What Are the Symptoms of Menopause?

Navigating the journey of menopause can be challenging as it brings a myriad of distinct symptoms that affect both body and mind, each one a testament to the complex natural progression of this significant phase of life.

Perimenopause, which means ‘around menopause’ and menopause are both transitional phases in a woman’s reproductive cycle. Perimenopause is the stage before menopause when hormones start to fluctuate and many women start to experience menopause like symptoms.

Menopause, when the ovaries produce no eggs and your periods stop, is categorised as when you haven’t had a period for 12 consecutive months. Most women will be in their early 50s when they reach menopause, with the average age being 51.

Many of the menopause symptoms can occur in perimenopause, and it’s very likely there will be an overlap of symptoms.

Women will differ both in the symptoms they experience, when they experience them, and for how long. One symptom might disappear, only to come back again down the line.

Surgical, medical or induced menopause

Some women will go through menopause earlier than they would have naturally because of treatment for a medical condition. This ‘cold turkey’ menopause can cause sudden shifts within the body’s hormone levels within days and weeks, rather than years.

The 4 symptomatic groups of menopause

The full list of menopause symptoms is separated into the following four symptomatic groups:

  • Psychological

    As well as bringing many physical changes, menopause also has a big impact on our mind and emotions. Lower hormone levels can alter how we feel and affect our mental well-being. Symptoms can include low mood and mood swings, panic attacks, low self-esteem, a lack of confidence,
    anxiety, and anger.

  • Physical (Somatic)

    Changing hormone levels can affect literally every part of your body, from joint pain to headaches, aching muscles, sleep disturbances, itchy skin, and more. We can also experience a change in body shape and weight gain.

  • Vasomotor

    Hot flushes, night sweats, cold sweats, chills, and heart palpitations fall under the category of vasomotor symptoms, mostly triggered by blood vessels dilating or contracting. During perimenopause and menopause, when hormone levels change, your body becomes more sensitive to temperature variations, leading to disruptions in your internal temperature regulation.

  • Sexual and Urogenital

    Declining estrogen can cause sexual, vaginal, and urinary symptoms including dryness, itching, irritation, low libido, and painful sex. Also, frequent urination or incontinence due to a weak pelvic floor.

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Comprehensive Checklist of Perimenopause and Menopause Symptoms

Not Feeling Yourself

Although 'not feeling yourself' or 'feeling out of balance' are not clinical symptoms on their own, they are common ways many women describe the general sense of discomfort or imbalance associated with hormonal changes during perimenopause and menopause.

Hot Flushes

One of the most common symtoms of perimenopause and menopause. A sudden and intense feelings of heat, especially in the face, neck, and chest, accompanied by sweating and rapid heartbeat. Some women have chills instead of or after a hot flush.

Night Sweats

Hot flushes that occur at night. Episodes of excessive sweating during sleep, you may wake up dripping in sweat, have soaking wet bedding, and be shivering cold.

Worsening PMS

It's not uncommon to notice more intense premenstrual syndrome (PMS) symptoms due to hormonal fluctuations as the body transitions towards menopause, including more severe mood swings, bloating, fatigue, and other PMS-related symptoms.

Inflammation

The hormone estrogen has anti-inflammatory effects in the body, so when estrogen levels decline during perimenopause and menopause, it can lead to increased inflammatory responses. This can contribute to conditions like frozen shoulders and cause general ‘unexplained’ aches and pains.

Sleep Disturbances

Broken sleep is one of the most common symptoms of the menopause transition, with irregular or disrupted sleep patterns making it challenging to get a restful night’s sleep. Hormonal fluctuations can interfere with the body's sleep-wake cycle, leading to difficulty staying asleep and frequent awakenings, leaving you feeling exhausted the next day.

Restless Legs

Restless legs syndrome is the uncontrollable urge to move your legs, often accompanied by uncomfortable sensations. Hormonal changes particularly fluctuations in estrogen levels can affect nerve function and muscle control making it tricky to get a restful sleep.

