Weird and horrible perimenopause symptoms: the odd ones nobody warns you about

Everyone warns you about hot flushes. Nobody mentions that your tongue might burn, your ears might itch, or you might feel tiny electric shocks under your skin. So when something strange starts, it's easy to worry that something is badly wrong, or to feel silly mentioning it.

Some of the most horrible perimenopause symptoms are the ones nobody talks about. These weird perimenopause symptoms are real. The Menopause Charity's A to Z of symptoms includes burning mouth, electric shocks, dry eyes, tinnitus and an altered sense of smell, alongside the better-known ones.

This guide covers the odd ones. For the full list, see our plain-English guide to perimenopause symptoms. But please don't assume every new symptom is hormonal. Many of these have other causes too, and some need checking.

Why does perimenopause cause such weird symptoms?

Oestrogen does far more than run your periods. The British Menopause Society says it also plays an important role in keeping your bones, heart and brain working well. In perimenopause your oestrogen levels start to change, and your body behaves differently as a result.

Skin is a good example. The Menopause Charity says a lack of oestrogen means your skin has less of its own natural moisturisers. A dermatology review found that dry skin and itching are common in women after the menopause.

For some of the odd symptoms below, though, the honest answer is that nobody knows exactly why they happen. There's much less research on them than on hot flushes.

The odd ones nobody warns you about

Burning mouth

A scalding, burning, tingling or numb feeling in your mouth, lips or tongue. It can come with a dry mouth or a bitter or metallic taste. The Menopause Charity says burning mouth syndrome is more common in women, particularly over 50, and is linked with low oestrogen.

Other things can cause it, so they need ruling out first. These include an underactive thyroid, some blood pressure medicines, low iron, zinc or some B vitamins, oral thrush, dry mouth and acid reflux. The charity suggests sipping plenty of fluids, sucking ice chips, and cutting back on acidic food, alcohol and cigarettes.

See a GP or dentist if you have a mouth ulcer that lasts longer than 3 weeks (NHS). Read more about mouth changes in menopause.

Electric shocks

Some women feel a sudden, brief zap, like a small electric shock on the skin. It's on the Menopause Charity's A to Z, but there's very little research on it. It can be unsettling. If it ever comes with numbness or weakness, see the box above. Read more about tingling, crawling skin and electric shocks.

Crawling skin (formication)

Some women describe a feeling of insects crawling on or under their skin. The medical name is formication. We couldn't find good research on it in perimenopause, and it isn't on the Menopause Charity's list by that name. The closest entries are pins and needles, and tingling hands or feet.

The NHS says pins and needles can have many causes, including diabetes, some medicines, a trapped nerve and heavy drinking. See a GP if you keep getting it or it lasts a long time. Our page on tingling and crawling skin has more.

Dry, gritty eyes

Eyes that feel dry, itchy or gritty are on the Menopause Charity's list. The NHS says you're more likely to get dry eyes if you're over 50 or look at screens for a long time without a break. A pharmacist can advise on eye drops.

Get an urgent GP appointment or call 111 if your eye is painful and red. Call 999 or go to A&E if your sight changes. Read more about dry eyes in menopause.

Itchy ears, itchy skin and an itchy scalp

An itch deep in your ears, all over your body, or across your scalp. The Menopause Charity says dry skin and itching are common in perimenopause and menopause, and can disturb your sleep. It suggests swapping soap for a mild cleanser or light moisturiser, and moisturising straight after a bath or shower.

The NHS says itchy skin is common after the menopause and usually gets better over time. Less often it can be a sign of a thyroid, liver or kidney problem, so see a GP if the itch is all over, severe or keeps coming back. Read more about itchy ears, itchy skin and itchy scalp.

Smelling different

The NHS says hot flushes can make you sweat a lot. Its page on body odour lists hormonal changes among the things that can make body odour worse. See a GP if your smell changes, or you suddenly sweat much more than usual. The Menopause Charity also lists an altered sense of smell, where the world smells different to you. Read more about perimenopause body odour.

