorders: conditions like hypothyroidism (underactive thyroid) or hyperthyroidism (overactive thyroid) can affect hormonal balance and amplify symptoms like hot flashes, fatigue, and mood disturbances.
  • Polycystic ovary syndrome (PCOS): Women with PCOS often have hormonal imbalances, including elevated androgen levels. Perimenopause can further disrupt these hormonal patterns, potentially intensifying symptoms like irregular periods, weight gain, and mood swings.
  • Diabetes: Uncontrolled diabetes can affect blood sugar levels, potentially worsening symptoms such as hot flashes, mood swings, and fatigue.
  • Autoimmune disorders: Conditions like rheumatoid arthritis or lupus can interact with hormonal changes during perimenopause, leading to increased joint pain and inflammation.
  • Depression and anxiety: Individuals with a history of depression or anxiety may be more susceptible to mood swings and emotional symptoms during perimenopause.

If you have any of these preexisting health conditions, it’s essential to work closely with a healthcare provider to manage both underlying conditions and perimenopausal symptoms effectively. In some cases, adjustments to medications or treatment plans may be necessary to address the unique challenges posed by perimenopause in the context of these health conditions.

How to get relief

Understanding the underlying causes of these symptoms is the first step in finding relief. Here are strategies and treatments to help manage and alleviate horrible perimenopause symptoms.

Hot flashes and night sweats

Stay cool by dressing in layers to easily remove clothing when you feel a hot flash coming on. Use fans and open windows to cool down quickly when you do experience one.

Caffeine, alcohol, spicy foods, and hot beverages can all trigger hot flashes and night sweats. Limiting your consumption of these foods can decrease the frequency of these symptoms.

Irregular periods

Track your menstrual cycle to monitor your periods and understand your hormone levels. Oova is an easy and efficient way to do this in the comfort of your own home.

When using Oova, you provide a urine sample on the test strip (either midstream or by dipping it into a cup), and scan the strip with your phone. Oova’s algorithm will analyze your strip to calculate how much luteinizing hormone, E3G (a urinary metabolite of estrogen), and PdG (a urinary metabolite of progesterone) is present and tell you what part of your cycle you’re in. As you continue scanning, Oova will learn your specific cycle and hormone trends—even if you’re experiencing irregular periods.

>>MORE: The Power of Cycle Tracking: Understanding Your Hormones and Taking Action

If you’d like to regulate your period, you can discuss hormonal birth control options and other medications with a healthcare professional. These medications can help control your hormonal balances and get your cycle on track.

Mood swings

Lifestyle changes like physical activity and mindfulness and meditation can help stabilize your mood and reduce stress.

If you’re experiencing difficult emotions, talking to a therapist or counselor can provide emotional support. In some cases, hormone therapy or antidepressants may help.

Sleep disturbances

Establishing good sleep hygiene can help combat sleep disturbances like trouble falling asleep or staying asleep. Make sure you have a regular sleep schedule, sleep in a comfortable environment, and avoid screens before bedtime. Deep breathing exercises and progressive muscle relaxation can also help calm your body down and prepare for a good night’s sleep.

Vaginal dryness and discomfort

Over-the-counter vaginal lubricants and moisturizers can ease discomfort during intercourse and long-term relief for dryness, respectively. Some estrogen-based creams or tablets must be prescribed. Talk to your doctor about what treatment might be right for you.

Decreased libido

Decreased libido can not only be a challenging symptom for you, but also for your partner. Discuss your concerns with your partner to facilitate open communication and seek emotional support. You might find focusing on intimacy and gentle sensual touch can help you find pleasure without pressure.

Talking to a professional, like a sex therapist, can also help you and your partner address sexual concerns and improve libido.

Weight gain

If you’re experiencing uncomfortable weight gain that exacerbates other horrible perimenopause symptoms, there are a few ways to manage your weight:

  • Eat a balanced diet rich in fruits, vegetables, lean protein, and whole grains.
  • Engage in regular physical activity, including strength training to boost metabolism and muscle mass.
  • Get quality sleep.

