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What Are the 34 Symptoms of Perimenopause: Perimenopause is a transitional phase before menopause characterized by hormonal changes. Common symptoms include hot flashes, night sweats, irregular periods, mood swings, fatigue, sleep disturbances, vaginal dryness, and changes in libido. Other symptoms can include breast tenderness, weight gain, headaches, joint pain, and cognitive difficulties. While not all women will experience all 34 symptoms, this list provides an overview of the potential physical, emotional, and psychological changes that can occur during this phase.