Because hormones can have such wide-ranging effects on the brain and nervous system, women report many symptoms that are not always found on the “typical signs of menopause” lists. But if they are, in fact, due to the changing levels of estrogen, these troublesome symptoms will be temporary and disappear as your body adjusts to new hormone levels.

Tinnitus

Tinnitus is defined as “ringing in the ears,” but it has also been described as whooshing, roaring, chirping, pulsing, and screeching. It can be any persistent noise that a person hears, but that is not generated outside the body. While women sometimes begin to notice it with the onset of perimenopause, it has also been associated with other hormone shifts such as puberty and pregnancy. It is not clear how much of this symptom is related to the change in hormone levels, and how much is the result of getting older. By the age of sixty-five, a third of women will report that they have tinnitus at least now and then.

One cause may be otosclerosis, which is a stiffening or hardening of the bones in the ear and can lead to loss of hearing. Tinnitus has also been reported as a side effect of menopausal hormone therapy, and has been related to fluid retention. There is no well-defined treatment for tinnitus, but here are some things you can do to help reduce it:

• Avoid loud sounds or excessively noisy environments.

• Decrease your intake of sodium/salt.

• Avoid stimulants such as caffeine and nicotine.

• Have your blood pressure checked to be sure it is within normal range.

• Get adequate exercise to increase blood flow to all of your body.

• Get enough sleep.

• Use “white noise” machines to make tinnitus less bothersome when trying to fall asleep.

• Practice relaxation or biofeedback exercises to reduce stress.

• Avoid aspirin or other pain medications in the non-steroidal anti-inflammatory (NSAID) family such as ibuprofen and naproxen.

Tingling/Burning and Other Paresthesias

A paresthesia is a skin sensation without an apparent physical cause. These sensations are reported by women in perimenopause, and can be unsettling. They take many forms, and may be described as numbness, pricking, burning, tingling, creepy crawly, pins and needles, or electric shocks; some women describe feeling “cobwebby” or feeling that they have “ants under the skin.” It is thought that they are the result of vasomotor instability, the same mechanism that brings you hot flashes. In fact, some women get a paresthesia just before a hot flash, as a sort of warning. Paresthesia may also be caused by the hyperventilation that some women experience with panic or anxiety attacks. Whatever the cause, they are usually transitory, and seem to improve after actual menopause occurs.

Some women experience facial paresthesias that signal a oncoming migraine headache. Most paresthesias are more emotionally disturbing than physically dangerous. But since multiple sclerosis and some neurological conditions have this as a symptom, you should report it to your medical provider.

You're Not Crazy!

This chapter has described many neurological and cognitive symptoms that occur during menopause. As with all menopausal symptoms, these are interrelated with your health and lifestyle, and must be considered as part of the larger picture of perimenopause. Your emotional health, physical health, and life situation all influence how your symptoms will express themselves. Realize that these symptoms change as you go through the perimenopause and that you are not “going crazy.” As with adolescence, your shift in hormones may cause changes that, although hard to keep up with, are perfectly normal.