Insomnia

Insomnia refers to the repeated pattern of having real difficulty falling or staying asleep. Reduced hormone levels, especially during perimenopause and menopause often disrupt sleep patterns, leading to chronic sleeplessness and fatigue.

Nighttime Anxiety

The feeling of heightened worry and unease that occurs primarily at night is mostly driven by decreased levels of estrogen and progesterone, which affect the nervous system and mood regulation, leading to increased anxiety and difficulty relaxing before bed.

Restlessness

Restlessness is a feeling of agitation and an inability to relax, making it difficult to fall asleep. This can be caused by hormonal imbalances, especially decreased progesterone, which impacts overall mood, energy levels, and the ability to unwind at night.

Decreased Libido

A reduced libido is a common symptom, mainly attributed to lower levels of estrogen and testosterone. This decrease can affect sexual thoughts and the physical response to sexual stimulation. Howevere, other symptoms can have a direct impact on libido, including fatigue, mood changes, and insomnia.

Lack of Desire

Lack of desire stems from hormonal shifts, but can also be influenced by emotional and psychological factors, such as stress, anxiety, relationship changes, and a negative body image. This symptom can also result from physical discomforts like vaginal dryness and soreness, making sexual activity less appealing.

Vaginal Dryness

Reduced estrogen leads to decreased blood flow and natural lubrication in the vaginal area, leading to dryness and discomfort when having sex. Lower hormone levels also cause the vaginal tissues to become thinner and more at risk of tears and inflammation.

Vaginal/Vulval Soreness

Soreness around the vagina or vulva during the menopause transition can be caused by changes in hormone levels that affect the delicate skin and tissues in this area. Reduced estrogen can lead to increased sensitivity and irritation, causing soreness and discomfort, often exacerbated by physical activities or friction from clothing.

Fatigue

For some women, menopause fatigue can be extreme and feel almost debilitating. It can be characterised by a feeling of constant tiredness or exhaustion, reduced energy levels, and difficulty maintaining daily activities.

Reduced Motivation

Many women experience ‘feeling flat’ or a lack motivation at somepoint during the menopause transition. Hormonal changes can lead to low energy, and decreased enthusiasm for daily tasks and personal goals, impacting productivity in both work and personal life.

Mental Slowdown (Mental Fatigue)

Mental slowdown, or "mental fatigue," is often experienced as levels of estrogen and testosterone start to decline. This can result in decreased mental alertness, slower cognitive processing, and an overall sense of tiredness or fatigue.

Difficulty Concentrating

Difficulty concentrating can be extremely frustrating, and in addition to decreased hormone levels, this lack of concentration is further exacerbated when we’re tired or fatigued.

Weight Gain

Many women experience weight gain during menopause due to several factors, including lower amounts of physical activity, mood changes and eating habits, and hormonal changes that can slow metabolism and redistribute fat.

Mood Swings

Emotional fluctuations are common during perimenopause and menopause. Unpredictable shifts in mood that can cause you to feel suddenly sad, weepy, or angry, even when those feelings are not related to life events.

Anxiety

Perimenopause and menopause can bring about can bring about feelings of anxiety, characterised by uneasiness, restlessness, nervousness, or worry. It can often be one of the first symptoms women notice and can come and go as the hormones fluctuate.

Low Confidence

Some women experience lower confidence levels during perimenopause and menopause due to hormones fluctuating and coping with the physical and emotional symptoms, which can reduce self-esteem.

Depression

Depression is a mood disorder that can manifest during the menopause transition as a decline in estrogen affects your happy hormones, dopamine, serotonin, and norepinephrine. You may experience persistent feelings of sadness, fatigue, and disinterest in daily activities. Life changes and stress can be contributing factors, and if you've experienced bouts of low moods in the past, evidence indicates you may be more likely to have mood-related symptoms during menopause. Always talk to your doctor if you are concerned.

If you find your regular doctor is unsympathetic, seek out a specialist menopause or women’s health doctor.

Brain Fog

For many women in perimenopause and menopause, brain fog becomes a frequent, unwanted companion, characterised by a sense of mental cloudiness or confusion that leads to difficulties in thinking clearly, making decisions, or feeling mentally sharp.

