No, You’re Probably Not Dying — It’s Just Perimenopause: 8 unusual perimenopause symptoms demystified

Nicolle Sloane
Photo by Yuris Alhumaydy on Unsplash

A few days ago, I could’ve sworn there was a feather tickling a spot on my ankle. I looked. Nothing. Just my usual ankle. The weird sensation continued intermittently throughout the day. I finally googled it — “Feeling of a feather tickling your skin when there is no feather tickling your skin.”

Aha! Such a thing is called “formication” (no, not the other word — and yes, I had to do a double-take too).

formication: (NOUN) a sensation like insects crawling over the skin.

And such a thing is a symptom of perimenopause!

I was relieved. It seems almost every creepy sensation I’ve experienced lately is related to “the change” I’m going through.

After reading about formication and a few other seemingly exotic perimenopausal symptoms, I decided to do a little digging to find out what else I might expect throughout the next few years. I got some answers and thought I’d share them here.

First of All, Estrogen is Everything

During perimenopause, which is the 3–4 years leading up to menopause (actual menopause is when you’ve stopped menstruating for an entire year, but perimenopause is when you experience more of these strange symptoms), the ovaries slowly wind down their production of estrogen.

According to Natalie Angier, Pulitzer prize-winning science writer for the New York Times and author of Woman: An Intimate Geography, estrogen receptors are everywhere in the female body. Therefore women can experience unusual estrogen-related symptoms in many different ways. “Very few parts of the body hate or ignore estrogen,” Angier writes, “Almost every two-bit organ or tissue wants a bite of it.”

Estrogen affects your reproductive tract, urinary tract, heart, blood vessels, breasts, bones, skin, hair, mucous membranes, pelvic muscles, and brain!

Besides fatigue, unusual menstrual cycles, and the usual moodiness that accompanies hormonal imbalance, there are also some unexpected — albeit bizarre — symptoms that can show up as estrogen and youth fade. Here they are in no particular order.

1. Is That a Bug Crawling on My Knee?

As mentioned above, the unexpected sensation of insects crawling across your skin is called formication and results from estrogen levels in decline.

Estrogen stimulates collagen production, which is what makes your skin supple and resilient. When estrogen levels fall, collagen production slows, and skin becomes drier, itchier, and prone to ailments, including odd ones like formication.

2. Pins and Needles, Cold Feet (and Hands), and Numbness, and Tingling

Paresthesia is in the same house as formication but involves tingling, numbness, and pins and needles. Falling estrogen levels cause mixed messages between the nervous system and other parts of the body.

Medical experts say the dropping estrogen levels also cause reduced blood flow to nerves and a tingling, numb, cold feeling in your extremities (but sometimes can occur in your face too, most notably on the tip of your nose!)

3. Night Sweats and B.O.

Waking up in the middle of the night soaked in sweat is no fun. The first time it happened to me, I was in the middle of a dream in which I thought that someone needed to wring me out as I groped around the bed in the dark. I felt like I was a washcloth, and I was soaking. Surprise, surprise — when I woke up, I was, in fact, soaking wet, pajamas and all.

And not only do you sweat your brains out, but you also give off a bothersome odor when you do. However, some experts say we’re the only ones who can smell our awful selves, because yes, yet another lovely symptom of perimenopause is a heightened sense of smell. So we’re wet, we stink, but we’re the only ones suffering. Husband dear is snoring away, oblivious to the chaos going on right next to him.

What causes such mayhem? The dropping estrogen levels play tricks with our hypothalamus (the part of the brain that regulates body temperature), causing it to think we’re hot when we’re not.

4. Boobs Growing and Falling

The breast expansion/swelling here isn’t necessarily the desired type of growth. Your breasts grow due to— you guessed it — a decline in estrogen (and an increase in progesterone — the hormone that also stimulates menstruation and pregnancy). And your breasts tend to expand more in the downward direction than in the more desirable outward orientation.

There is also mastalgia — the medical term for breast pain. And sometimes, oddly enough, only one breast hurts while the other feels just fine. I’m told once the periods stop for a year, the breast pain recedes. The size doesn’t, and the direction of growth doesn’t either.

