Last checked September 2026 against 5 sources · Editorial policy

Perimenopause symptoms checklist

Perimenopause can cause far more than hot flashes. Below are 40 symptoms in plain words, grouped by where you feel them. Tick the ones you have, note how often and since when, and bring the list to your appointment: that's the pattern a doctor needs to see.

Get the printable checklist

All 40 symptoms on one page, with boxes for how often and since when, plus a page on what else it could be. Free PDF.

The 40 symptoms

Heat

Sleep

Mood

Memory and focus

Energy, weight and heart

Joints and muscles

Head and senses

Skin, hair and nails

Stomach, breasts and allergies

What else it could be

Three common conditions can look like perimenopause, and each has a simple test.

Thyroid
- Feeling cold when others don't
- Hair thinning or coarse
- New constipation
- Unexplained weight change
- Neck swelling
- Thyroid problems in the family
If three or more fit, ask about a TSH test.
Iron deficiency
- Periods heavier than they used to be
- Clots bigger than a coin
- Soaking through in under 2 hours
- Breathless on stairs
- Craving ice
If two or more fit, ask about ferritin and a full blood count. Soaking through in under 2 hours needs a doctor soon.
Sleep apnea
- Told you snore loudly
- Told you stop breathing in your sleep
- Falling asleep in the day
- Morning headaches
- High blood pressure
- Neck over 40 cm (about 16 inches)
- BMI over 30
If three or more fit, ask about a sleep study.

See a doctor now if

Bleeding after 12 months without a period always needs checking.
Soaking through a pad or tampon in under 2 hours: see a doctor promptly.
Chest pain, breathlessness or fainting: call 911.

Frequently asked questions

How many symptoms do I need for it to be perimenopause?▾

There's no set number. Perimenopause is judged on your age, how your cycle is changing, and how your symptoms fit together. Some women notice two or three symptoms, others a dozen. The checklist is for spotting the pattern and showing it to your doctor.

Can a blood test confirm perimenopause instead?▾

Usually not. Hormone levels swing from day to day in perimenopause, so a single FSH or estrogen result can look normal. Guidelines diagnose it from age, cycle changes and symptoms. Blood tests are useful for ruling out lookalikes like thyroid problems or low iron.

Why write down how often and since when?▾

Frequency and timing are what a doctor needs to judge a symptom. A symptom that started with cycle changes and comes daily is read differently from one you've had for years. Writing it down also stops the appointment from depending on what you remember on the day.

Should I bring the checklist to my appointment?▾

Yes. Tick what you have, fill in how often and since when, and hand it over at the start. It keeps a short appointment focused on what matters to you.