By Elyse Hamilton, PeriSlayer founder

Perimenopause can start in your late 30s and last several years, and the symptoms rarely show up as the classic hot flash first. Tick everything you have noticed in the last 3 months, even if it seems unrelated. Bring the printed list to your doctor or nurse. It turns "I just feel off" into something they can act on.

1. Your cycle

1. Periods coming closer together or further apart
2. Periods heavier or lasting longer than they used to
3. Periods lighter or shorter than they used to
4. Spotting between periods
5. Skipped periods
6. PMS that feels stronger than before
7. Breast tenderness or swelling

2. Temperature and heart

8. Hot flashes
9. Night sweats
10. Sudden cold chills
11. Heart racing or fluttering (palpitations)

3. Sleep and energy

12. Trouble falling asleep
13. Waking at 3 or 4am and struggling to get back to sleep
14. Feeling exhausted even after a full night
15. Afternoon energy crashes

4. Mood and mind

16. Brain fog
17. Forgetting words or names mid-sentence
18. Trouble concentrating
19. Anxiety that seems to come from nowhere
20. Irritability or sudden rage
21. Low mood or feeling flat
22. Mood swings
23. Feeling overwhelmed by things you used to handle easily
24. Loss of confidence

5. Body and skin

25. Weight gain around the middle, even with no change in habits
26. Bloating
27. Joint aches and stiffness, especially in the morning
28. Muscle tension or new aches
29. Headaches or migraines, often around your period
30. Dry, itchy or thinning skin
31. Hair thinning or more hair in the shower drain
32. New adult acne
33. Brittle nails

6. Digestion and bladder

34. Heartburn or acid reflux
35. New food sensitivities or digestive changes
36. Needing to pee more often or more urgently
37. More frequent UTIs

7. Intimacy

38. Vaginal dryness or irritation
39. Lower sex drive
40. Discomfort during sex

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Most women in perimenopause notice several of these at once, often in more than one group. This is a conversation starter, not a diagnosis.

PeriSlayer is a tracking app, not a medical provider. This checklist is for information and to help you talk to a clinician.

Is it perimenopause? The 40-symptom checklist