5. Heart Taking Flight

About a week or so ago, as I was settling into bed to read my book, my heart suddenly began to flutter. It felt like a butterfly was trying to take flight from my chest. I stopped reading and looked over at my husband (who was sound asleep next to me — surprise, surprise) and thought I might need to wake him to take me to the ER! Then the fluttering stopped. I have other friends in the throes of perimenopause who have demanded EKGs and more from their doctors when they’ve felt this weird sensation.

Medical experts say these odd heart palpitations are harmless and a result of declining estrogen. As estrogen levels dip, your heart rhythm sometimes changes, which can cause a common but at first bewildering condition called Premature Ventricular Contractions (PVC). According to the Mayo Clinic, the heart beats a few extra times in its two lower ventricles (the pumping chambers).

A scary sensation? Yes, at first. Eventually, you get used to it. I usually take a few deep breaths and say something like, “This too shall pass….” Soon enough, the extra beats subside, and all is well again. That said, it’s always a good idea to check in with your doctor when you suspect your heart is acting strange.

6. Beard Shaving

Are you wondering why you suddenly feel the need to grab your husband’s electric razor and shave your chin? Yeah — that‘s your estrogen dropping again. But while estrogen levels dip in women during perimenopause, testosterone (the male androgen hormone produced at lower levels in women) doesn’t. This imbalance of hormones can cause perimenopausal women to take on some common male characteristics, including a bit of a beard (well, maybe not an actual beard but some seriously coarse chin hair).

You may think I’m a bit dramatic here, but those extra-thick chin hairs are not a look I aspire to, plus they feel itchy and poky. While shaving might seem like a bit much, an excellent facial hair wax can get the job done — I recommend this one.

7. The Mouth of Fire

As estrogen diminishes, the mucus membranes in our mouths begin to dry out, causing the sensation of “cotton mouth.” You might experience bad breath, bleeding gums, and loss of teeth (yikes!!!). Some women complain of their mouths burning — I think this is where the term “Dragon Breath” came from.

8. Alto Voice

Voice change is an often overlooked symptom of perimenopause.

Right before my period, I have often noticed a drop in the octave of my voice. I suddenly have a bit of a man voice. But while it used to only happen a day or two before my period, it now happens at intervals I can’t decipher.

According to medical experts, it’s very normal for our voices to have slight variations before and after ovulation, and it is also a weird but common symptom of perimenopause.

But the voice drop in perimenopause eventually becomes permanent in menopause.

What causes this man voice phenomenon?

While estrogen levels dip, the male hormone testosterone levels mainly rise unchecked, and the larynx and vocal cords are very sensitive to these sex hormone fluctuations.

Many professional singers find they can’t reach the high notes after menopause. Researcher Berit Schneider, MD, a speech pathologist at the University of Vienna in Austria, studied menopausal vocal changes after aging singers in Austria, the land of music, exhibited diminished vocal range and hoarseness. His study showed menopausal women “often suffer from dryness and thinning of many body tissues because of loss of collagen and muscle mass — which likely affects the vocal cords.”

And So it Goes…

And so you see, no part of the body isn’t somewhat affected by estrogen’s last dance.

In more primitive times, along with the end of expecting to expect, women’s life expectancy was right around 50 years. As our ability to procreate ceased and estrogen acquiesced, it was time to meet our maker anyway.

But that’s not the case anymore! Women can lead long, healthy lives way past the throes of perimenopause and menopause.

“We might expect that during the evolution of the hominid life extension program, the female body developed mechanisms specifically to compensate for ovarian ‘failure,’’’ writes Angier. Thankfully, other body parts — including the adrenal glands and fat (!) — can produce estrogen after the ovaries take their final bow. But we also have great doctors, organic chemists, and things like hormone replacement therapy. We’ve come a long way, baby.

So, while the symptoms might make you feel your life is in a downward spiral, keep in mind that there is a light at the end of the tunnel. Many women find the mid-life shift of menopause empowering and say that once they get through the night sweats, formication, and dry mouth, they feel more resilient and better than they ever have.

**None of what I say here is “medical advice,” and some of these symptoms are sometimes signs of other potential illnesses. It’s best to consult your doctor if you think you’re experiencing perimenopausal symptoms to rule out other possible medical issues.

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