Memory Issues

Memory issues mostly stem from fluctuating hormone levels, particularly estrogen, which affects neurotransmitters involved in memory retention. Forgetfulness or trouble recalling names and dates is experienced by most women in some stage of menopause.

Reduced Mental Clarity

Reduced mental clarity can make everyday tasks feel more challenging, as your thoughts may seem sluggish or less precise. You might find it harder to process information quickly or make decisions as efficiently as before.

Reduced Focus

Changes in hormone levels affect cognitive function, impacting your ability to stay focused. You may find it harder to stay engaged in activities, concentrate on work projects, or follow through with daily tasks.

Word Finding Difficulty

Word finding difficulty, or 'word wobbles' involves struggling to recall specific words during conversations, often referred to as "tip-of-the-tongue" moments. This symptom is linked to the decline in estrogen, which plays a crucial role in language and cognitive processing.

Dry Skin

Estrogen plays an important role in maintaining the skin's natural hydration mechanisms, so when levels decline, the skin can feel dry, tight, flaky, or itchy.

Joint Pain

Estrogen plays an important role in decreasing inflammation and keeping joints lubricated. As a result, when estrogen levels are low, you're prone to more joint aches and pains.

Bloating and Digestive Changes

Bloating, water retention, gassiness, and slower digestion can all be experienced for a number of reasons, including anxiety and stress. Lowering hormones can also affect our microbiome, which can cause changes in digestion.

Irregular Periods

Throughout the menopausal transition, it is normal to have irregular or missed periods and changes in flow, which can be either lighter or heavier. Eventually, periods will stop entirely.

Hair Loss or Thinning

During menopause, lower hormone levels can cause the hair follicles to shrink; the hair grows slower, which leads to reduced hair density and hair loss.

Breast Tenderness

Breast tenderness, experienced mostly during perimenopause, can involve soreness, sensitivity, or discomfort in the breast tissue resulting from hormonal changes and fluctuations.

Brittle Nails

As we go through the stages of menopause, our bodies may produce less keratin, which is needed for strong nails. Lower keratin levels can lead to weak, brittle nails that break more easily.

Changes in Body Odor

All stages of menopause can bring changes in body odour, primarily due to hormonal fluctuations that can affect sweat production and skin bacteria. Some women notice their sweat smells stronger, which can be exacerbated by hot flushes and night sweats.

Gum Problems

Hormonal changes can affect our oral health, leading to gum problems, including gum sensitivity, receding gums, bleeding, or discomfort.

Electric Shocks

Some women may experience sensations that resemble electric shocks during perimneopause and menopause, often described as brief, sharp, tingling sensations. These may occur in various parts of the body and are thought to be related to hormonal fluctuations in the nervous system.

Tingling Extremities

Tingling sensations, particularly in the hands, feet, arms, and legs, can be a symptom of both perimenopause and menopause, brought on by hormonal changes affecting the central nervous system and typically lasting only a couple of minutes at a time.

Increased Allergies

During the menopause transition, you may experience spikes in histamine, the chemical that causes allergic reactions, which can lead to new or worsening allergy symptoms

Heart Palpitations

Palpitations are caused by fluctuating estrogen levels, which can influence the heart's electrical impulse pathways. It can feel like your heartbeat is irregular or beating faster than usual; some describe it as a fluttering sensation, while others feel like their heart is racing out of control.

Itchy Skin

Estrogen plays an important role in collagen production and keeping our skin hydrated, so when estrogen declines, you may experience skin irritation, dryness, and itching sensations anywhere on the body.

Osteoporosis Risk

As women age, we're at an increased risk of bone density loss, which is again linked to the decline in estrogen. In some cases, this can lead to osteoporosis, which causes the bones to become weaker and break more easily.

Urinary Incontinence

Changes in hormone levels as we transition through the stages of menopause can cause the vaginal tissues to become thinner and the pelvic and bladder muscles to become weaker. This is a common symptom, and you may experience the need to urinate morefrequently, or experience leakage, especially when sneezing, coughing, or laughing.

