Phantom Smells?! The Surprising Perimenopause Symptoms Women Over 40 Often Dismiss as Something Else
Hormone changes can trigger far more than just hot flashes and mood swings—here's what they are and how to find relief
Picture this: You’re in bed and trying to sleep when you suddenly start smelling smoke. Panicked, you frantically check every room only to find everything in perfect order. The real culprit? Perimenopause. (Yes, you read that right.) While we all know about hot flashes and night sweats, mood swings and brain fog, there are surprisingly sneaky symptoms of perimenopause that many of us never see coming. And now, women are sharing their experiences—especially with phantom smells—on TikTok. So we talked to the experts to find out what you should really expect during the menopause transition, plus tips to make it more manageable.
What is perimenopause and when does it start?
“Perimenopause is the transition period leading up to menopause when your reproductive hormone levels begin to decline,” says Jessica Shepherd, MD, Chief Medical Officer at Hers. “It can start in a woman’s mid-to-late 40s, but the timing varies. Some women experience perimenopause symptoms in their 30s or early 40s.” (Learn how women are delaying menopause.)
This transition period lasts about four years on average, but it can continue for up to a decade. As Dr. Shepherd explains, you officially reach menopause once you’ve gone a full year without a menstrual cycle. “During perimenopause, estrogen levels drop and you may notice more irregularity in your periods, and that’s a sign you’re getting closer to menopause,” she adds.
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5 surprising perimenopause symptoms women don’t expect
Many of us are familiar with the more common perimenopause and menopause symptoms, such as vaginal dryness and stubborn weight gain. But there are some less-talked-about signs that we tend to dismiss or write off as something else. Here’s what to watch for:
Phantom smells
If you’ve searched every corner of your home for a smell you can’t find, there’s a name for it. “Phantosmia means smelling something that isn’t actually there,” says Navya Mysore, MD, Medical Director of Women’s Health at Nurx. “It’s also called a phantom smell. People often describe scents like smoke, chemicals or something burning, even though there’s no real source.”
Hormonal fluctuations during perimenopause can affect your sensory perception in surprising ways. “Because estrogen affects the brain and the nerves involved in smell, the early hormone swings of perimenopause could make some women more sensitive to smell or more likely to notice phantom scents,” says Dr. Mysore.
Women have taken to social media to discuss phantosmia, with many specifically mentioning smoke. That said, “the odors are different from person to person and may be foul or pleasant,” says Dr. Shepherd.
Phantosmia could also show up alongside other changes during perimenopause or early menopause. “Sleep changes, migraines and stress—all of which are very common in perimenopause—can also trigger phantosmia in some people,” says Dr. Mysore.
Metallic tastes or a burning sensation
Some women notice unusual mouth sensations during this time. “Changes in estrogen can affect saliva production and the nerves that control taste, leading to dryness, burning sensations or a metallic taste,” says Dr. Mysore. (Learn more about burning mouth syndrome during menopause.)
Heart palpitations
A sudden thumping or racing heartbeat is a sneaky perimenopause symptom that can catch women off guard. “Estrogen interacts with the cardiovascular system, so sudden drops can make your heart beat faster or harder,” says Dr. Mysore. “These episodes can feel scary but are usually harmless.”
New or more intense migraines
That splitting headache? You can probably blame perimenopause. “Estrogen has a strong impact on the brain’s pain pathways,” says Dr. Mysore. “When levels swing up and down, migraines can start for the first time or become more intense.”
Morning joint stiffness
You might wake up feeling achy and stiff lately, and you’re not alone. “Estrogen helps protect cartilage and reduce inflammation,” says Dr. Mysore. “As levels fall, women may notice new joint aches, especially in the morning.”
Simple ways to find relief from perimenopause symptoms
If reaching perimenopause has triggered unwanted symptoms, you don’t have to suffer through them. Here’s what can help:
Look for a pattern
Whether you use a notebook, your phone or a cycle tracking app, logging your perimenopause symptoms can help you and your doctor come up with a plan to better manage them. “Track your symptoms so you can spot patterns and discuss them with your clinician,” adds Dr. Mysore.
Get moving
Movement can ease many perimenopause symptoms naturally. “Prioritize strength training and movement that supports your changing body,” says Dr. Shepherd. “Building and maintaining muscle mass is critical for metabolism, bone density and overall function. Combine this with short high-intensity intervals, mobility work and mindful recovery to support heart, brain and hormonal health.”
Be open to different treatment options
Exploring additional support in the form of menopausal hormone therapy can make a real difference. “Consider evidence-based treatments like hormone therapy, non-hormonal medications or supplements if appropriate—but always do this consultation with a licensed healthcare provider,” says Dr. Mysore.
Tips for navigating perimenopause with confidence
Approaching perimenopause can feel overwhelming, and being in it can be frustrating. But here’s what matters: You’re not powerless. “While the changes perimenopause and menopause bring can be startling and disruptive, it can also inspire women to reinvent themselves and who they want to be in this phase of life,” says Dr. Shepherd.
By understanding what’s happening in your body, you’re already equipped to advocate for yourself, make informed choices about your health and move through this transition with confidence.
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