Certain conditions like PCOS can make it more difficult to manage and lose weight. Consult with a healthcare professional if lifestyle factors aren’t helping you alleviate this symptom.

Memory and concentration issues

Lifestyle factors, like a balanced diet, regular exercise, and adequate sleep can help improve cognition function. To practice and engage your mental function in the short-term, engage in puzzles, reading, and other activities that challenge your mind.

Breast tenderness

Wearing well-fitting, supportive bras—or no bra at all—can help minimize discomfort. Reducing caffeine and salt intake can help prevent further breast tenderness.

Hair changes

If you’re experiencing changes to hair texture, use mild shampoos and avoid excessive heat styling.

If you’re experiencing severe hair loss, consult a dermatologist for treatment options.

Bone health concerns

To strengthen your bones, ensure you’re getting the right amount of calcium and vitamin D, whether through your diet or supplements. You can also engage in weight-bearing activities like walking or weightlifting, starting from a light and gentle routine until you build up more strength.

Digestive problems

First, identify foods that might be triggering digestive issues of bloating and indigestion. Keep a list of what you’re eating and when you’re experiencing symptoms to understand what foods might be the problem. Limiting or avoiding these foods all together may reduce symptoms.

Adding probiotics to your diet can also help promote gut health and prevent future problems.

Joint pain

To alleviate symptoms of joint pain, consult with a doctor to see if there are medications that might be right for you. For long-term pain relief, engaging in low-impact exercise like swimming and yoga can help reduce join stress.

Headaches

Like treatment for joint pain, medication can help temporary relieve or address headache symptoms. To help prevent future headaches, stay hydrated and practice stress reduction techniques.

Skin changes

If you’re experiencing dry skin, a moisturizer suitable for your skin type can help. If you’re more prone to acne, keeping your face clean—with a regular cleansing routine and avoiding touching your face—can help.

>>RELATED: Learn how to cycle-sync your skin care routine.

Remember that these relief strategies can vary in effectiveness from person to person. Consult with a healthcare provider for personalized advice and treatment options tailored to your specific symptoms and needs.

Horrible perimenopause symptoms: the bottom line

Horrible perimenopause symptoms are, well, horrible to deal with. Whether you have them because of drastic hormone fluctuations, lifestyle factors, or genetics, there are tons of ways to manage and alleviate symptoms as they come on. You’re not alone—understanding your symptoms is a great first step, and searching for help (like you did with this article!) is an amazing second one.

About the author

Zoe Kaplan
Zoe Kaplan is a writer and content strategist passionate about creating content that helps people navigate the world a little more easily. Zoe has worked across verticals, from women's career development to reproductive health. You can check out more of her work at zoeakaplan.com.