Burning Mouth or Tongue

Our mouths contain lots of estrogen receptors, so it's not surprising that many women will experience symptoms around the mouth and tongue. These can include a feeling of bunring, tingling, tenderness, heat, or even a numbing sensation.

Dry Eyes

You may experience drier eyes that can feel itchy and sore as estrogen levels drop. And even though the eyes feel dry, it's not uncommon to have excessive tear production too.

Changes in Taste

Some women find foods can taste different when hormones are no longer in balance and affecting their taste buds. You may find flavours stronger or experience a metallic taste in the mouth.

Gum Bleeding

Hormonal changes can make gums more susceptible to irritation and inflammation, which can often result in the gums bleeding when brushing teeth.

Changes in Body Shape

Menopause can bring about changes in body shape, typically characterised by an increase in abdominal fat. Hormonal shifts can affect fat distribution, often leading to a more centralised weight gain pattern.

Cold Flushes

Cold flushes are sudden waves of chills that can make you shiver uncontrollably, even in warm weather. These chills are caused by fluctuations in your body’s temperature regulation due to changes in estrogen levels, which can affect how your body senses and responds to temperature.

Dizziness

Feeling lightheaded is a surprisingly common symptom during perimenopause and menopause. Fluctuating levels of estrogen, progesterone, and testosterone can affect how your blood vessels widen and narrow, leading to feelings of light-headedness and dizziness. These hormones can also impact the balance centers in your brain and inner ear, contributing to these sensations.

Collagen Loss

During all stages of menopause, you'll notice your skin becoming less firm and more prone to wrinkles. This is mostly due to your body’s production of collagen decreasing as estrogen levels drop. Estrogen helps stimulate collagen production, so lower levels mean your skin starts to lose some of its elasticity.

Unwanted Hair Growth

A change in the ratio of estrogen to testosterone levels can stimulate hair growth, causing unwanted hair to start growing on the upper lip, chin, cheeks, and jawline.

Acne

Acne can reappear during perimenopause and menopause due to hormonal changes that increase oil production in your skin. As estrogen levels drop, the ratio of male hormones (androgens) becomes relatively higher, which may make your skin more prone to breakouts.

Reflux

Around 50% of perimenopausal and menopausal women experience heartburn, also known as acid reflux. Fluctuating estrogen levels can alter the amount of acid your stomach produces, leading to a burning sensation in the chest and throat as stomach acid moves up into the esophagus.

Sun Sensitivity

Increased sun sensitivity is very common during the menopause transition. As estrogen levels drop, the skin becomes thinner and more reactive, producing less melanin (the pigment that protects the skin from UV rays). This can lead to redness, itching, and prickly-heat type rashes after sun exposure.

Rosacea

Flushing is a common symptom of menopause caused by hormonal changes. It can also be a sign of rosacea, a condition where the blood vessels in the skin become overly reactive, leading to redness and visible blood vessels. Rosacea is more common in women, especially during perimenopause when hormones are fluctuating.

Muscle Loss

Reduced estrogen and testosterone levels make it harder for your body to build and maintain muscle. Both hormones help keep muscles strong, so when their levels drop, muscles can become weaker and smaller.

How many symptoms will I experience?

We understand that the list of symptoms can seem overwhelming. What's important to remember is that most of us won't experience all of them. Each woman's journey through perimenopause and menopause is unique, with her own combination, frequency, and severity of symptoms. You may experience just a few and even others that aren’t on this list.

Because hormone receptors are distributed throughout the body, perimenopause and menopause can affect both the brain and the body in numerous ways. In fact, recent studies suggest there may be potentially more than 100 different symptoms.

Treatments for menopause symptoms

The good news is that the majority of symptoms can be treated effectively, be it with prescribed menopause medications, support from natural remedies, lifestyle changes, eating well, or practicing self-care, which, whether alone or combined, can all have a big impact on how you are feeling.

Remember, there's no right or wrong; just whatever works for you.

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