Sara Davies, 42, says perimenopause gave her 'tennis elbow' – 4 surprising symptoms women should know

Our understanding of perimenopause has come a long way over the last decade, but there’s still plenty to learn about the wider impact of hormonal changes. Perimenopause can influence everything from our skin and hair to our mood and cognitive function – and, as entrepreneur and Dragon’s Den star Sara Davies recently discovered, our tendons and ligaments.

‘Bloody perimenopause has a lot to answer for, doesn’t it?’ Davies said in a recent video uploaded to her Instagram. ‘I’ve had a bad elbow – it's been aching around here for about two weeks now. I asked my PT about it because I was like, “I cannot lift any weight using my elbow”. And when I described it she said, “I think that’s tennis elbow”. I don’t even bloody play tennis.’

She continued: ‘Anyway, I was talking to my friend Katie and she said, “Oh yeah, it’s another one of the things with perimenopause – you're more likely to get tennis elbow.”’

An overuse injury that affects the tendon that attaches your forearm muscles to the outside of your elbow, tennis elbow isn’t just caused by tennis. In fact, it can be caused by activities that involve gripping something and repeatedly twisting your wrist and forearm, such as typing, using a mouse, gardening or housework.

And while the link between perimenopause and the condition might seem unclear, hormonal changes during perimenopause – especially falling oestrogen levels – may play a role in tendon and ligament health.

But an increased risk of tennis elbow isn’t the only surprising symptom that perimenopause can trigger. Here are some of the other lesser-known symptoms to be aware of.

It may not be as well-known a symptom as hot flushes and irregular periods, but brain fog during perimenopause is incredibly common. In fact, according to new research from Menopause Mandate, one in four women report brain fog as their first symptom during perimenopause.

Lower oestrogen levels are thought to be one of the main culprits, because oestrogen plays a role in brain function and energy metabolism. As oestrogen levels fluctuate and decline during perimenopause, this can contribute to the ‘woolly’, foggy-brain feeling.

Struggling with bloating and other digestive symptoms – such as gas, stomach pain and constipation – can be a knock-on effect of fluctuating hormone levels during perimenopause.

In fact, according to a new survey from Yakult, two-thirds (66%) of women aged 45-54 going through perimenopause experience monthly bloating.

This is likely because reproductive hormones such as oestrogen and progesterone – the levels of which fluctuate during perimenopause – can affect things such as gut motility and fluid balance.

According to GP and women’s health specialist Dr Louise Newson, around 50% of women experience heart palpitations during perimenopause and menopause. And although they can feel alarming, in most cases they’re harmless.

These kinds of palpitations are thought to be caused by fluctuating hormone levels affecting the electrical pathways in your heart, which can lead to changes in the way it beats.

However, while these kinds of heart palpitations usually aren’t cause for concern, it’s still worth seeing a healthcare professional to rule out other causes if you’ve noticed changes.

Changes in your skin during perimenopause are quite common. These may include dryness, increased sensitivity, itchiness and breakouts, but can span a range of issues.

‘As hormone levels shift during perimenopause and menopause, many women notice increased dryness, sensitivity, redness, flushing, breakouts, loss of firmness and changes in facial volume,’ explains Dr Stefanie Williams, a dermatologist and medical director of Eudelo.

‘Declining oestrogen levels affect the skin’s barrier function, hydration and collagen production, contributing to thinner, less elastic skin and more visible signs of ageing.’

Lauren Geall is deputy site editor for Women’s Health UK and Men’s Health UK. She graduated from Exeter University with a BA in English Literature before studying an MA in Magazine Journalism at City, University London. She’s been writing about health, fitness and wellbeing for over five years, with a total of seven years in digital journalism. Prior to her current role, she worked at Stylist as the acting health and fitness editor. As well as being a keen runner, Lauren is passionate about women’s sport and can often be found cheering on Arsenal Women at the Emirates or keeping tabs on the Red Roses’ latest win.