Symptoms of Menopause

Depressed woman
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Menopause, or more accurately perimenopause, is the time when your body begins to react to dropping levels of estrogen and other hormones. Every woman will experience this differently, so your menopause may not be the same as your friend’s. But some menopause symptoms are very common, some are less common, and some are serious and should not be ignored. Here's a list of things you may notice as you enter menopause.

Frequent Symptoms

For many women, the symptoms of menopause are mild, while others find them bothersome. These are ones commonly reported.

Menstrual Irregularities

Often the first symptom of impending menopause is a change in the length of your cycle. It may be longer between periods, shorter between periods, or a combination of the two.

Hot Flashes and Night Sweats

A hot flash is a sensation of “flushing,” or a sudden feeling of heat, often accompanied by sweating. When this occurs during sleep, it's called night sweats. Hot flashes are the menopause symptom most often mentioned by women—about 75 percent of women will experience them as they go through menopause. While they tend to peak one year after menopause, some women experience them for several years. Night sweats can disrupt your sleep, which can have an impact on your overall health and wellness.

Vaginal Dryness and Urinary Problems

This symptom is also one for which women seek help. As estrogen is less available, the walls of the bladder, urethra, and vagina become drier and less flexible. This makes the tissue more easily damaged and more prone to infection.

Some of the symptoms of this loss of elasticity include:

  • Pain or bleeding with sexual activity
  • Vaginal dryness or burning
  • Urinary incontinence
  • More frequent bladder infections
  • Burning or urgency with urination
  • Watery vaginal discharge

Mood Swings

As estrogen and progesterone decline, some women describe themselves as “emotional.” They report being more easily triggered into strong emotional responses such as sadness, anger, irritability or delight. Because they see themselves as suddenly unpredictable, women find this unsettling and are likely to seek help for this symptom.

Headaches

Both migraines and tension headaches may increase during menopause. Since migraine headaches are vascular in nature, and since the vascular system is more unstable during menopause, migraines can become more frequent and difficult to manage.

Insomnia

Many women report a greater tendency to be wakeful. Sometimes this is due to night sweats and sometimes due to neurological excitability, both of which are more common during menopause. Once awake, they find it difficult to go back to sleep and can suffer from sleep deprivation as a result.

Weight Gain

Your metabolism will slow with age, so weight gain is common in menopause. The combination of changing patterns of fat deposit, less muscle mass, and a slower metabolism can give you a larger abdomen and “flabby” arms and legs that send you off to the gym for help.

Memory and Cognitive Changes

This symptom, too, is one that is distressing for women. While some loss of memory is normal with aging—especially word retrieval and short-term memory—if cognitive changes interfere with your ability to do everyday things, it’s a good idea to get them checked by your health care provider.

Fatigue

Some women experience a profound fatigue during menopause, though fortunately it's usually temporary, and is your body’s adjustment to lower estrogen. If fatigue prevents you from doing your daily activities, however—or if it lasts more than two months—see a health care provider to rule out other causes.

Decreased Libido

Many women notice that their sexual desire lessens when they become menopausal. Sometimes this is a temporary response to hormone shifts, while sometimes it's a reaction to other things like stressors or difficult life situations. If you notice that you desire sex less often or don’t seem to enjoy it, and this creates problems in your life or relationships, talk to your doctor or provider about possible treatments.​

Rare Symptoms

See your physician or medical provider if you experience any of the following more serious symptoms.

Heavy Bleeding

If you find that your periods are increasingly heavy and that you have to change your super tampon or maxi pad more than once an hour for eight hours, your bleeding may be damaging your health. Heavy bleeding can be a sign of fibroid tumors, uterine polyps or uterine cancer. It can also cause you to become anemic and should be evaluated by a medical professional.

High Blood Pressure

After the age of 50 women catch up with men in the "heart disease" department. High blood pressure might be the first sign that your cardiovascular system is beginning to show some wear and tear. As your estrogen decreases, the walls of your blood vessels may become less flexible. This can cause your blood pressure to rise, which is a risk factor for stroke and heart disease. Blood pressure can climb slowly, unannounced. Or it can suddenly be quite high, without any obvious symptoms.

When you begin to see signs of menopause, get your blood pressure checked at least every six months. You can do it at a local drug store, fire station, or your doctor’s office, but try to have it done at the same place each time so you can compare it reliably.

