Printable Perimenopause Symptom Checklist: 36 Signs by Body System
Print this perimenopause symptom checklist grouped by body system, then narrow 36 possible signs to the few symptoms you will consistently track.
How to Use This Checklist
Read it once, all the way through, and mark what is present. Most people find two or three things they had quietly explained away as stress, age or a bad month. That first pass is the whole point of a long list.
Then throw most of it away. Pick three to six items to log daily, with a severity rating and a note on impact. A six-field record you complete every evening for a month will tell a clinician more than a thirty-six-field record you filled in twice.
For a smaller routine after completing the checklist, read how to turn a checklist into daily app entries. If you are choosing software, use the practical app trial checklist to test logging and the report before paying.
The groupings below follow the NHS symptom guidance and the categories used in the ACOG Menopause Symptom Tracker. Each group links to a deep-dive guide with what to record, what else can cause it, and the point at which it needs a clinician rather than a tracker.
Every Symptom Guide in One Place
| Body system | Deep-dive guide | What it covers |
|---|---|---|
| Cycle and bleeding | Irregular periods and bleeding | Expected cycle change vs the five ACOG patterns that are not normal |
| Vasomotor | Hot flashes, night sweats and cold flashes and chills | Counting flashes — hot and cold — without logging every warm moment |
| Sleep | Insomnia and 3 a.m. waking and restless legs at night | Which of the sleep problems you actually have |
| Energy | Fatigue | When tired stops covering it |
| Mood | Mood swings and rage, anxiety, grief and trauma and perimenopause or depression | Volatility and recovery time vs persistent low mood |
| Breathing | Shortness of breath and air hunger | When breathlessness needs a GP or 999 — never self-diagnosed |
| Nerves and sensation | Tingling, numbness and pins and needles | Paresthesia vs the causes worth excluding (B12, trapped nerve) |
| Mouth and teeth | Dry mouth and oral changes | Why a dry mouth raises tooth-decay risk |
| Cognition | Brain fog | A 14-day record that stays specific |
| Joints and muscles | Joint pain and stiffness | The 30-minute morning stiffness rule, and frozen shoulder |
| Head | Headaches and migraines | Mapping attacks against your cycle |
| Heart and circulation | Heart palpitations and high blood pressure | What to log, when to call 999, and the symptom you can't feel |
| Balance | Dizziness and vertigo | Lightheadedness vs true spinning |
| Urogenital | Vaginal dryness and urinary symptoms, orgasm and sensation and low libido | The symptom group that does not settle on its own |
| Breast | Breast tenderness and changes | Cyclical pain vs the urgent list |
| Skin and hair | Itchy skin and dryness and hair loss | What to change first, and why the GP comes before the hair clinic |
| Digestion | Reflux, nausea and gut changes, bloating and water retention | Logging different symptoms — gas, fluid, reflux — as different symptoms |
| Weight and body composition | Weight gain | The four-week baseline before any diet change |
| Less common | Tinnitus, dry eyes and burning mouth and seven patterns beyond hot flashes | The ones nobody warned you about |
Not sure where to start? Take the free perimenopause symptom quiz to organise these into a summary in about a minute, then use the guides above to go deeper on whatever stands out.
1. Cycle and Bleeding
| Sign | What to note |
|---|---|
| Cycles getting shorter | Actual start dates — the gap is the data |
| Cycles getting longer or skipped | How many days late, or how many months missed |
| Heavier bleeding | Products used per day, and whether it changed your plans |
| Lighter bleeding or spotting | When in the cycle it happened |
| Periods lasting more or fewer days | First and last day, every time |
| Worsening cramps or pelvic pain | Severity and whether pain relief was needed |
Bleeding is the one category where certain changes should go to a clinician rather than into a tracker first — see the red flags at the end, and our fuller guide to what to log about irregular periods.
2. Vasomotor Symptoms
| Sign | What to note |
|---|---|
| Hot flushes | Rough count, severity, and whether one interrupted an activity |
| Night sweats | How many times you woke, and whether you changed clothes or bedding |
| Sudden chills after a flush | Whether it disrupted sleep or concentration |
| Flushing or sweating triggers | Alcohol, caffeine, spicy food, a warm room, a stressful moment |
Our hot flash tracker guide covers how to log flashes without turning every warm moment into an entry.
3. Sleep
| Sign | What to note |
|---|---|
| Trouble falling asleep | Rough time to sleep, and what was on your mind |
| Waking in the early hours | The time, and whether a night sweat woke you |
| Unrefreshing sleep | How rested you felt on a 1–5 scale in the morning |
| Daytime fatigue | Whether it changed what you did that day |
| Restless legs or new snoring | Worth mentioning — these point to other causes too |
See the night sweats and sleep guide, and perimenopause fatigue if tiredness is the dominant complaint.
4. Mood and Cognition
| Sign | What to note |
|---|---|
| Low mood | A simple rating plus one word — flat, tearful, numb, hopeless |
| Anxiety or a racing mind | When it peaks, and what it stopped you doing |
| Irritability | Whether it affected a relationship or a work interaction |
| Reduced motivation or confidence | Tasks avoided or postponed |
| Memory lapses | The specific type — a lost word, a forgotten errand, a dropped thread |
| Difficulty concentrating | How long you could focus, and on what |
The 14-day brain fog tracker is the narrower tool for this group, and perimenopause mental health covers when mood changes need more than tracking.
