Surprising Symptoms of Perimenopause & Menopause

A few weeks ago, I participated in a virtual menopause summit, Midlife ReLaunch: Candid Conversations on Hormones, Menopause, and Mindset. This event was facilitated Hilary DeCesare of the ReLaunch Co. Hilary is a renowned neuro-performance coach, best-selling author, and founder and CEO of ReLaunch Co., and I am so blessed to call her my friend. She is brilliant at bringing women together and creating an energetic, collaborative environment that fosters growth. For this event, Hilary was joined by Marcella Hill, author and founder of Wake Her Up, and Dr. Michelle Sands, naturopathic physician, author, and founder of Glow Natural Wellness. Wake Her Up is the site that I referenced in “Is it Time to Break Up with Your OBGYN” with the largest global hormone specialist directory created by women for women. Dr. Sands takes an individualized approach to helping women harness their best health through creating a natural hormone balance.

The Panelists shared the common goal of empowering women through awareness, with the message of we shouldn’t settle for “normal” – we deserve to thrive. It was a great night of learning, and we covered topics including finding the right care providers, HRT, as well as the broad age ranges of perimenopause and menopause and the myriad of symptoms associated with them. Participants were able to engage and ask questions via a comments side-bar.

As a nurse, one of the most important aspects of my job is educating patients. I loved the opportunity this event gave me to engage with and see questions from so many women from all over. It allowed me to see, on a large scale, how misinformation within the medical community has caused so much fear and confusion, which inspired my article: “Hormone Replacement Therapy; Why is there so much Conflicting Information?”.

Another favorite from this event was witnessing the “Aha” moments that women had when they learned that some of the crazy things they were experiencing were actually related to their hormonal changes. There is a rather astounding list of symptoms that seem completely unrelated to menopause and perimenopause but are, in fact, due to fluctuations in Estrogen. Because these symptoms seem so random, many women don’t associate them with peri and menopause. They suffer in silence, without asking their physicians or even their girlfriends about it. It’s often said that misery loves company, and in this case it’s quite true. I’ve heard so many women say, “I thought it was just me!”, and express a sense of relief that they aren’t the only ones suffering from some wacky symptoms.

I think we’re all familiar with the common symptoms:

Hot Flashes / Night Sweats
Joint Pain
Sleep Problems
Fatigue . . . Exhaustion!
Weight Gain
Mood Fluctuations
Depression / Anxiety
Vaginal dryness and discomfort
Brain fog
Bladder Issues

Today, we’re going to set those aside and focus on a few of the lesser known symptoms.

Now, with the genuine hope that you’ll have your own “Aha Moment” and feel a shared sense of relief that you’re not going crazy . . . let’s break down . . .

Surprising Symptoms of Perimenopause and Menopause

We can blame decreased estrogen as the root cause of all of the following symptoms. Hormone Replacement Therapy (HRT) would likely improve most of these, but if you’re not ready to go down that road, I’ve provided other solutions to try.

Itchy, “Creepy Crawly” Skin
- Itchiness, also known as pruritis, can range from mild to severe.
- The “creepy crawly” sensation (like bugs crawling under your skin – ick!) is also known as formication.
- In both cases, diminishing estrogen causes dryness and thinning of the skin as well as changes in the functioning of skin’s nerve cells.
- Solutions that may help:
  - Take cooler showers. Hot water not only strips more of your natural oils, but it can also cause those irritated nerves to flare-up even more.
  - Cool compresses placed on areas of isolated itching can help to calm those nerves.
  - Use unscented products that contain fewer irritants. From soap to lotion to laundry detergent – the fewer perfumes we use, the better.
  - Supplementing with:
    - Omega 3 fatty acids will help your skin produce more natural oils.
    - Collagen will help with your skin’s moisture levels (as well as elasticity)
    - Phytoceramides restore ceramide levels in the skin, which helps with moisture retention.
  - If the itching gets beyond “mildly annoying” and is severe enough that it’s impacting your sleep or quality of life, please go see your doctor. There are prescription treatments that can help, and you deserve to feel better!!

Itchy Nipples
- I know. It seems like adding insult to injury.
- Thankfully, one of my girlfriends gave me the heads-up about this years ago. So when I got it, at least I knew what it was.
- The solutions for this are going to be similar to the ones listed above for itchy skin.
- I just want you to know that this really is a thing, and you’re not alone!
- I also want you to pay attention to certain signs that would require a visit to the doctor:
  - Cracked nipples could indicate a yeast infection, and you should get this checked out.
  - Changes in the appearance of the skin on your breasts:
    - Peau D’Orange is when the skin on your breasts develops an orange peel-like appearance. This can be an indication of a form of inflammatory breast cancer, so if you notice any changes in the skin of your breasts, see your doctor.

Because I am a big advocate for breast health, I want you to be certain that you are including a visual inspection of your breast tissue as a vital part of your monthly breast exam. Here is a link to wonderful instructions for your monthly breast exam.

Cold Flashes
- Yep, we don’t all get hot flashes . . . some of us get really cold. I have a couple of friends who deal with this. At first, I didn’t feel that sorry for them, but then my friend, Katie, had to borrow my husband’s giant ski parka and to wear inside our house . . . last summer.
- Often, a cold flash can follow a hot flash. So that’s super fun.
- In the case of cold (and hot flashes), it comes down to problems with thermoregulation. Diminished estrogen impacts the function of the hypothalamus – the part of our brain that acts as our bodies’ thermostat. I wrote in more detail about the hypothalamus in this article, “Creating a Sleep Environment to Elevate our Zzzz’s”.
- Solutions that could help:
  - Wear a sweater ~ lol! 😂 I had to say it! Obviously, if you’re cold, bundle up!
  - Some Herbal Treatments labeled for Hot Flashes can also help with cold flashes . . . because the root cause (problem with thermoregulation) is the same.
    - Black Cohosh
    - Products containing Phytoestrogens – plant-derived products that mimic the effects of estrogen in our bodies. Commonly found in soy products or flax seeds.
    - Rhubarb root extract has compounds that bind to receptors that are impacted by estrogen levels and have been shown to alleviate symptoms for some.
    - If Cold (or hot) flashes are impacting your quality of life, please see your doctor. In addition to Hormone Replacement Therapy, there are several prescription medications that can help with menopause-related thermoregulation problems.