Sources

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https://www.oova.life/blog/progesterone-supplementation-guide
Can I take progesterone if I'm breastfeeding?
Yes, progesterone is generally safe while breastfeeding and doesn't significantly affect milk supply. However, always discuss with your healthcare provider before starting any hormone supplementation while nursing.
https://www.oova.life/blog/progesterone-supplementation-guide
Is it safe to take progesterone throughout pregnancy?
Yes, when prescribed by your healthcare provider. Progesterone supplementation in early pregnancy is safe and can reduce miscarriage risk in women with low progesterone or a history of pregnancy loss. Most providers continue supplementation through the first trimester (weeks 10-12) when the placenta takes over.
https://www.oova.life/blog/progesterone-supplementation-guide
Can progesterone supplementation cause weight gain?
Progesterone can cause temporary water retention and bloating, which may show up as a few pounds on the scale, but it doesn't cause true fat weight gain. Most women don't experience significant weight changes from progesterone supplementation.
https://www.oova.life/blog/progesterone-supplementation-guide
Can I switch from pills to suppositories or vice versa?
Yes, but only under your doctor's guidance. The dosing and timing may need adjustment when switching between forms since they're absorbed differently. Never switch on your own, especially if you're pregnant or undergoing fertility treatment.
https://www.oova.life/blog/progesterone-supplementation-guide
Will progesterone supplementation delay my period?
Yes, progesterone keeps the uterine lining intact, so if you're not pregnant and continue taking progesterone, your period will be delayed. Once you stop taking it, your period should start within 2-10 days. If you are pregnant, progesterone helps maintain the pregnancy and you won't get a period.
https://www.oova.life/blog/progesterone-supplementation-guide
Should I take progesterone pills orally or vaginally?
For fertility and pregnancy support, vaginal progesterone is usually preferred because it delivers higher concentrations directly to the uterus. For perimenopause or general hormone balance, oral progesterone often works well and is more convenient. Your doctor will recommend the best route based on your specific needs.
https://www.oova.life/blog/progesterone-supplementation-guide
When should I start taking progesterone after ovulation?
Typically, progesterone supplementation for luteal phase support starts 2-3 days after ovulation (confirmed by LH surge or temperature rise). Your doctor will give you specific timing based on your protocol. Some women start immediately after a positive ovulation test.
https://www.oova.life/blog/progesterone-supplementation-guide
What's better: progesterone cream or pills?
Pills (oral micronized progesterone) are generally more effective and reliable than creams because absorption from creams is inconsistent. For medical conditions like fertility issues, low progesterone, or HRT, prescription pills or suppositories are strongly recommended over over-the-counter creams.
https://www.oova.life/blog/low-vs-high-progesterone-symptoms
How can I tell if I have low or high progesterone?
The only definitive way to know is through hormone testing via blood tests or at-home urine tests that measure progesterone metabolites. However, symptom patterns can provide clues: anxiety and irregular periods suggest low progesterone, while bloating and extreme fatigue suggest high progesterone.
https://www.oova.life/blog/low-vs-high-progesterone-symptoms
When during my cycle should I test progesterone levels?
Test progesterone levels during the luteal phase, typically 7 days after ovulation or around day 21 of a 28-day cycle. This is when progesterone should be at its peak, making it easier to identify if levels are too low or too high.
https://www.oova.life/blog/low-vs-high-progesterone-symptoms
What are the main differences between low and high progesterone symptoms?
Low progesterone typically causes irregular or heavy periods, anxiety, hot flashes, and sleep issues. High progesterone causes bloating, fatigue, intense breast tenderness, and depression-like mood changes. Low progesterone symptoms persist throughout your cycle, while high progesterone symptoms are most intense during the luteal phase.
https://www.oova.life/blog/low-vs-high-progesterone-symptoms
Can you have symptoms of both low and high progesterone?
Some symptoms like breast tenderness and mood changes can occur with both low and high progesterone, making it confusing. However, the timing, intensity, and accompanying symptoms differ. Hormone testing is the best way to determine which imbalance you're experiencing.
https://www.oova.life/blog/10-dpo
Can stress affect 10 DPO symptoms?
Yes, stress can worsen or mimic 10 DPO symptoms. Stress increases cortisol, which can cause cramping, fatigue, and mood changes similar to both PMS and early pregnancy. During the two-week wait, try stress-reduction techniques like gentle exercise, meditation, or spending time with loved ones.
