Perimenopause symptoms
It’s not just hot flashes. We counted 40 signs of perimenopause.
You’re not imagining it. From frozen shoulder to ringing ears, perimenopause symptoms show up all over the body, often years before your period changes. Check the signs you’ve noticed, then see what’s behind them and what to do next.
Based on Nava’s Perimenopause Guide by Stephanie Misanik, MS, CNS, LDN, Clinical Director
Check your signs
Which of these have you noticed?
Tap every sign that sounds familiar, even if it feels unrelated. Perimenopause rarely shows up as one symptom. It shows up as a pattern.
Your pattern
Start tapping the signs you’ve noticed.
Your count updates as you go. Nothing you tap is saved or sent anywhere.
The next step is to test, not guess.
Start with Labs Not ready? Get the free guide and symptom trackerThis self-check is for education and isn’t a diagnosis.
Why it happens
Hormones don’t decline in a straight line. They swing.
Estrogen, progesterone and testosterone act on receptors in the brain, heart, joints, skin, bladder, gut and eyes. That’s why symptoms come and go, and why one random blood draw can come back normal.
Wright et al., Climacteric, 2024. DOI: 10.1080/13697137.2024.2380363
of women experience musculoskeletal symptoms through the menopause transition.
are disabled by them.
Why it gets missed
Four symptoms. Four different doctors.
Picture a woman at 42. Each symptom sends her to a different specialist, each one looks at a single piece, and nobody connects the dots.
Cardiologist
for palpitations
Dermatologist
for crawling skin
Orthopedist
for a frozen shoulder
Therapist
for anxiety out of nowhere
At Nava, one clinician looks at all of it together.
What testing can tell you
Why one blood test isn’t enough.
Hormones swing month to month, so a single draw is one moment, not the whole story. That’s why a random result can come back normal while symptoms continue.
Some signs also overlap with other causes. Thyroid changes and blood sugar shifts can bring fatigue, mood changes, weight gain or thinning hair too.
What Nava does differently
- Hormone labs timed to your cycle while periods continue
- 70+ biomarkers across hormones, thyroid, metabolic health and inflammation
- Results read alongside your symptoms, not in isolation
- Retesting to see what’s changing over time
Who’s behind this
Meet Stephanie Misanik, MS, CNS, LDN.
Stephanie Misanik, MSACN, CNS, LDN, is a functional medicine practitioner and Clinical Director at Nava Health, with more than a decade of experience. She specializes in women’s health, perimenopause, sports nutrition, and hormone optimization.
The signs on this page come from her Perimenopause Guide, built from the research and written for real conversations with your clinician.
What happens next
Three steps to the whole picture.
Test with timing.
70+ biomarkers, drawn at one of 2,000+ lab locations. While periods continue, hormones are drawn at the right point in the cycle. Results in 5 to 7 business days.
Review it as one picture.
A 60-minute consult with a physician or nurse practitioner, plus 60 minutes with a registered dietitian.
Follow a plan that’s measured.
A personalized plan, your Nava Health Score and dashboard, and prescriptions delivered if needed. Retesting shows what’s working.
What clients say about Nava.
Choose a starting point
Two ways to start.
Start with one complete review, or track changes over time with the membership. HSA/FSA eligible.
One-time diagnostic lab and clinical review.
$299
- Whole-body testing, 70+ biomarkers
- Two 60-minute consults: physician or NP, and dietitian
- Nava Health Score and dashboard
- Personalized plan and prescription delivery
Nava Vitality Membership.
$199 /month
- Testing and consults 3 times a year, so hormone swings show up over time
- Nava Health Score and dashboard
- Personalized plan and prescription delivery
Real people. Real answers.
Talk to a Nava care coordinator.
- Callback within one hour during business hours
- Free, no obligation
- Cash-pay, HSA/FSA eligible
Mon-Fri 7:30am-7:00pm ET · Sat 9:00am-4:00pm ET
Request a call.
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Questions women ask first.
Can one blood test diagnose perimenopause?
Not on its own. Hormones swing month to month, so a single draw is one moment. Nava times hormone labs to the cycle and reads them alongside your symptoms.
My periods are still regular. Could it still be perimenopause?
It can. Early changes often show up before cycles change. That’s why tracking symptoms against your cycle matters.
Am I too young for perimenopause?
Not necessarily. Perimenopause can start years before your period changes.
What happens after my labs?
A 60-minute consult with a physician or nurse practitioner, a 60-minute consult with a registered dietitian, and a personalized plan.
Is it covered by insurance?
Nava is cash-pay and HSA/FSA eligible.
One provider. The whole picture.
Longer appointments, more diagnostics and measured outcomes.