5 Surprising Perimenopausal symptoms No One Warns You About

Perimenopause symptoms aren’t always hot flashes or missed periods. In this video, I break down 5 surprising perimenopause symptoms women aren’t warned about and explain why they happen.

Perimenopause can show up in ways that feel confusing, random, and even unsettling, especially if no one ever told you what to expect in your 40s.

In this video, we explore:
• Why perimenopause symptoms can look unrelated
• How hormone fluctuations affect multiple systems in the body
• Why many women are told it’s “just stress” when it’s not
• How understanding the why helps you feel steadier and more in control

This is not about fear or diagnosis. It’s about helping you understand what your body is communicating so you can stop second-guessing yourself in this season.

Want support and clarity for this phase of life?
Join the perimenopause waitlist here:
 https://waitlist.embrmornings.com

Which part of this episode surprised you most? Or what have you experienced that no one warned you about? Your comment may help another woman feel less alone.

Subscribe for clear, grounded conversations about perimenopause and midlife, so you can understand your body instead of fighting it.

EMBR MIDLIFE METHOD

YouTube

Facebook

Instagram

LinkedIn

Mindvalley

Typeset

Kimberly Hoyt is a physician assistant with two decades of clinical experience who helps women navigate perimenopause and menopause with clarity and confidence. Her work focuses on midlife health and education, helping women understand what is happening in their bodies so they feel prepared, informed, supported and empowered.

Medical Disclaimer: The information shared on this channel is for educational and informational purposes only and is not intended as medical advice. Kimberly Hoyt, PA-C, and associated content are not a substitute for professional medical care, diagnosis, or treatment. Viewing/Listening to this content does not establish a patient-provider relationship. Always consult your own healthcare provider before making changes to your health plan, starting supplements, or addressing medical concerns.

General Disclaimer: I am not a CPA, attorney, insurance/real estate agent, contractor, l...

