A Guide to Navigating Uncommon Perimenopause Symptoms

Perimenopause |
5 min read

Written By

Brittany Dick

Published

December 13, 2024

Medically reviewed by

Alyssa Dweck MS, MD, FACOG, MSCP, Chief Medical Officer

Are you experiencing symptoms like dry eyes, tingling arms, “burning mouth,” or sudden dizzy spells?

Believe it or not, for a portion of women navigating menopause, these symptoms can be connected to the hormonal shifts experienced during this transitional time.

Sometimes, the unusual symptoms women experience during perimenopause are simply because of their ever-changing hormones during this transitional period. Other times, they could potentially be signals of underlying health conditions that are unrelated to menopause.

Here we review a few uncommon perimenopause symptoms that can potentially occur and examine how to know when certain symptoms may warrant a trip to your healthcare provider.

Perimenopause Symptoms No One Talks About

Experiencing unusual or disruptive symptoms that could be related to menopause? You’re not alone.

While many menopause transitional experiences are accompanied by hallmark symptoms, such as hot flashes and mood swings, some women may experience less common symptoms that they may or may not recognize as being menopause-related.

Dry Eyes and Skin

Hormonal changes during menopause may affect not only the skin, but also the olfactory surfaces of the eyes, which involves tear production.¹ This can result in what vision experts refer to as “dry eye syndrome".

Women with “dry eye syndrome” may experience:²

Burning sensations in the eye
Itchy eyes
Feeling of “grittiness” in the eye
Excessive tearing

There are many potential causes of dry eyes, such as autoimmune issues, thyroid disease, diabetes or prior eye surgery, but it may be surprising to know that menopause can perhaps be one of them. Some experts believe shifting androgen levels (a type of sex hormone) as a result of menopause can contribute to dry eyes – this could be related to the impact the hormone has on tear production.³

Untreated dry eyes can lead to more serious complications like eye infections, corneal scratches, eye ulcers, and even vision loss.⁴ Fortunately, a thorough eye exam can assess both the quality and quantity of your tears, which can help to narrow down the most appropriate treatment options to address your dry eyes. These treatments may include experimenting with dietary changes, taking an anti-inflammatory medication, using artificial tears or lubricating eye drops, and/or undergoing specific medical procedures designed to correct this specific issue.⁵

Declining estrogen levels may have similar drying effects on the skin during menopause. Hormonal shifts can potentially cause the skin to retain less water, contributing to dryness that intensifies in dry weather, it’s also associated with a decreased production of collagen and hyaluronic acid, which impact the skin. To combat this, dermatologists often recommend:⁶

Using fragrance-free, mild cleaners
Applying fragrance-free moisturizer after showers/cleansing and throughout the day as necessary

“Burning” Mouth

“Burning tongue” or “burning mouth syndrome” refers to a symptom that causes a burning sensation in the mouth, gums, throat, and/or lips.⁷ These sensations may accompany a metallic taste in the mouth, along with dryness, tingling, loss of taste, and even numbness. While this symptom set is less commonly reported, it can be associated with menopause and has been found to occur in up to 33%of postmenopausal women.⁸

As with other symptoms associated with menopause, menopause-related “burning mouth syndrome” can be due to changing hormones. But because treatment options such as hormone replacement therapy (HRT) may not be successful for everyone at addressing this symptom,⁹ management options often involve medications designed to calm nerve pain, such as gabapentin, as well as prescribed, stress-management therapies.¹⁰

Two of the highest risk factors for “burning mouth syndrome” are being female and being over the age of 50¹¹— however, the symptoms can be a sign of other medical conditions, like specific infections, fibromyalgia, neuropathy, and several autoimmune diseases.¹²

It’s best to seek help from your healthcare provider to obtain a proper diagnosis and medical treatment plan to address burning mouth syndrome during menopause just to ensure you rule out any other potential causes, such as reflux.

Tingling Arms, Legs, and Feet

The medical term “paresthesia” refers to tingling, prickly, or burning sensations in the arms, legs, hands, or feet.¹³

If you’re menopausal, this symptom can manifest from fluctuating hormone levels that influence how your central nervous system is functioning.¹⁴ Rest assured, while the sensations associated with this symptom may be annoying, and possibly even concerning, they’re often harmless. It’s also believed that menopause-induced paresthesia will likely subside postmenopause, when hormone volatility and declines end.¹⁵

It's important to note that paresthesia can also be a symptom of certain nutritional deficiencies (such as low levels of B-12), can be due to the use of certain medications or are associated with other neurological conditions or infections (such as Lyme disease).¹⁶ For this reason, it’s best to seek out the help of a healthcare provider who can perform necessary blood tests and other evaluations to determine the root cause of your symptoms.

More Uncommon Menopause Symptoms

With more than 34 recognized symptoms of menopause, chances are you’re not the only one experiencing an unusual symptom of perimenopause. Other uncommon perimenopause symptoms can include:^17,18

Hair changes (hair loss or thinning)
Headaches
Brain fog
Brittle nails
Bone and/or joint pain
Increased body odor

When to See a Healthcare Provider for Uncommon Perimenopause Symptoms

While some unusual menopause symptoms have a benign cause and may resolve in time, others can be a sign of underlying medical conditions worth exploring.

For this reason, it’s recommended to see a healthcare professional if any new symptoms arise. This way, an experienced physician can help to rule out or diagnose conditions that may be unrelated to menopause and provide treatment options that can help you feel more like yourself again.

Resources

https://www.medicalnewstoday.com/articles/dry-eyes-with-menopause
https://www.sciencedirect.com/science/article/abs/pii/S1751485118302344
https://www.ncbi.nlm.nih.gov/books/NBK470411/
https://www.medicalnewstoday.com/articles/dry-eyes-with-menopause#when-to-see-a-doctor
https://www.ncbi.nlm.nih.gov/books/NBK470411/
https://www.aad.org/public/everyday-care/skin-care-secrets/anti-aging/skin-care-during-menopause
https://newsnetwork.mayoclinic.org/discussion/burning-mouth-syndrome-why-doctors-sometimes-fight-its-fire-with-fire/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3425145/
https://newsnetwork.mayoclinic.org/discussion/burning-mouth-syndrome-why-doctors-sometimes-fight-its-fire-with-fire/
https://pmc.ncbi.nlm.nih.gov/articles/PMC3570906/#ref25
https://newsnetwork.mayoclinic.org/discussion/burning-mouth-syndrome-why-doctors-sometimes-fight-its-fire-with-fire/
https://newsnetwork.mayoclinic.org/discussion/burning-mouth-syndrome-why-doctors-sometimes-fight-its-fire-with-fire/
https://my.clevelandclinic.org/health/symptoms/24932-paresthesia
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3570906/
https://www.firstforwomen.com/health/menopause/expert-advice-tingling-menopause
https://www.healthline.com/health/paresthesia#causes
https://www.healthline.com/health/menopause/9-less-common-perimenopause-symptoms#emotional-symptoms
https://www.everydayhealth.com/menopause-pictures/menopause-symptoms-that-may-surprise-you.aspx