Can perimenopause feel like flu? (+1 observations)

In this article, we will discuss whether perimenopause feels like you are having flu. We will also discuss the mechanism and other complications of perimenopause.

Can perimenopause feel like flu?

Yes, perimenopause may feel like flu. If you are in perimenopause you may feel ‘flu-like’ symptoms such as severe headache, fever, hot flushes, and cold chills. You may also experience muscle and joint pain, fatigue, low mood, and poor concentration.

However, it is not always necessary that you will experience flu-like symptoms during perimenopause. You should visit your doctor to identify if you really have flu. If the symptoms persist for many weeks, it is due to hormonal imbalance. 

How does perimenopause cause flu-like symptoms?

When you go through perimenopause, your body’s production of female hormones, including estrogen and progesterone, rises and falls. This creates a hormonal imbalance in your body.

The fluctuation of hormones during perimenopause disrupts the normal functioning of the hypothalamus. The hypothalamus is a part of the brain that controls the body temperature (homeostasis). Low levels of estrogen also promote sleep which makes you feel tired (1).

When you try to check your body temperature through a thermometer, you will notice that you do not have a fever. You are just feeling hot or having cold chills because of the hormonal imbalance. 

What does research suggest?

In one of the clinical reports, perimenopausal women (n=1388) presented with menstrual cycle-associated symptoms like breast swelling and body cramps. The women undergoing perimenopause also reported increased fatigue, low mood, headache, and brain fog.

These symptoms were lesser in women undergoing premenopause (n=1115) and menopause (n=2286). Menopausal women complained of mood swings, vasomotor symptoms (heart palpitation, night sweats), cognitive symptoms (deficit in memory and attention), and pain (2). 

What symptoms resemble flu during perimenopause?

You may experience the following symptoms during perimenopause that may remble flu illness (3, 4):

  • Fatigue,
  • Hot flushes or cold chills,
  • Loss of appetite,
  • Low mood,
  • Severe headache,
  • Body aches, and
  • Nausea.

What are other complications of perimenopause?

Most of the symptoms associated with perimenopause are often vague, as they can be triggered due to many other reasons. Some of the common complications, other than flu-like symptoms, include (2, 4):

  • Heavy and frequent bleeding may cause anaemia in some women.
  • Excessive night sweats and hot flushes.
  • Anxiety and depression,
  • Urinary incontinence (sudden and involuntary urination), and frequent urinary tract infection.
  • Vaginal dryness, irritation, and frequent itching.
  • Low libido, impaired sex drive, lack of lubrication, and pain during sex.
  • Alopecia (hair loss),
  • Brittle nails and dry skin,
  • Weight gain and abdominal bloating,
  • Insomnia or changes in sleeping pattern,
  • Change of body odour.

How to manage flu-like symptoms during perimenopause?

Although, you can never be sure if you are having flu or just getting the feeling of having flu-like symptoms. However, there are a few things which you can do to lessen the severity of symptoms with perimenopause.

Talk to your doctor

If you have flu-like symptoms and are also undergoing perimenopause, then you should talk to your doctor before taking any medication. Your doctor will diagnose the condition and identify the actual cause of the symptoms.

Hormonal therapy

Systemic estrogen therapy, available as skin patches, creams, and pills, is the most effective way of relieving perimenopausal flu-like symptoms. Systemic estrogen also helps control bone demineralization and prevents bone loss (5).

Estrogen can also be given through the vaginal route as vaginal rings, vaginal tablets, and creams. Vaginal estrogen is often prescribed to reduce vaginal dryness, especially if you experience pain during intercourse due to decreased lubrication (5).

Pain relievers

You may take acetaminophen and ibuprofen to lessen the severity of body aches, and muscle and joint pains. If you have an allergy to ibuprofen, you may take naproxen after consulting your doctor. Additionally, ibuprofen should be avoided with Paroxetine.


Your doctor may prescribe antidepressants if you suffer from anxiety, low mood, hot flushes, and depression due to perimenopause. Paroxetine is the only FDA (Food and Drug Administration) approved antidepressant for perimenopausal-associated vasomotor symptoms.

Every woman has a different physical makeup and situation which influences her condition, especially during perimenopause and menopause. As a pharmacist, I would suggest that you keep track of your menstrual cycle and associated symptoms.

Every woman has to undergo perimenopause and menopause eventually. You can work with your doctor to make it more bearable. A balanced healthy diet, exercise, hormonal therapy, and avoiding stressful conditions are the key points to lessen the severity of symptoms

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Kelly MJ, Qiu J, Rønnekleiv OK. Estrogen signaling in the hypothalamus. Vitamins & Hormones. 2005 Jan 1;71:123-45.


Aras SG, Grant AD, Konhilas JP. Clustering of> 145,000 Symptom Logs Reveals Distinct Pre, Peri, and Post Menopausal Phenotypes. medRxiv. 2023:2023-12.


Short H, Mander A, Wilkinson J. A Case of Subacute Thyroiditis Presenting with Oligomenorrhea. Gynecol Obstet (Sunnyvale). 2015;5(325):2161-0932.


Gadgil ND, Kulkarni AA. An Understanding and Comprehensive Approach Towards Perimenopausal Stress–A Review.


Troìa L, Martone S, Morgante G, Luisi S. Management of perimenopause disorders: hormonal treatment. Gynecological Endocrinology. 2021 Mar 4;37(3):195-200.