5. Musculoskeletal and Cardiovascular
| Sign | What to note |
|---|---|
| Joint aches and stiffness | Which joints, time of day, and how long stiffness lasts |
| Muscle aches | Whether it followed exercise or appeared without cause |
| Reduced strength or stamina | A concrete example — stairs, shopping, a usual workout |
| Heart palpitations | When, how long, and any associated symptoms |
| Headaches or migraines | Frequency and any relationship to your cycle |
6. Urogenital and Sexual Health
| Sign | What to note |
|---|---|
| Vaginal dryness | Whether it affects comfort day to day or only during sex |
| Discomfort during sex | Severity and whether it changed intimacy |
| Reduced libido | A simple rating over weeks, not a single day |
| Changes in orgasm or sensation | Worth recording — it is a common and under-discussed change |
| Urinary urgency or frequency | Roughly how often, and any night-time waking to urinate |
| Recurrent urinary tract infections | Dates and treatments — a pattern matters here |
| Leaking with cough, laugh or exercise | How often, and whether it changed what you do |
Perimenopause, orgasm and genital sensation covers this group in more depth, including how to raise it in a consultation.
7. Skin, Hair, Weight and Other Changes
| Sign | What to note |
|---|---|
| Thinning hair or hair loss | Where — parting, temples, overall density |
| Dry, itchy or crawling skin | Where, when, and whether anything relieves it |
| New or worsening acne | Timing across the cycle |
| Weight change, especially around the middle | Direction and rough pace, not daily numbers |
| Bloating or digestive changes | Timing relative to meals and to your cycle |
| Breast tenderness | Where in the cycle it lands |
| Dry eyes or mouth | Whether it is constant or intermittent |
| Changes in body odour or temperature tolerance | Any consistent trigger |
For the weight and body-composition items, what to track before you change your diet is a better starting point than a calorie target, and menopause bloating covers digestive patterns and red flags.
Now Cut It Down to Six
- Circle everything present from the seven groups above.
- Cross out anything mild and stable that does not change your day.
- Keep cycle or bleeding — it stays on the list regardless.
- Pick your two worst symptoms by impact, not by intensity.
- Add sleep and mood as context, since they interact with almost everything else.
- Add one free-text field for what else changed: medicine, alcohol, illness, travel, stress.
That is your daily check-in. Run it for thirty days using the 30-day tracking routine, or let Perim keep the fields, dates and trends together on your iPhone so the summary writes itself.
Red Flags: Stop Tracking and Get Assessed
ACOG lists bleeding or spotting between periods, bleeding or spotting after sex, heavy bleeding, bleeding heavier or longer than usual, and any bleeding after menopause as abnormal and worth an ob-gyn appointment — see its guidance. Also seek care for severe or rapidly worsening symptoms, unexplained weight loss, a new breast lump, severe headache unlike your usual pattern, chest pain, breathlessness, or thoughts of self-harm. A checklist is never the right response to those.
Frequently Asked Questions
What are the most common perimenopause symptoms?
Changes to periods, hot flushes and night sweats, disturbed sleep, mood changes, and problems with memory or concentration are the ones most often reported. Joint aches, palpitations, vaginal dryness, urinary changes, thinning hair and reduced libido are also on the NHS list.
How many perimenopause symptoms are there?
There is no fixed number, because the lists group things differently. The checklist here covers 36 signs across seven body systems, drawn from NHS symptom guidance and the ACOG Menopause Symptom Tracker. Most people experience a handful, not all of them.
Should I track every symptom on the checklist?
No. Use the full list once, to notice what you had explained away. Then track three to six that are present and matter to you. A short record completed daily is far easier to interpret than a long checklist with missing entries.
Is there a printable perimenopause symptom checklist?
You can copy or print the table on this page, which is grouped by body system with a note on what to record for each. If you prefer logging on a phone, a tracker keeps dates and severity attached to each entry automatically.
Which perimenopause symptoms are not normal?
ACOG flags bleeding or spotting between periods, bleeding after sex, heavy bleeding, bleeding heavier or longer than usual, and any bleeding after menopause as reasons to see an ob-gyn. Severe, sudden or rapidly worsening symptoms of any kind need medical assessment rather than tracking.
Can a symptom checklist diagnose perimenopause?
No. A checklist organises what you are experiencing. Diagnosis considers your age, cycle history, symptoms, medicines and other possible causes such as thyroid problems, anaemia, sleep disorders or mood conditions, and that judgement belongs to a qualified health professional.
Sources
- NHS — Menopause and perimenopause symptoms
- ACOG — Menopause Symptom Tracker
- ACOG — Perimenopausal Bleeding and Bleeding After Menopause
- Office on Women’s Health — Menopause basics
- National Institute on Aging — What Is Menopause?
Written for general wellness education on 4 August 2026. Not medical advice and not a diagnosis. Speak to a qualified health professional about your own symptoms, tests or treatment.