While hot flashes, night sweats, and mood swings are commonly associated with perimenopause, millions of women experience a wider, and often more baffling, array of symptoms linked to declining hormone levels, according to hormone health expert Dr. Louise Newson.
Dr. Newson, founder of the Balance app, notes that many women spend months or years seeking medical explanations for peculiar physical changes, unaware that these could stem from fluctuating progesterone, estradiol, and testosterone. These hormones interact with receptors throughout the body, and their decrease can manifest in unexpected ways.
Tinnitus
Many women report that tinnitus, characterized by ringing or buzzing in the ears, either begins or intensifies during perimenopause. The inner ear and brain possess hormone receptors for progesterone, estradiol, and testosterone, whose function can be impacted by insufficient levels of these hormones. This symptom can be particularly pronounced at night when hormone levels are typically at their lowest. Dr. Newson has observed that in her clinic, many women experience a reduction or complete resolution of tinnitus after being prescribed the appropriate dosage and type of hormone replacement therapy.
New Onset Allergies
Perimenopause can trigger the development of new allergies in some women, even if they have no prior history of allergic reactions. Fluctuating and decreasing levels of testosterone, estradiol, and progesterone can affect the function of mast cells and other immune cells, which are critical in releasing histamine during allergic responses and inflammation. Progesterone and testosterone play a role in stabilizing mast cells and reducing histamine; conversely, low levels of these hormones may contribute to allergies, mast cell activation, and histamine intolerance. Hormone therapy, particularly with testosterone and progesterone, has shown to improve these symptoms for many women, though the specific type of hormone is crucial, as estradiol can sometimes exacerbate these issues.
Burning Mouth Syndrome
Around 40% of women experience burning mouth syndrome during menopause, a condition causing discomfort, pain, or a burning sensation in the mouth. This occurs when nerve pathways that transmit sensory information about temperature and taste to the brain are altered. Hormonal changes, including the fluctuations and decline in progesterone, estradiol, and testosterone, can trigger burning mouth syndrome because these hormones are essential for maintaining healthy nerve function. Many women report significant improvement in these oral symptoms when treated with the correct dosage and type of hormone therapy.
Increased Clumsiness
Many women find themselves becoming clumsier as they transition through perimenopause and menopause. Hormones influence spatial ability, cognitive function, and brain areas responsible for coordinating movement. Progesterone, in particular, affects fine motor skills and spatial task performance. When hormone levels decrease, impaired coordination can lead to balance issues, resulting in trips and falls, or difficulty with tasks like holding objects, explaining why women might find themselves dropping things more frequently.
Restless Legs Syndrome
Restless legs syndrome, characterized by an intense urge to move the legs, often occurring when sitting or lying down and interfering with sleep, can also be linked to hormonal changes. Dr. Newson states that this condition can significantly improve with hormone treatments such as progesterone, estradiol, and testosterone. She notes that it is frustrating when women with restless legs syndrome are not offered hormone therapy and are instead prescribed other medications that may carry more significant side effects and risks.
