When most people think about menopause, hot flushes and night sweats are probably the first things that come to mind.
But the menopausal transition can affect so much more than temperature regulation.
The hormonal changes that occur during perimenopause and menopause can influence sleep, mood, energy, cognition, muscles and joints, sexual health and the menstrual cycle.
For some people, these changes are gradual and manageable. For others, it can feel as though their body has suddenly become unfamiliar.
At Yin, we often hear women say: “I just don’t feel like myself anymore.”
And sometimes, the symptoms having the biggest impact aren’t the ones we traditionally associate with menopause.
You might be sleeping badly, feeling more anxious or irritable, struggling to concentrate, noticing new aches and pains or wondering where your usual energy has gone.
You may even find yourself thinking, “Is this just me getting older? Is this my new ‘normal’?”
It may be part of the transition, but it’s worth paying attention to what your body is telling you.
What are the symptoms of perimenopause and menopause?
1. Your sleep has suddenly changed
You might find yourself waking at 2am or 3am, struggling to fall asleep, waking frequently throughout the night or simply not feeling refreshed in the morning.
Sometimes sleep disruption happens alongside night sweats or hot flushes. But it doesn’t always.
And once your sleep is disrupted, you may notice the ripple effects during the day, such as fatigue, irritability, difficulty concentrating and feeling less resilient when life throws another thing at you.
Sleep is one of the areas we commonly discuss when supporting people through perimenopause and menopause.
Rather than simply accepting poor sleep as something you have to put up with, it can be helpful to pause and look at the bigger picture.
2. Your brain feels a little… different
“Brain fog” is something we hear about a lot during perimenopause and menopause.
You might walk into a room and forget why you’re there, lose a word that was right on the tip of your tongue, struggle to concentrate or find yourself wondering why something that used to feel easy suddenly requires so much more effort.
It can be unsettling, particularly when you feel like you’re not quite as sharp, focused or mentally “on” as you used to be.
And sometimes it’s not just about memory. You may notice that your ability to juggle multiple things has changed, that you feel more easily overwhelmed or that your brain simply seems to need more time and space.
The hormonal shifts of perimenopause can be part of this picture, but so too can the accumulation of poor sleep, stress, emotional load and everything else that may be happening in your life at this stage.
Rather than seeing these changes as something that is simply “wrong”, it can be useful to pause and notice what else your body and mind might be asking for.
Sometimes a little more rest, support and space to reset can make a bigger difference than we realise.
3. Your joints and muscles are complaining
You might notice new aches, stiffness or changes in how your body feels during perimenopause and menopause.
Perhaps you wake up feeling stiff, your knees or hips aren’t as happy as they used to be, or you’re finding that your usual workout takes longer to recover from.
Hormonal changes can influence musculoskeletal health, but new or persistent pain shouldn’t simply be dismissed as “just menopause”. There can be many possible causes, and getting the right assessment is important.
Acupuncture can be part of a broader approach to managing pain, supporting movement and helping you feel more comfortable in your body.
4. Your mood feels different
You might feel more irritable, anxious, flat or emotionally reactive than usual.
Sometimes women describe it as having a much shorter fuse. Other times, it’s a feeling of being overwhelmed by things that previously felt manageable.
Hormonal changes can play a role, but so can poor sleep, stress, life circumstances and the many demands that often come with this stage of life.
And for some people, menopause can bring up more emotionally than they expected.
It’s a time of significant change – physically, psychologically and sometimes in the way we see ourselves and the life we’re living.
That experience is different for everyone.
5. Your energy has disappeared
Feeling tired after a poor night’s sleep is understandable.
Feeling exhausted all the time is another story.
Some people notice that their usual energy levels have changed during perimenopause. The things that previously felt easy suddenly require more effort, and recovery from a busy day or a workout can take longer.
It can be frustrating when you feel like you’re doing all the “right” things but your body isn’t responding in the way you expect.
Fatigue does, however, have many possible causes, so it’s important not to assume that every change is hormonal. Your GP can help investigate other contributors such as iron deficiency, thyroid conditions, sleep disorders and other health issues.
6. Your libido has changed
Changes in sexual desire are common during the menopausal transition, but they’re not always talked about.
