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7 unexpected symptoms that could be signs of perimenopause: Experts explain what to look out for

7 unexpected symptoms that could be signs of perimenopause: Experts explain what to look out for

From itchy skin to burning feet, menopause experts reveal 7 surprising symptoms linked to perimenopause, and when to see your GP.

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Amber Middleton

Published: October 22, 2026 at 10:15 AM

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This feature was first published on our Apple News channel. Follow us on Apple News to see content like this first.

As most of us know from secondary school biology, menopause occurs when our ovaries are in decline, have stopped releasing eggs and our hormone levels have depleted.

But in the run-up to menopause, we also have perimenopause, a time when we can experience a large array of bizarre symptoms.

During perimenopause, “there's effectively hormonal chaos,” explains Dr Helen Wall, a menopause specialist. The levels of progesterone and oestrogen are fluctuating unpredictably and, due to the hormone receptors we have all over the body, the symptoms can feel a tad random.

In fact, you may be going through those symptoms and not realise they might be perimenopause.

Symptoms are also vast and varied between women. What we experience personally could be, in part, down to genetics, Dr Alison Elsey, a menopause expert who works with Stripe and Stare on menopause-friendly underwear, explains.

But, she adds, lifestyle factors can also contribute to certain symptoms, as well as whether you have an underlying medical condition.

While there are more than 30 recognised symptoms of perimenopause, some are so unexpected that many women don't realise their hormones could be playing a role. We asked the experts what some of the more unique symptoms are that we should look out for, and how to deal with them.

1. Eczema

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New research of over 700 women in the UK who suffer from eczema and dry skin found that a quarter experienced it for the first time during menopause.

Dr Elsey says that this can come about due to a “lack of oestrogen which causes drier skin and an impaired skin barrier”. The reduced oestrogen levels cause trans-epidermal water loss (TEWL), where water travels through the layers of skin and evaporates. While TEWL happens to all of us, at an excessive rate it can cause skin issues including eczema.

While eczema can appear for the first time in menopause, it tends to be more common in those who have had childhood eczema or have other atopic problems, a group of allergic conditions, such as asthma and hay fever.

To reduce symptoms, Dr Wall says “it's about conditioning the skin, keeping it moisturised, not over washing it and not using products that trigger irritation or dryness”.

2. Tinnitus

Tinnitus, a constant ringing, buzzing or humming sound you may hear in one or both ears, can be a problem in perimenopause too, although it’s not common, Dr Elsey says.

“I had one patient where tinnitus was their most prominent symptom. It’s thought to be related to oestrogen receptors in the inner ear,” she explains.

And if you don’t experience tinnitus itself, heightened hearing sensitivity can also occur, again linked to lower oestrogen, research suggests.

Tinnitus can also be amplified by other perimenopause symptoms, such as problems with sleep or anxiety.

“Anyone with tinnitus should have a hearing assessment, because we shouldn't assume it's menopause,” Dr Wall says.

However, if it is a perimenopause symptom, research shows that HRT can both reduce symptoms and reduce the risk of experiencing it in the first place.

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3. Brain zaps

If you’ve never had a brain zap, count yourself lucky. They feel like mini shock-like jolts that occur in your brain and body. While it is less formally studied than other symptoms, Dr Wall has had patients experience it.

Doctors aren’t aware of why it happens just yet, but there are theories.

“It could relate to changes in the chemical messengers in the brain, particularly serotonin, GABA (gamma-aminobutyric acid) – the nerves become more excitable,” she suggests.

Again, HRT may reduce brain zaps, however it can be useful to look into other symptoms, too. For example, anxiety and stress could, once again, contribute, as could changes to antidepressants. Brain zaps are a common symptom of antidepressant withdrawal.

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4. Itchiness

Some women report feeling itchiness in some way or another: itchy feet, an itchy body or feeling like insects are crawling over the skin.

“This is common and associated with dry skin,” Dr Elsey explains. “Reduction in collagen and elastin contributes to this.” This causes an increased sensitivity to histamine release, a natural chemical messenger in the body.

Interestingly, the histamine response can also cause women to “suddenly become more sensitive to certain foods, wines, fragrances or skin care products,” Dr Wall adds.

Natural moisturisers may help with dry skin, while antihistamines could also help. You can speak to your pharmacist for help picking out the right option for you.

5. ADHD

Dr Wall has written a whole book about ADHD in menopause and is well-versed in the topic. But it's not so much that perimenopause causes ADHD, rather it exacerbates the symptoms, often leading to first-time diagnoses during this period.

ADHD is a condition where the brain struggles to use and regulate dopamine effectively. And “oestrogen strongly influences dopamine production and signalling,” she explains. So, lower oestrogen can essentially make ADHD symptoms worse.

Low dopamine can also cause motivation to drop, and you may notice changes in how you process information. The low levels can also contribute to binge-eating or gambling, as the brain looks for the quickest, easiest hit of dopamine possible.

This can be helped by trying to find other ways to get your dopamine hit, Dr Wall suggests. “Exercise, sleep and sometimes HRT can improve things.”

6. Burning feet

Some women can experience burning feet in perimenopause, especially at night, which can also accompany pins and needles.

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Dr Elsey explains that this is related to “vasodilation of the capillaries” that comes with hot flushes. Essentially, it’s the widening of your blood vessels that happens as the drop in oestrogen disrupts the brain’s temperature control.

HRT can help, but she recommends getting any symptoms of burning feet checked out by your doctor first, as they could be linked to other problems such as diabetes and B12 deficiency.

7. Thinning eyebrows and eyelashes

Thinning hair happens a lot during menopause, Dr Elsey says. This can affect your eyebrows and eyelashes too and can be upsetting for a lot of women.

“When oestrogen declines, hair spends less time in the growth phase and more hair enters the shedding phase,” Dr Wall explains. The result is reduced volume, wider partings and thinning hair on your head.

This affects eyebrows too, with some losing the outer third of their eyebrows, she adds. It’s the same with eyelashes: “They might become shorter, thinner or more fragile”.

Again, both experts recommend getting it checked out by a doctor, as the problem could also be related to an underactive thyroid or iron deficiency.

When should you speak to your GP about perimenopause symptoms?

Perimenopause can affect almost every part of the body, so it's no surprise that some symptoms seem completely unrelated at first. While hot flushes and changes to your periods are well known, issues such as itchy skin, tinnitus or burning feet can also be linked to fluctuating hormone levels.

That said, it's important not to assume every new symptom is caused by perimenopause. Many of the signs listed above can also be linked to other health conditions, so if you're concerned or your symptoms are persistent, it's worth speaking to your GP.

Getting the right diagnosis can help you access the most effective treatment and feel more like yourself again.

Authors

Amber Middleton