Ringing in your ears

The Menopause Charity lists tinnitus: a ringing or buzzing sound in your ears, even when it's quiet. The NHS says it's linked to many things, including hearing loss, thyroid problems, anxiety and some medicines. Ask for an urgent GP appointment if it beats in time with your pulse. Go to A&E or call 999 if it comes with sudden hearing loss. Read more about tinnitus and menopause.

Feeling dizzy

Dizziness or feeling faint can come out of nowhere, says the Menopause Charity, and vertigo is on its list too. The NHS says hot flushes can make you feel dizzy. Read more about menopause dizziness.

A racing or fluttering heart

The NHS lists a faster, slower or more noticeable heartbeat as a symptom, and says to see a GP if you have palpitations. Women's Health Concern says palpitations can happen quite normally with hot flushes, and a diary can show whether yours come with flushes or with stress. Read more about perimenopause heart palpitations.

Rage that doesn't feel like you

Irritability is on the Menopause Charity's list, and the NHS lists irritability and mood swings too. For some women it's a short fuse. For others it's anger that feels far too big for what caused it. Read more about perimenopause rage.

Focus problems that feel like ADHD

The Menopause Charity says you may not be able to focus or multi-task as well as you used to. The NHS lists memory and concentration problems, often called brain fog. If you have ADHD, or wonder if you might, our page explains what is and isn't known. Read more about ADHD and menopause and our guide to menopause brain fog.

Frozen shoulder

Shoulder pain and stiffness that make it hard to lift your arm. The NHS says the pain can be worse at night, and it can take months or years to get better. It's talked about a lot as a menopause symptom, but it isn't on the NHS menopause page or the Menopause Charity's list. Muscle aches and joint pains are on both. Read more about frozen shoulder and menopause.

Feeling sick

Queasiness, or an urge to be sick, is on the Menopause Charity's list. If there's any chance you could be pregnant, do a test, because periods can be unpredictable in perimenopause. Read more about perimenopause nausea.

Restless legs

Legs that feel irritable or jumpy at night, making it hard to keep them still, says the Menopause Charity. The NHS says restless legs can bring tingling, throbbing or itching, and are thought to be linked to iron levels. See a GP if it's disturbing your sleep. Read more about restless legs.

Spots and skin that has changed

Your skin may become drier, more sensitive, or different in texture, says the Menopause Charity. Spots can come back too. The NHS says changes in hormone levels, including during the menopause, can cause acne. The dermatology review says the cause of menopausal acne isn't clear, but a shift in the balance between oestrogen and male-type hormones is thought to play a part. Read more about menopause skin changes and menopause acne.

How do you know if a weird symptom is perimenopause?

There's no test that can say "this one is hormonal". But a few things make it more likely:

• It started around the same time as other changes. The British Menopause Society says that in early perimenopause, your cycle starts to change and symptoms can appear alongside those changes.
• You have other symptoms too, such as hot flushes, poor sleep, low mood or brain fog.
• Other causes have been checked. Several of the symptoms above can also be caused by thyroid problems, low iron, diabetes or medicines.

Keep a short diary for a few weeks. Note what happens, when, and anything else going on, such as your periods, sleep, stress or what you ate. Patterns are much easier to spot on paper.

How to talk to your GP about odd symptoms

It can feel embarrassing to say "my tongue burns" or "my skin feels like it's crawling". But a full picture helps your GP work out what's going on.

• Take a list. Our free symptoms checklist lets you tick everything you've noticed and print it for your appointment.
• Mention your periods. Say if they've changed, even a little.
• Ask what else it could be. Many of these symptoms have other causes, and it's worth ruling those out.
• Ask about your options. The British Menopause Society says HRT is the most effective treatment for menopause symptoms, and CBT is an option if you don't want HRT or can't take it. The NHS says to see a GP if you think you have menopause or perimenopause symptoms and want to know your options.

You're not imagining these things, and you don't have to put up with them in silence.

For more, read our guides to perimenopause symptoms, what a hot flush feels like and menopause anxiety.

This page is general information, not medical advice. If you're worried about any symptom, please talk to your GP or pharmacist.