See your healthcare provider right away if you find you are having:

  • Headaches that are more often or severe than usual
  • Trouble with your vision
  • Unusual fatigue
  • Problems with breathing, either at rest or after exercise
  • Any sort of chest pain
  • Lightheadedness or fainting
  • Periods of confusion
  • Blood in your urine

While these are obvious signs of a problem, high blood pressure can also have no symptoms at all. Again, as you approach the age of menopause, have your blood pressure screened regularly so you can get treatment at the first signs of concern.

Heart Palpitations

Some occasional heart palpitations or irregular beats can be normal during the time around menopause. But if they are happening frequently, or are accompanied by troubled breathing, fainting, chest pain, anxiety, or nausea, they could be signs of heart disease or a heart attack.

Depression

The hormone changes in menopause can trigger depression, especially if you have a personal or family history of it. Even if you have not had problems with depression in the past, the stresses and hormone shifts that come at this time of life can overwhelm your ability to cope. Sometimes the combination of situations and hormones will send you into depression despite your best efforts to manage your mood.

Make an appointment with your healthcare provider if you notice that you:

  • Cry more than usual
  • Feel hopeless or overwhelmingly anxious
  • Have thoughts about dying or hurting yourself
  • Can’t enjoy things you used to, including sex
  • Lose your appetite
  • Have a weight gain or loss that you can’t really explain
  • Are irritable or angry more than usual

Confide in a close friend or family member when you suspect that you may be depressed. If you need a little moral support to see a doctor or counselor, ask your friend, husband or partner to go with you to the first appointment.

Less Common Symptoms

Since menopause will have its own effect on your body and system, there are many symptoms that you may notice during this time. Women have reported many unusual ways that their body responds to the change in hormones, including:

  • Low blood pressure
  • Dizziness
  • Ringing in the ears (tinnitus)
  • Asthma
  • Aching joints and muscles
  • Bizarre dreams
  • Indigestion
  • Hair loss
  • Burning sensation in the mouth
  • Change in breath odor or “bad taste” in the mouth
  • Change in body odor
  • Unusual neurological experiences like “creepy crawly” feelings in the skin, tingling, numbness, itching, “electric shocks”

If you experience any of these, check with your healthcare provider to see whether it's a side effect of menopause or something more serious.

Complications/Sub-Group Indications

The usual age for naturally-occurring menopause is 52, with the normal range being between 40 and 58. There are additional concerns for those who don't fit this profile:

  • Premature Menopause: If you go into menopause before age 40, it is considered to be abnormal. Autoimmune disorders are often associated with premature menopause, and going into menopause at this early age puts you at increased risk of osteoporosis.
  • Induced Menopause: If you have an injury to or removal of your ovaries, you can go into menopause abruptly. This often results in more intense menopausal symptoms.

After menopause, a woman's risk of cardiovascular disease increases. Unfortunately, this is the leading cause of death for women. You will need to pay attention to managing your risks for cardiovascular disease. That means ensuring you get enough exercise, maintain a healthy weight, and eat a heart-healthy diet. If you have high cholesterol or high blood pressure, talk to your doctor about how to manage those conditions.

Menopause leads to rapid loss of bone density, especially in the first few years. This can lead to osteoporosis and increase your risk of breaking your hip, wrist, or spine. Be sure that your bone density is assessed and you take medications and supplements as advised by your doctor.

If you are already being treated for depression, anxiety, or any mood disorder, you may have increased symptoms during perimenopause. Talk to your doctor to see if you need additional therapy or adjustments to your medications.

When to See the Doctor/Go to the Hospital

While a hot flash and heart palpitations may just be menopausal symptoms, call 911 if they are accompanied by signs such as chest pain, a burning sensation, difficulty breathing, sweating, fatigue, or sudden anxiety. In women, the signs of a heart attack can be different from the classic signs.

If you have any thoughts of harm to yourself or others, seek immediate help by calling the national suicide prevention lifeline at 1-800-273-8255 (TALK) or 911.

If you have any new or unusual symptoms, talk with your doctor to see if you need further evaluation. They may be due to an unrelated condition that should be fully diagnosed and treated.

A Word From Verywell

You will need time to adjust to and understand your “new” body and paying attention to symptoms can help you identify health issues early. Menopause is a great excuse to start taking good care of yourself with exercise, stress relief, a better diet, and ensuring you get all of your preventative health checks. Pamper yourself and look forward to your next stages of life.

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