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When most people think about perimenopause or menopause, the first thing that comes to mind is hot flashes. Maybe night sweats. Possibly mood swings. But the truth is, the hormonal changes we go through at this stage of life can cause a whole range of symptoms that aren’t talked about nearly enough. These lesser-known signs can be confusing—and even a little scary—if you don’t know they’re connected to shifting estrogen and progesterone levels.
And I’ll be honest. My mom and grandma’s generation didn’t talk about these symptoms. So I felt absolutely blindsided by the intensity of the symptoms I did feel! And I’m not alone. I’m hearing more and more women talk about being blindsided as well. That’s why it’s so important to speak out and share our experiences! Because you’re NOT crazy…and you’re NOT alone!
Let’s shine some light on the symptoms that often fly under the radar.
1. Burning mouth syndrome
A strange but real symptom—some women develop a burning, tingling, or metallic taste in their mouth. Changes in estrogen can affect the taste buds and oral tissues, leading to discomfort that’s often mistaken for dental problems.
2. Creeping anxiety & heart palpitations
Even women who’ve never struggled with anxiety may suddenly find themselves feeling restless, panicky, or on edge. Hormonal fluctuations can also trigger heart palpitations, which feel alarming but are often harmless. Can we just talk about how scary this one can be? And the heart palpitations can cause anxiety to become MUCH worse. When I experienced heart palpitations, there were so many times I was terrified that I was going to die!
It is important to see a doctor if you are experiencing regular heart palpitations to rule out heart issues.
3. Formication (The sensation of bugs crawling on the skin)
This unsettling symptom is caused by changes in the nervous system linked to lower estrogen levels. It’s harmless but can be distressing until you know what’s behind it.
4. Joint pain and stiffness
You might think your knees or hands are suddenly aging overnight, but estrogen plays a role in reducing inflammation and maintaining joint health. When levels drop, stiffness and aches can set in. I didn’t have a lot of hot flashes. But the joint pain I experienced was pretty bad!
5. Tinnitus and hearing changes
Ringing in the ears, muffled hearing, or increased sound sensitivity can crop up. While menopause isn’t the only cause of these issues, hormonal shifts can impact the delicate structures in the ear.
6. Skin crawls and itchiness
Not just dryness, estrogen loss can thin the skin, affect oil production, and change how your nerve endings send signals, leading to intense itchiness or prickling sensations.
7. Digestive surprises
Bloating, new food sensitivities, or changes in bowel habits can appear seemingly out of nowhere. That’s because hormones also affect gut motility and the balance of bacteria in the digestive system.
8. Electric shock sensations
Some women describe feeling tiny “zaps” in the head or body. While not fully understood, this may be linked to nerve changes during hormonal fluctuation.
9. The “rage” nobody warned you about
One of the most jarring and least talked about symptoms of perimenopause and menopause is sudden, intense anger. You might find yourself snapping over small things or feeling an almost volcanic wave of irritation that seems to come out of nowhere. Paired with brain fog, mood swings, and unpredictable emotions, it can leave you wondering if you’re “losing it.” In reality, these feelings are often the result of fluctuating estrogen and progesterone, which affect mood regulation and stress response. Knowing the cause doesn’t erase the frustration, but it can help you understand you’re not “crazy”…you’re hormonal.
10. When neurodivergence feels “louder”
For women who are autistic, ADHD, dyslexic, or otherwise neurodivergent, perimenopause and menopause can dial up existing traits in unexpected ways. Hormonal shifts, especially the drop in estrogen, which plays a role in dopamine and serotonin regulation, can intensify sensory sensitivities, executive dysfunction, emotional dysregulation, and even social burnout. You might notice it’s harder to mask, focus, or manage overwhelm, and coping strategies that once worked may suddenly feel less effective. This isn’t a personal failing; it’s your brain reacting to a major biochemical transition, and it may mean adjusting routines, supports, and self-compassion to meet your changing needs.
For those who are undiagnosed, this can be debilitating. For me, the last 18 months of perimenopause made it incredibly challenging for me to function. To the point that my life pretty much fell apart, and I lost my house.
Final thoughts
Perimenopause and menopause are deeply individual experiences. What’s true for one woman may not be for another. But the more we talk about these lesser-known symptoms, the more we can normalize them and help women get the answers they deserve. If you’re experiencing any of these signs, you’re not alone, and it’s worth discussing them with a healthcare provider who understands midlife hormonal changes.
