If you’ve hit your 40s, chances are you’ve either experienced or heard about the “classic” perimenopause symptoms: moodiness, hot flashes, irregular or heavy periods, painful intercourse, weight gain around the middle, and dry skin.
But what about the weird perimenopause symptoms no one warns you about?
Strange things like:
- Itchy ears
- A low humming or ringing sound
- Intermittent muffled hearing
- Shoulder or knee pain
- Plantar fasciitis
- Sciatica
- TMJ pain
- Changes in your body scent
- A metallic taste in your mouth
- A choking sensation in your throat
- Palpitations (a racing or pounding heartbeat)
- Dizziness
- Feeling like you can’t take a deep breath (oxygen hunger)
- Brain fog
- Urinary urgency
- Insomnia
- Breast pain or tenderness
If you’ve had one or more of these and wondered what on earth is going on, you are not alone. I literally had this conversation with a friend last week. She was shocked that both her itchy ears and knee pain were symptoms of perimenopause.
But why these “weird” symptoms?
The short answer: estrogen.
Estrogen isn’t just about reproduction. It’s a key neuromodulator in the body, it helps regulate brain chemistry and nervous system function. It influences serotonin, dopamine, and GABA (the neurotransmitters that impact mood, focus, and sleep). It also affects how nerves send signals throughout the body. And, it’s a great anti-inflammatory.
When estrogen levels start to fluctuate during perimenopause, the nervous system becomes dysregulated. That’s why you may notice seemingly unrelated symptoms cropping up, from itchy ears and muffled hearing to joint pain and palpitations.
Breaking Down the Weird Perimenopause Symptoms
Sensory shifts:
Itchy ears, humming sounds, muffled hearing, metallic taste, or even changes in your body scent. These arise because estrogen plays a role in how sensory signals are processed and in maintaining healthy mucous membranes and skin.
Changes in your autonomic nervous system (your “fight-or-flight” vs. “rest-and-digest” responses):
This can cause changes in your blood pressure, breathing, and even your heart rate, causing symptoms like heart palpitations, breathlessness, and urinary urgency.
Brain fog and insomnia:
Estrogen supports synaptic plasticity (the brain’s ability to learn and adapt) and circadian rhythm regulation. Without its steady presence, sleep and mental clarity often take a hit.
Breast tenderness and joint pain:
Shifts in estrogen affect water balance, pain perception, and local inflammation, which explains why shoulders, knees, feet, joints, or breast tissue might suddenly ache.
Support for Body and Mind
The good news is that there are gentle, supportive approaches that can ease this transition and help your body rebalance. As a naturopathic doctor I have a few favorites, some include gentle phytoestrogens.
These are plant-based compounds that lightly mimic estrogen in the body, helping buffer the swings and dips:
- Soy: Found in whole soy foods like tofu, tempeh, and miso; research supports its role in easing hot flashes and protecting bone health.
- Dioscorea (wild yam): Rich in diosgenin, a compound with mild estrogen-like effects that can support tissues sensitive to estrogen decline.
- Flaxseeds: High in lignans a source of phytoestrogens, also a good source of fiber.
Nervines for the Nervous System
Because so many symptoms stem from a frazzled nervous system, nervine herbs can be a powerful ally. Please be sure to consult with a professional, such as a naturopathic doctor, before starting these as some react with common medications.
- Lemon balm: Calms a racing mind and helps with sleep.
- Passionflower: Supports relaxation and can ease nighttime wakefulness.
- Chamomile: Soothes both digestion and nervous tension, making it a wonderful evening tea.
- Oat straw: Nourishes the nervous system and may help with mood swings and stress.
These can be enjoyed as teas, tinctures, or gentle supplements, depending on your preferences.
A “hack” to calm down your nervous system is to apply cold compresses to your chest and side of your neck.
Don’t Forget the Basics
- Hydration: Keeps skin, joints, and mucous membranes more comfortable.
- Movement: Supports heart health, bone strength, and stress resilience.
- Sleep hygiene: Simple steps like reducing screen time before bed, dimming lights, and creating a bedtime routine can make a big difference.
- Community: Sharing your experiences with friends, support groups, or your healthcare provider can help you feel less alone in the process.
Perimenopause isn’t just hot flashes and mood swings.
Because estrogen affects so many systems in the body, its ups and downs can show up in unexpected and sometimes bizarre ways. If you’re experiencing symptoms that seem random, you’re not imagining things and you don’t have to just live with them.
Gentle phytoestrogens, nervine herbs, and supportive lifestyle strategies, and even HRT can help smooth the bumps along the way. If you’re curious about what’s right for you, let’s talk, we can personalize a plan that helps you feel more like yourself again.
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Dr. Jennifer Potter, ND
Naturopathic Doctor San Jose
408-356-1364
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