Tinnitus (ringing in ears)
- I had tinnitus in my mid-40s and had no idea that it was likely due to perimenopause. I wish I had known! I wish I had thought to ask my friends if they were experiencing it, too! My misery would have loved some company.
- Tinnitus, related to declining and fluctuating estrogen levels, can be the result of signal misinterpretations in the auditory nerve. When stimuli travel from the cochlea (inner ear) to the brainstem, reduced estrogen (affecting blood flow and nerve function) can cause miscommunication, resulting in unwanted inner ear noise.
- Solutions to explore:
  - Stress can increase tinnitus severity, so relaxation through yoga or guided meditation can help.
  - Tinnitus Sound Therapy, or Sound Enrichment introduces external sounds that help our brains cancel out the tinnitus sounds.
  - Pink Noise (a variation of white noise) has been found to be helpful for tinnitus because it taps into lower sound frequencies that help the brain modulate the superfluous sounds.
  - There is limited research on the effectiveness, but some tinnitus sufferers have reported improvements from taking supplements containing Lipo-Flavonoids
  - For severe tinnitus: There is a specialty within the Cognitive Behavioral Therapy realm that focuses on coping strategies and behavioral modification for managing the stress and lifestyle impacts of tinnitus.
Itchy ears
- This is another symptoms that I thought was just me! I had no idea this was related to Perimenopause.
- As we know by now, low estrogen dries us out . . . even our ear canals! In most cases, the itchiness is due to a reduction in natural oils.
- Solutions that should help:
  - Avoid q-tips and excessive cleaning of the ear canal – it will just add to the irritation
  - Consider a drop of olive oil, or other natural, gentle oil to help moisturize your ear canal.
  - Hydrate! It’s tricky in the winter months, but be sure you’re drinking enough water.
  - Consider a humidifier. Again, with the winter and hydration thing!

If you are experiencing uncontrollable itching, discharge or changes in hearing – see an ear nose and throat specialist. You may need a prescription medication, medical ear wax removal, or allergy testing.

Electric Shock Sensations (ESS)
- Sometimes happening just before a hot flash, these “zapping” sensations can occur anywhere on the body, including the face and head.
- During Perimenopause, estrogen is not just declining; it is fluctuating. Our nervous system has estrogen receptors throughout it, and ESS is thought to be related to that hormonal fluctuation affecting nerve signals.
- One solution that may help:
  - Supplementing with Magnesium. Magnesium helps to calm the nervous system. You can read more about it in my article, “Magnesium Matters.”
- I’m also including Numb or Tingling extremities and higher incidence of our limbs falling asleep in this category. The same estrogen-nervous system explanation applies
  - Additionally, estrogen affects blood flow, and lower estrogen can cause diminished blood flow to extremities . . . thus the “falling asleep” result.

If your numb or tingling extremities become severe and/or persistent, especially if you are experiencing additional symptoms like weakness or loss of coordination, see your doctor. These could be indications of an underlying condition.

Burning Tongue Syndrome (aka: Burning Mouth Syndrome, BMS)
Metallic Taste in Mouth
- At this point, you’re probably thinking, “Holy crap, can’t we catch a break?”. Same, friend. Same.
- The Root cause for this is not completely understood. It is believed to be linked to lower estrogen causing changes in the oral mucosa and a decrease in saliva production.
- Solution:
  - Stay well hydrated.
  - Avoid smoking and alcohol. (Alcohol dehydrates us)
  - Avoid strong mouthwashes containing alcohol.
  - Try adding citrus to your water to mask the metallic taste and freshen your mouth.

Fragile, Brittle, Peeling Fingernails (or toenails)
- The root cause of this is, you guessed it, hydration! We can also blame reductions in our production of keratin and collagen.
- Solutions:
  - Wear gloves when cleaning and doing dishes.
  - Hand cream . . . lots of it!
  - I’ve recently been massaging jojoba oil into my nails. The jury is still out on this, but I’ll update you soon!
  - Biotin supplements (a form of Vitamin B) are supposed to support the healthy growth of hair and nails. (If my jojoba experiment doesn’t work, I might go down this road . . . yet another supplement!)

Well, friends, that was a lot. Truthfully, there are many, many more symptoms that I could have included. But I had to stop for my own sanity. Hopefully, you’re not like me . . . I think while writing this, I experienced new and sudden onset of each and every one of these symptoms. Ahh, the power of suggestion!

My sincere hope is that this article will give you some solutions to these super annoying symptoms. I also hope that you’re able to see that you’re not crazy and you’re not alone!

Estrogen is a massively powerful hormone, and its fluctuations can wreak havoc in some incredibly weird ways. However, knowledge is power, and we can share tips and support each other through these things. If you have other symptoms you want to discuss or some solutions that have helped you, please share them in the comments section. Like I love to say – We have soooo much to learn from each other!

Thank you so much to all the women who were so candid and generous in the Menopause Summit! I loved learning from you and with you.

See you Friday, Friends! ❤️