When most people think about perimenopause, they think about hot flushes, night sweats, irregular periods and mood swings.
But what about itchy ears?
Or tinnitus?
Or dry eyes, sensitive teeth, phantom smells, acne and hair loss?
These are some of the weird symptoms of perimenopause that women frequently experience, yet they rarely get talked about.
As a result, many women end up feeling confused, dismissed, or convinced they’re imagining things.
In this episode of the Empowered Perimenopause Podcast, I’m exploring some of the more unusual perimenopause symptoms that often go unrecognised, including why they happen and the role fluctuating hormones may be playing.
In This Episode We Cover:
- Why oestrogen affects far more than your reproductive system
- The surprising number of symptoms associated with perimenopause
- Why dry eyes, dry mouth and sensitive teeth can occur
- The connection between itchy ears, itchy skin and hormones
- Why acne can suddenly appear in your 40s
- Hair loss in perimenopause and what else should be investigated
- The possible link between tinnitus and menopause
- Why some women experience phantom smells during perimenopause
- The impact of fluctuating hormones on mood, anxiety and depression
- Why perimenopause is a whole-body transition
Why There Are So Many Unexpected Menopause Symptoms
One of the biggest misconceptions about perimenopause is that it only affects your reproductive system.
In reality, oestrogen receptors are found throughout the body, including the:
- Brain
- Skin
- Eyes
- Mouth
- Ears
- Bladder
- Vagina
- Urethra
- Gut
- Cardiovascular system
- Bones
- Joints
This is one reason why researchers have now identified more than 100 symptoms associated with perimenopause and menopause.
When oestrogen begins fluctuating and declining, the effects can potentially be felt throughout the body, not just within the reproductive system.
Dry Eyes, Dry Mouth and Sensitive Teeth
Many women are aware that vaginal dryness can occur during perimenopause.
What often comes as a surprise is that declining oestrogen can affect mucous membranes throughout the entire body.
Mucous membranes line areas such as the:
- Eyes
- Nose
- Mouth
- Sinuses
- Throat
- Digestive tract
- Bladder
- Urethra
- Vagina
As oestrogen declines, these tissues can become thinner, drier and more sensitive.
This may contribute to symptoms such as:
- Dry eyes
- Gritty eyes
- Contact lenses becoming uncomfortable
- Dry mouth
- Increased dental sensitivity
- Dry nose
- Recurrent urinary tract infections
- Vaginal dryness
For many women, these symptoms seem completely unrelated to hormones when they first appear.
Itchy Ears in Perimenopause: Is There a Connection?
One of the more unusual perimenopause symptoms is itching.
Many women report experiencing:
- Itchy ears
- Itchy scalp
- Itchy skin
- Crawling sensations
- Increased skin sensitivity
Part of this may relate to reduced skin hydration and dryness.
However, histamine may also play a role.
Oestrogen and histamine have a complex relationship, and higher histamine levels can contribute to:
- Itching
- Flushing
- Skin sensitivity
- Headaches
- Anxiety
This may help explain why some women notice itching symptoms fluctuate throughout their cycle.
Why Am I Getting Acne During Perimenopause?
One of the most common questions women ask is:
“Why do I suddenly have acne in my 40s when my skin was clear for years?”
The answer isn’t necessarily that testosterone is increasing.
Often, it’s because the balance between hormones is changing.
As oestrogen and progesterone fluctuate and decline, testosterone can become relatively more dominant.
This can contribute to:
- Increased oil production
- Congestion
- Breakouts
- Jawline acne
Blood sugar dysregulation may also play a role, which is why supporting blood sugar balance remains an important foundation during perimenopause.
Hair Loss in Perimenopause: Is It Hormones or Something Else?
Hair loss in perimenopause can be incredibly distressing.
Hormonal changes may contribute, particularly as declining oestrogen can affect the hair growth cycle.
However, this is an area where it’s important not to assume hormones are the only cause.
Hair thinning and hair loss may also be associated with:
- Low iron
- Low ferritin
- Thyroid dysfunction
- Hashimoto’s thyroiditis
- Nutritional deficiencies
- Chronic stress
- Low protein intake
Often, multiple factors can coexist at the same time.
This is why investigating the bigger picture is so important.
Tinnitus and Menopause: Could Hormones Be Involved?
Many women notice ringing, buzzing or humming in their ears during perimenopause.
The relationship between tinnitus and menopause is still being researched, and the exact mechanisms aren’t fully understood.
However, we do know that oestrogen influences:
- Blood flow
- Nerve signalling
- Neurotransmitters
- Auditory processing
within both the brain and inner ear.
While tinnitus can have many different causes, some women notice symptoms appear or worsen during periods of hormonal change.
Phantom Smells and Perimenopause
Perhaps one of the strangest symptoms reported by women is phantom smells.
This is known medically as phantosmia.
Women often describe smelling:
- Cigarette smoke
- Burning
- Sewage
- Chemicals
even when nobody else can smell anything.
The exact cause isn’t fully understood, but hormones influence sensory processing and neurotransmitter activity within the brain.
As hormone levels fluctuate, some women notice temporary changes in smell perception.
While unusual, it’s certainly not unheard of.
Anxiety, Low Mood and Depression During Perimenopause
Many women expect physical symptoms during perimenopause.
What often catches them off guard are the emotional and psychological changes.
Anxiety, low mood, loss of confidence and depression are among the most commonly reported symptoms during the menopausal transition.
This is partly because oestrogen influences key neurotransmitters involved in emotional wellbeing, including:
- Serotonin
- Dopamine
- GABA
When these systems are affected, women may feel very different emotionally, even if they can’t identify a clear reason why.
For some women, it can genuinely feel as though their personality has changed.
Perimenopause Is a Whole-Body Transition
If you’ve ever found yourself thinking:
“Surely this can’t be perimenopause?”
I hope this episode provides some reassurance.
Perimenopause affects far more than periods and hot flushes.
Because oestrogen receptors are found throughout the body, symptoms can appear in places you would never expect.
That doesn’t mean every symptom is caused by hormones.
But it does mean we shouldn’t dismiss unusual symptoms simply because they don’t fit the traditional menopause narrative.
The more we understand the weird symptoms of perimenopause, the less confusing and frightening this transition becomes.
And the more empowered we become to seek the support and answers we deserve.
Listen to the Episode
In this episode, I explain why these unexpected menopause symptoms occur, the science behind them, and when it may be worth looking beyond hormones to investigate other contributing factors.
If you’ve ever wondered whether your itchy ears, dry eyes, tinnitus, acne, hair loss or phantom smells could be connected to perimenopause, this episode is for you.
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