https://www.oova.life/blog/10-dpo
Is it better to test at 10 DPO or wait?
It's better to wait until 12–14 DPO for more accurate results. Testing at 10 DPO often leads to false negatives because hCG levels may still be too low. If you absolutely can't wait, use a sensitive early detection test with first morning urine, and be prepared to retest in 2–3 days if negative.
https://www.oova.life/blog/10-dpo
What does implantation bleeding look like at 10 DPO?
Implantation bleeding at 10 DPO is typically light pink or brown, much lighter than a period, and lasts 1–2 days. It's often just spotting when you wipe or a few drops on a panty liner. However, only 15–20% of pregnant women experience implantation bleeding—most don't have any bleeding at all.
https://www.oova.life/blog/10-dpo
Why am I cramping at 10 DPO?
Cramping at 10 DPO can be caused by elevated progesterone (whether you're pregnant or not), implantation (if you're pregnant), or premenstrual cramping. Unfortunately, cramping alone can't tell you if you're pregnant since progesterone causes similar symptoms in both scenarios.
https://www.oova.life/blog/10-dpo
What are the chances of a BFP at 10 DPO?
If you're pregnant, you have about a 50–60% chance of getting a positive test at 10 DPO. This means there's a 40–50% chance of a false negative even if you conceived. Chances improve significantly by 12–14 DPO.
https://www.oova.life/blog/10-dpo
What DPO is most accurate for pregnancy testing?
14 DPO (the day of your missed period) is the most accurate time to test, with 99% accuracy. 12 DPO offers 80–90% accuracy. 10 DPO has only 50–60% accuracy. For best results, wait as long as you can—ideally until 12–14 DPO.
https://www.oova.life/blog/10-dpo
Is 10 DPO too early to test?
10 DPO is considered early for pregnancy testing. While some women get positives at 10 DPO, accuracy is only 50–60% if you're pregnant. For best results, wait until 12 DPO (80–90% accuracy) or 14 DPO/missed period (99% accuracy).
https://www.oova.life/blog/10-dpo
Can you have implantation at 10 DPO?
Yes, implantation can still occur at 10 DPO, though 84% of women have already implanted by this point. Late implantation at 10–12 DPO is normal. If implantation happens at 10 DPO, you won't get a positive pregnancy test for another 2–3 days.
https://www.oova.life/blog/10-dpo
What does a negative test at 10 DPO mean?
A negative test at 10 DPO does not mean you're not pregnant. It's very common to get negatives at 10 DPO even if you conceived. Your hCG levels may still be too low, or implantation may have occurred later. Wait until 12–14 DPO to retest for more accurate results.
https://www.oova.life/blog/10-dpo
Can you get a positive pregnancy test at 10 DPO?
Yes, but only about 50–60% of pregnant women will get a positive at 10 DPO. The other 40–50% have hCG levels that are still too low to detect. If you test negative at 10 DPO, wait 2–3 days and test again.
https://www.oova.life/blog/high-progesterone-symptoms
Can high progesterone cause weight gain?
Yes, elevated progesterone can cause temporary weight gain through water retention and bloating. This is a normal part of the luteal phase and early pregnancy.
https://www.oova.life/blog/how-to-increase-estrogen
Does stress affect estrogen levels?
Yes, chronic stress elevates cortisol, which can suppress estrogen production and disrupt hormonal balance. Stress reduction through meditation, yoga, adequate sleep, and self-care practices helps maintain optimal estrogen levels.
https://www.oova.life/blog/how-to-increase-estrogen
When should I consider medical treatment for low estrogen?
Consider medical intervention if natural methods don't improve symptoms after 3 months, if symptoms severely impact quality of life, if you're experiencing early menopause (before 40), or if you have fertility concerns. Hormone replacement therapy may be appropriate in these cases.
https://www.oova.life/blog/how-to-increase-estrogen
What are the signs that my estrogen is increasing?
Signs of rising estrogen include more regular menstrual cycles, reduced hot flashes, improved vaginal lubrication, better mood stability, increased energy, and improved skin elasticity. You may also notice reduced symptoms that originally indicated low estrogen.
https://www.oova.life/blog/how-to-increase-estrogen
Can exercise increase estrogen levels?
Yes, moderate exercise stimulates estrogen release and helps maintain hormonal balance. Aim for 150 minutes of moderate cardio weekly plus strength training twice per week. However, excessive exercise can actually lower estrogen, so balance is key.
https://www.oova.life/blog/how-to-increase-estrogen
How long does it take to increase estrogen naturally?
With consistent dietary and lifestyle changes, you may notice improvements in symptoms within 4-8 weeks. However, significant hormonal changes typically take 2-3 months. Tracking your cycle and symptoms can help you monitor progress.
https://www.oova.life/blog/how-to-increase-estrogen
What foods increase estrogen levels naturally?