Transcript

Kimberly Hoyt: 0:00

If you thought perimenopause was just about hot flashes and irregular periods, you may have been lied to though not on purpose, but just by omission. Hormones do not just affect your ovaries. They affect your brain, your skin, your eyes, your mouth, your metabolism, and even your nervous system. So when things start shifting, your symptoms can look random, but they are not random. They are connected. By the end of this video, you're going to realize your body isn't malfunctioning, it's communicating. Hi, I am Kimberly Hoyt and I'm a physician assistant and a midlife girly walking through this midlife shift right alongside you. Today we're talking about five surprising perimenopause symptoms that most women are never warned about. And I'm gonna do two things in this video. First, of course, we're gonna talk about the symptoms in a way that helps you recognize it. And second, I'll explain the why in plain English. so you can stop thinking you're falling apart. Quick note before we dive in. Not every symptom is perimenopause. If something is sudden severe, one-sided or truly alarming, always get checked out. My goal here is clarity, not self-diagnosis. Here's the big idea that makes all of this make sense. In perimenopause, estrogen and progesterone do not just gradually decline. They fluctuate and sometimes wildly, and these hormones interact with neurotransmitters like serotonin and gaba and dopamine, with histamine and inflammation, and with how our bodies handle insulin and our stress hormones. So the symptoms can show up in places you don't expect. Let's get into the five. Symptom number one, itchy ears. This one sounds almost silly until it's happening to you. It is a deep itch in the ear canal and you look for the obvious causes. Is it wax? Do you have an infection? Maybe it's allergies, and sometimes it is those things, but a lot of women notice itchy ears with no clear explanation, and it seems to be right around this perimenopause time. This is one for me that I had. I was cleaning my ears out and because I work in the medical field, I had my friend Melanie look in my ears and she's like, girl, those are the cleanest ears I've ever seen. There's no wax, there's nothing. They look fine. It was just this crazy shift because of perimenopause. So here's the why. Estrogen supports skin thickness, skin hydration, and collagen production. It also influences the oil and moisture balance in our tissues. When estrogen fluctuates, skin can get drier and more sensitive, that includes the skin you would never think about like the ear canal. There is also a second layer here. Hormone shifts can make your immune system more reactive and can amplify histamine activity. So histamine is involved in itching. Some women feel itchier in general, including ears, scalp, and even random patches of skin. This is another one that has shown up for me. I have this itchy spot on my back. I can barely reach it, and it has driven me crazy for years. So what to do next, without overcomplicating it, if there's pain, drainage, hearing loss, fever, or one-sided severe symptoms, please get evaluated. If it's just dryness and itch. Think of hydration, environmental dryness, consider talking to your provider before you start putting random things in your ear. Your ear canal is not a DIY science project. If you're thinking, why is everything drying out? This is another one that you might hate a little bit, but it will also make you feel less crazy. Symptom number two, dry eyes and subtle vision changes. Dry eyes can feel like gritty eyes burning, stinging, watery eyes that are actually dry, and eyes that feel worse on screens. Some women also notice that their vision feels a little blurrier by the end of the day, even with their glasses on, and here's why. Your tear film is not just water. It has layers including an oil layer that keeps the tears from evaporating too quickly. Hormones including estrogen and androgens, influence the glands that produce parts of that tear film. So as your hormones fluctuate, tear quality and quantity can change. Also, estrogen influences collagen and fluid balance in the tissues, and that includes the tissues of your eye and your cornea. So some women notice subtle changes that make contacts less comfortable, eyes more irritated, and screen time more draining. What to do next. Dry eye can be common, but it should not be dismissed. If you have new floaters, flashes of light, curtain like vision loss or severe pain that is urgent or emergent. Make sure you are seen. For a more typical dry eye picture. Consider reducing screen strain. Blinking more intentionally, but definitely talk to your eye doctor if it's a persistent problem. There are good options and you do not have to just suffer through it. Now let's move to the symptom that makes women feel like they're doing something wrong, even when they're not. Symptom number three, weight redistribution and visceral fat. A lot of women say, my weight did not just change my shape, changed. Less fullness in the hips or thighs, but more around the middle. Or they feel like they suddenly have that belly that does not respond the way it used to. Here's the why, and I want you to hear this clearly. This is not just willpower, it is physiology. Estrogen influences how and where your body stores fat. When estrogen is higher, women tend to store more fat subcutaneously, meaning under the skin, often around the hips and thighs. As estrogen declines and fluctuates, fat storage shifts towards the abdomen, and more of it can be visceral fat, meaning deeper fat around the organs. There's also an insulin piece. In midlife many women become more insulin resistant, meaning the body needs more insulin to manage the same blood sugar level. Higher insulin levels favor fat storage and make it harder to access stored fat, especially around the midsection. And there's a stress piece to it too. Cortisol doesn't cause everything despite the internet acting like it's the villain in a superhero movie, but chronic stress, poor sleep, can worsen insulin resistance and appetite regulation. And we know that perimenopause often disrupts sleep, so it becomes this vicious cycle and this loop. So what do you need to do next? You do not need extreme dieting, that tends to backfire. In general, strength training, protein, fiber, and walking do far more than punishing cardio and undereating. Now you may want a deeper dive and a deeper look so you can talk to your provider about labs for metabolic markers and, and not just use the number on the scale to gauge where things are. Now we're gonna shift from these body changes to brain and nervous system changes. This next one is wild and can make you feel like you have a much shorter fuse or much thinner skin. Symptom number four, sensory overload and smell intolerance. This is different from phantom smells that we talked about in the last video. Phantom smells are smelling something that truly is not there. Sensory overload is when real input feels louder, stronger, more intense, or more irritating than it used to. Perfume suddenly feels like chemical warfare. The TV feels too loud, crowds feel overwhelming, and you feel like your nervous system is running on overdrive. Here's the why. Estrogen and progesterone interact with neurotransmitters in the brain. Progesterone through its metabolites, can have calming effects via gaba, which is the neurotransmitter that helps your brain feel settled. When progesterone drops some women feel less buffered, more easily overstimulated or irritated. Estrogen also influences serotonin and norepinephrine pathways, which affects mood, sensitivity to stress and how the brain processes sensory input. So when hormones fluctuate, your brain can interpret the same environment as more intense. There may also be a migraine connection here even without headaches some women have a migraine type sensitivity pattern where light and sound tolerance changes with hormonal shifts. What to do next? First, name it. Naming it helps you just recognize it. Second, reduce your stimulation load where you can, because white knuckling it all day is not a badge of honor. If it's significant, track it Patterns matter. your cycle timing, sleep, caffeine, alcohol, dehydration, and stress all modulate this. And if you have any neurological red flags or you're concerned in any way, get evaluated. And now for one that truly annoys people because it feels unrelated and it can make you worried that something bigger is wrong. Symptom number five, gum sensitivity and dental changes. Some women notice bleeding gums, even though they didn't change how they brushed their teeth or their routine. You may notice more sensitivity, dry mouth, more cavities, or your gums just feel more inflamed. Here's the why. All goes back to estrogen. Estrogen supports the integrity of the mucus membranes, blood flow, and connective tissues. When estrogen declines, tissues can become more vulnerable to inflammation and dryness that includes gum tissue. There's also a bone density angle here. We usually talk about bone density as hips and spine, but it can affect all our bones, including our jaw. So oral health can shift in midlife and inflammation matters. Hormonal changes can shift the inflammatory balance in the body, and the gums are a place where inflammation shows up fast because the mouth is a high bacterial environment. What to do next. Don't ignore it. Talk to your dentist and let them know that you're in perimenopause and ask them what those hormonal shifts may mean for your oral health. If you're dealing with dry mouth, hydration and gum safe strategies can be super helpful here, and your dentist should be able to guide you on those strategies. Also, if you have new or severe symptoms, do not assume hormones, get it checked out. All right, so to recap, the five itchy ears, dry eyes, and subtle vision changes. Weight redistribution, especially around the middle, sensory overload and smell intolerances, and then finally, gum sensitivity and dental changes. Here's the truth of the day. Perimenopause symptoms can look random, but they, they're often just your body responding to fluctuating hormones across multiple systems. The goal is not to obsess over every symptom. The goal is to understand your patterns so you can make smarter choices and have better conversations with your healthcare providers. If this video made you feel seen, like, and subscribe, I'm gonna continue breaking down perimenopause in a way that actually makes sense. And share this with a friend who might be noticing similar changes and wondering what's going on. I would love for you to drop in the comments, which one of these symptoms surprised you most? Or what symptom have you been dealing with that doesn't get talked about enough? Your comment might help another woman connect the dots. Tune in next time where we're talking about that stubborn belly fat and what to do about it.