Pillar 2 · The Female Body, Explained Calmly

8 Perimenopause Symptoms Women Get Wrong (and the Ordinary Name for Each)

By Zeinab Kamara, Oncology Nurse · 9 September 2026 · 9 min read · Companion to this video

"I thought it was my nerves. I thought I had bed bugs. I thought I was going crazy." Those are three different women describing the same year of their lives, word for word, from under a doctor's perimenopause video. Look at the shape of that sentence: I thought it was, and then the ending. The ending is never something ordinary. It is an infestation, madness, dying. Nobody writes "I thought it was a normal hormonal transition." These women noticed everything accurately and early. They were just never handed the ordinary name, so the mind reached for the worst one. That is not anxiety or a character flaw. It is a labelling problem, and understanding it is part of the female body, explained calmly. It is also, underneath, a story about self-blame: you were not reading your body wrong.

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The eight, from the ones you half suspect to the ones nobody connects

1. Joint pain and stiffness. The wrong name: just getting old, or arthritis already at 45. Oestrogen helps your joints keep inflammation down and tissue supple, so when it swings, joints can ache strangely fast. The speed is the clue: ageing is gradual, a decade at a time. If your knees and fingers changed inside one year, that is not a decade's worth of ageing.
2. Heart palpitations. The wrong name is a frightening one: something is wrong with my heart. Fluttering and racing episodes are common in this transition, often alongside hot flushes and broken nights. But hear me as a nurse: palpitations are the one symptom you never wave away without a check. Tell your doctor, do the simple tests. The point is what happens after the workup comes back fine, which for many women it does: with the right name, she walks out with an answer instead of quietly believing her heart is failing.
3. Frozen shoulder. The wrong name: I slept on it badly, I must have lifted something. Except it does not pass, it worsens, and no injury explains it. The classic patient is a woman in her 40s or 50s. In 2024 researchers named the musculoskeletal syndrome of menopause for the joint, muscle, and bone changes of this stage. Frozen shoulder is not formally on that list yet, and the argument is still live, but the age pattern is not a coincidence.
4. A burning mouth or tongue. The wrong name: my teeth, an infection, something I ate. The dentist finds nothing, and now it feels like it is in your head. It is not. Burning mouth syndrome concentrates in exactly this stage of life, and hormone receptors sit in the lining of your mouth, your saliva glands, even the nerve that supplies your face.
5. Ringing or whooshing in your ears. The wrong name: hearing damage, something inside my head. But your ears are not exempt from hormones, and ear symptoms are a documented part of this transition that almost no symptom list bothers to include.
6. Your smell changes. Almost nobody says this one out loud, which is why it belongs here. The wrong name: something is wrong with my hygiene. It is chemistry, not cleanliness. Sweat patterns and skin change, and a scent you have had your whole adult life can shift. Washing more was never going to fix chemistry, and none of it is a verdict on you.
7. Crawling, tingling, prickling skin, with nothing there. The medical name is formication, from the Latin for ant. Women scratch until they bleed and treat their houses for bed bugs that do not exist. Your skin and its nerve endings are oestrogen territory too, so when the signal swings, skin can report sensations with nothing on it. You were never infested, and you were never imagining it. The sensation is real, and it has an ordinary name.
8. The rage, the anxiety, the fog. The rage that arrives out of nowhere at people you love, the anxiety spikes with no trigger, the place where words used to be. The wrong name here is the cruellest: I am going crazy, I am not myself anymore. The right name is the same as the other seven: the same signal, swinging, reaching the organ that happens to generate your moods and your thoughts. It was never madness, and it was never who you are.

How one thing explains eight problems in eight places

Two simple facts. First, oestrogen is not a reproductive hormone that stays in its lane. It has receptors in nearly every system you own: your joints, skin, mouth, ears, your heart's rhythm system, your brain. So when it changes, the symptoms do not appear in one tidy place. They scatter, which is exactly why no one connects them.

Second, and this is the fact that explains the wrong names: in the years before your last period, oestrogen does not decline in a slow, polite line. The word the research uses is erratic. It swings, high in some cycles, barely there in others. A swinging signal produces symptoms that come and go: here for three weeks, gone for two months, back without warning.

"The pattern that should have been the biggest clue that this is hormonal, the coming and going, is the very thing that persuades you it is not."

Because in most people's minds a real condition stays. A symptom that vanishes for eight weeks feels like it cannot have been real, so you conclude it was you, your nerves, your imagination. It is the same swinging pattern behind the symptoms nobody told you were perimenopause, and behind the insulin signal your blood panel misses.

This is not a reason to skip the doctor

Please take the opposite from this. This decade is also when other real things can begin, and a new symptom deserves a proper look. I said it about your heart, and it goes for the rest of the list too. The right name is not a reason to skip the doctor. It is what you bring to the doctor, so the conversation starts in the right place instead of ending with a shrug.

Two minutes and a pen

Here is something to do tonight. Take the frightening name you gave yourself, the ending of your own "I thought it was" sentence. Write it down. Cross it out. Next to it, write the ordinary name you learned today. This is not journaling. Putting an accurate name on what you are experiencing measurably calms the brain's threat response; naming it right is a physiological act (Torre and Lieberman, 2018). You cannot fix a problem you have misnamed, and you have been trying to fix the frightening version for years.

The reframe to leave with: all this time you thought you were reading your body wrong. You were not. The instrument was working. You noticed everything, accurately and early. What you were missing was never judgement and never sanity. It was one piece of information, and now you have it. What you build on that name is the subject of the companion piece, how to plan for your worst week, not your best.