Foods high in phytoestrogens can help increase estrogen naturally. The best options include flax seeds (high in lignans), soy products (tofu, tempeh, edamame), lentils, chickpeas, whole grains (oats, quinoa, brown rice), and garlic. These plant compounds mimic estrogen's effects in the body.
https://www.oova.life/blog/perimenopause
What helps relieve hot flashes quickly?
Cool environments, layered clothing, herbal teas, and medical treatments like gabapentin or HRT may help—depending on severity. Lifestyle changes like reducing caffeine and alcohol can also provide relief.
https://www.oova.life/blog/perimenopause
Are there tests to confirm perimenopause?
Yes. Tests measuring estradiol, LH, and FSH levels can indicate hormonal shifts—but diagnosis is often symptom-based since hormone levels fluctuate widely during perimenopause.
https://www.oova.life/blog/perimenopause
How do I know it's perimenopause and not something else?
A doctor may recommend hormone testing (like LH, E3G, and PdG) and track symptom timing. Diagnosis is often based on symptoms combined with age and menstrual pattern changes.
https://www.oova.life/blog/perimenopause
What's the earliest age perimenopause can start?
Some women begin experiencing symptoms as early as their mid-30s, though perimenopause typically starts between ages 38-45.
https://www.oova.life/blog/perimenopause
Does perimenopause affect mental clarity?
Yes. Brain fog and difficulty concentrating are common during hormone fluctuations in perimenopause.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
What happens after the last sign of perimenopause?
After your final period, you enter postmenopause. You'll need 12 consecutive months without a period to confirm menopause. Many symptoms gradually improve, though some like vaginal dryness may persist without treatment.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
When do perimenopause symptoms finally stop?
Some symptoms like brain fog improve after menopause, while others like hot flashes may continue for up to 10 years post-menopause. Vaginal symptoms often persist or worsen without treatment. Each person's timeline is different.
https://www.oova.life/blog/high-progesterone-symptoms
Is high progesterone a sign of pregnancy?
Yes, high progesterone is one of the earliest indicators of pregnancy. Progesterone levels rise significantly after conception to support the developing embryo and reach their peak during the third trimester.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
Can you still get pregnant in late perimenopause?
Yes, you can still get pregnant during perimenopause as long as you're having periods, even if they're infrequent. Continue using birth control until you've gone 12 consecutive months without a period and have officially reached menopause.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
Do symptoms get worse before perimenopause ends?
Yes, most perimenopause symptoms intensify in the final 1-2 years before menopause. Hot flashes peak around your final period, vaginal symptoms worsen, and mood changes increase. However, brain fog typically improves in late perimenopause.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
How long does late perimenopause last?
Late perimenopause typically lasts 1-3 years before your final period. However, the exact duration varies significantly from person to person. You've reached menopause after 12 consecutive months without a period.
https://www.oova.life/blog/high-progesterone-symptoms
What are the symptoms of high progesterone?
High progesterone symptoms include fatigue, bloating, breast tenderness, weight gain, anxiety, depression, headaches, and food cravings. During pregnancy, you may also experience increased nipple sensitivity and muscle aches.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
What are the first signs that perimenopause is ending?
The earliest signs include longer gaps between periods (60+ days), intensifying hot flashes that peak around your final period, and worsening vaginal dryness. These symptoms typically increase in late perimenopause before you reach official menopause.
https://www.oova.life/blog/high-progesterone-symptoms
When should I be concerned about high progesterone?
Consult a healthcare provider if you experience high progesterone symptoms outside your luteal phase when not pregnant, or if symptoms include severe pelvic pain, abnormal vaginal bleeding, or rapid weight gain while on hormone therapy.
https://www.oova.life/blog/high-progesterone-symptoms
How do you test progesterone levels?
Progesterone can be measured through blood tests at your doctor's office or at-home urine tests that measure PdG (a progesterone metabolite). Testing is typically done during the luteal phase, about 7 days after ovulation.

About the Oova Blog:
‍Our content is developed with a commitment to high editorial standards and reliability. We prioritize referencing reputable sources and sharing where our insights come from. The Oova Blog is intended for informational purposes only and is never a substitute for professional medical advice. Always consult a healthcare provider before making any health decisions.

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