Misophonia is NOT a Recognized Symptom of Perimenopause
Misophonia is not listed among the established symptoms of perimenopause according to current clinical guidelines, and there is no evidence linking these two conditions. 1, 2
Established Perimenopausal Symptoms
The symptoms consistently linked to the menopausal transition based on current evidence include only: 1
- Vasomotor symptoms (hot flashes and night sweats) 1, 2
- Atrophic vaginitis (vaginal dryness, dyspareunia, urinary urgency) 1
- Sleep disturbances 1, 3
- Depression and mood disturbances 1, 3
- Sexual dysfunction and reduced libido 1
- Cognitive dysfunction (brain fog) 4
Notably, guidelines explicitly state that "only vasomotor symptoms, atrophic vaginitis, dyspareunia, sleep disturbances and depression are consistently linked to the menopause transition, on the basis of currently available evidence." 1
What Misophonia Actually Is
Misophonia is a distinct condition characterized by intense emotional reactions (anger, rage, anxiety, disgust) to specific sounds, particularly human-generated noises like chewing, pen clicking, or lip smacking. 5, 6 It produces autonomic arousal responses and has been studied as a potential discrete psychiatric disorder, not as a hormonal or menopausal symptom. 5, 6
Clinical Approach for Your Patient
If a perimenopausal woman presents with sound sensitivity concerns:
- Evaluate for established perimenopausal symptoms including anxiety and depression, which are recognized menopausal symptoms and can co-occur with misophonia 1, 7
- Screen for anxiety disorders specifically, as misophonia severity correlates most strongly with anxiety symptoms 7
- Consider that misophonia, if present, is a separate condition requiring its own evaluation and management, potentially with acceptance and commitment therapy (ACT) 8
- Rule out other medical causes such as thyroid disease before attributing symptoms to perimenopause 1, 2
Important Caveat
While anxiety and mood disturbances do increase during perimenopause 3, and misophonia can be associated with anxiety 7, this does not make misophonia itself a perimenopausal symptom. The temporal association would be coincidental rather than causative.