A change in libido can be influenced by hormonal changes, sleep, stress, mood, relationship factors, body image, medications and physical symptoms such as vaginal dryness or discomfort.
There’s no single “normal” level of libido and you don’t have to simply accept a change that is bothering you.
It’s worth talking about.
Sometimes acknowledging that something has changed is the first step towards understanding what you need.
7. Your periods are doing things you weren’t expecting
Before periods stop altogether, the menstrual cycle can become increasingly unpredictable.
Cycles may become shorter or longer, bleeding may become heavier or lighter, and symptoms that were once predictable can change.
These changes can be part of perimenopause, but significant changes in bleeding should still be assessed by your doctor – particularly if bleeding is very heavy, occurs between periods or after sex or happens after menopause.
Your menstrual cycle can also provide useful information about what is happening during the years leading up to menopause.
Rather than viewing these changes as something to simply put up with, they can be useful clues about what’s happening in your body.
So, where does acupuncture fit?
There isn’t one single “menopause treatment” in acupuncture.
And that’s actually one of the things I value about this approach.
In Chinese medicine, we don’t simply treat the label of “menopause” or focus on one symptom in isolation. We look at the pattern – the combination of symptoms, how they show up for you, your individual constitution and what else may be happening in your life and health at the time.
Two people can come to acupuncture with the same symptom but have very different patterns underneath it, which means their treatment may look quite different. For one person, sleep might be the biggest issue. For another, it might be hot flushes, headaches, anxiety, joint pain or feeling completely depleted. And sometimes it’s the combination of several smaller changes that leaves you thinking, “I just don’t feel like myself.”
This is why each treatment is individualised. We take the time to understand what’s happening for you, rather than simply treating “menopause” as one condition.
There is also growing research into the role of acupuncture during the menopausal transition. A 2025 systematic review and meta-analysis of 28 randomised controlled trials found that acupuncture may improve sleep quality and other measures of insomnia in women experiencing menopausal sleep difficulties, although the authors noted that the overall certainty of the evidence ranged from very low to moderate. More recently, a 2026 systematic review and network meta-analysis of 49 randomised controlled trials involving 4,579 participants found beneficial effects from different acupuncture approaches across a range of perimenopausal symptoms, while noting that further high-quality research is needed.
Acupuncture may be used alongside other approaches to help manage symptoms and support wellbeing during this transition. It can also sit comfortably alongside conventional medical care, including appropriate medical assessment and treatment.
It doesn’t have to be either/or.
A note on your symptoms
If you’re experiencing new, severe or persistent symptoms (or anything that concerns you) it’s important to speak with your GP or another appropriate health professional. If you’re looking for support specifically around menopause, you may also find it helpful to see a GP with a particular interest or experience in menopause care.
Menopause is a transition, not a single symptom
One of the things I love about treating people through perimenopause and menopause is that no two experiences are exactly the same.
For some, hot flushes are the main problem. For others, it’s the combination of poor sleep, brain fog, anxiety and feeling exhausted. And sometimes it’s simply the sense that your body has changed and you aren’t quite sure how to navigate it.
You don’t need to have every symptom on the list to seek support.
If something has changed and it’s affecting how you feel, sleep, work, exercise or enjoy your life, it’s worth paying attention to.
Rather than wondering whether you should just “push through”, this can be an opportunity to pause, notice what has changed and work out what support might help you feel more like yourself again.
At Yin, we support people through all stages of hormonal health – from their first period, through fertility and pregnancy, and into perimenopause and menopause.
References
Zhang, X., Liu, C., Qin, S., Chen, C., Wang, X., Jiang, Y., & Wu, W. (2025). Acupuncture as an independent or adjuvant therapy to standard management for menopausal insomnia: A systematic review and meta-analysis. PLOS ONE, 20(2), e0318562.
Yang, X., Zhu, F., Zhong, Y., Liao, P., Ji, Q., Li, S., Feng, X., Zheng, Y., Xue, Q., & Chen, G. (2026). Comparative effectiveness of different acupuncture therapies for perimenopausal syndrome: A systematic review and network meta-analysis. Frontiers in Neurology, 16, 1696085.