We need to talk openly about a waning libido. Menopause often brings a drop in desire due to lower estrogen and progesterone levels. When you can’t even recall the last time you felt sexual spark, it’s natural to feel emotionally stressed.

The first sign of perimenopause is often a change in your menstrual cycle. While it’s different for every woman, you know something’s changed. You may notice heavier or lighter bleeding, and the reliable rhythm you once depended on is disrupted. As perimenopause advances, you might even skip your period entirely—and if the bleeding stops for several months then returns, the clock to menopause resets.

Ordinarily, you manage whatever life throws at you, but these days, even minor issues trigger lingering anxiety. You might feel irritable, jittery, or panicky. The phrase “instinctive reaction” gains a new, profound meaning as you experience more frequent bouts of exhaustion and tension.

You’re scatterbrained, confused, and prone to forgetting even simple things. Concentrating becomes a challenge, especially at work, and you quickly lose track of what you’re doing. Even basic words can escape you. You may question, "What’s wrong with me?" or miss your former self. Remember, you’re not alone—many women in menopause feel exactly the same.

Symptoms of a urinary infection can involve a burning feeling when you pee, more frequent trips to the bathroom, altered odor or color of your urine, cramps, fever, and/or nausea. As you approach menopause, lower estrogen levels upset your vaginal bacteria and thin the tissues, increasing your risk of UTIs. Be sure to see your doctor if you think you have an infection.

A hot flash is an abrupt, intense wave of heat—most commonly in your chest, neck, or face—that can last from 30 seconds to several minutes. It might cause your face to flush, your heart to pound, and trigger a lot of sweating. When these episodes happen during sleep, they’re known as night sweats, often leaving both you and your sheets wet. Such erratic temperature shifts are known as vasomotor symptoms (VMS).

During the menopause transition, many women notice weight gain, particularly in the belly and thighs. This isn’t solely about added weight—it also alters your silhouette, especially around the waist (think more apple, less hourglass). In your forties, factors like aging, genetics, and lifestyle contribute alongside hormonal changes.

Falling asleep, staying asleep, and returning to sleep can all be challenging during perimenopause. Over half of women in this stage suffer from sleep disturbances. Such disrupted sleep, usually due to unstable body temperatures, can lead to mood changes—and those mood shifts can, in turn, create more sleep issues.

When estrogen drops, your vaginal wall loses thickness, moisture, and elasticity, causing pain during or after sex. Over a quarter of menopausal women experience dyspareunia—a condition that brings physical and emotional pain and may impact your relationship. If you’re dealing with this issue, speak with a menopause expert about your treatment options.

Your heart can beat, flutter, or skip a beat. Hormonal fluctuations can skyrocket your heart rate by up to 16 additional beats per minute. To make matters even more uncomfortable, palpitations often accompany hot flashes. While it is important to link heart palpitations to the transition into menopause, they may be indicative of other long-term health risks and should be reported to your physician.

Many women going through menopause report discomfort, warmth, and swelling in the neck, back, knees, ankles, fingers, elbows, or jaw. Roughly half of perimenopausal women suffer from joint pain, and you may wake up feeling unusually stiff due to a drop in estrogen, which normally helps keep inflammation at bay.

Your patience wears thin, and you snap at the smallest detail. Irritability is the most common symptom for perimenopausal women, often driven by hormonal ups and downs. Don't be hard on yourself—you’re not alone.