Menopause Symptoms

Symptoms are primarily related to a lowered production of estrogen, and vary widely because of the many effects estrogen has on the female body. Estrogen regulates the menstrual cycle and affects the reproductive tract, the urinary tract, the heart and blood vessels, bones, breasts, skin, hair, mucous membranes, pelvic muscles, and the brain. The symptoms of menopause start to appear before the one-year anniversary of your final period.

Common Menopause Symptoms

Changes in Menstrual Cycle

Your periods may become irregular: more or less frequently than is typical for you, shorter or longer in duration, and you might bleed more or less than usual. See a doctor if your periods start coming very close together, you have unusually heavy bleeding, you are spotting, or if your periods last more than a week. A missed period may indicate the start of menopause, but it can also be a sign of pregnancy, so make sure to take a pregnancy test to rule that out. If you experience any spotting once your periods have stopped for 12 continuous months, talk to your doctor to rule out any serious conditions, such as cancer.

Hot Flashes

Hot flashes can be a sudden feeling of heat in the upper portion of your body or all over your body. Your face and neck may turn red, and you may feel sweaty or flushed. A hot flash can be mild or very strong, even waking you from sleep. Usually a hot flash lasts between 30 seconds and 10 minutes. Most women experience hot flashes for a year or two after their final menstrual period. Some will have them for longer, but they will always decrease over time.

Approximately three out of four menopausal women experience hot flashes. Treatment is usually not necessary, but it is available. If hot flashes are disrupting your daily life, you can explore, with your doctor’s help, options such as lifestyle changes, prescription medications, and other remedies.

Read about other causes of hot flashes.

Vaginal Dryness and/or Pain with Intercourse

Hormonal changes can affect the thin layer of moisture coating your vaginal walls. The amount of this moisture and its consistency can change with age. Dryness can occur at any age, but it is a particular problem for menopausal women. Signs may include itching around the vaginal opening as well as stinging or burning. This condition can make intercourse painful or uncomfortable. You may experience light bleeding with sex and the desire to urinate frequently. See a doctor if your symptoms are not relieved by over-the-counter treatments such as vaginal moisturizers for dryness and water-based lubricants for intercourse.

Learn about other causes of vaginal dryness.

Insomnia or Disrupted Sleep Patterns

Doctors recommend seven to eight hours of sleep each night for adults. During menopause, you may have trouble falling and/or staying asleep. You may also have trouble going back to sleep if you wake up during the night. Using relaxation techniques and exercising during the day can aid in getting a good night’s rest. 

Read about other causes of insomnia. 

Frequent Urination or Urinary Incontinence

Loss of bladder control or the need to urinate frequently can occur during menopause because the tissues in your vagina and urethra lose their elasticity and the lining thins. The surrounding pelvic muscles may also weaken. This can cause more frequent urination, urgency even when the bladder isn’t full, and painful urination. If these become a problem, seek medical advice. Treatments, such as medications and pelvic floor muscle exercises, are available.

Learn about other causes of frequent urination.

Urinary Tract Infections

Some women may experience an increase in the number of urinary tract infections (UTIs) they contract during menopause. The lack of estrogen causes changes in the urinary tract and makes it more susceptible to infection. If you experience a persistent urge to urinate or a burning sensation when you urinate, visit your doctor. He or she will most likely analyze a urine specimen and may treat you with a round of antibiotics.

Decreased Libido

During menopause, some women experience a decreased interest in sex or a difficulty in becoming aroused. This is primarily due to physiological changes caused by the lowered estrogen production that is associated with menopause: delayed clitoral reaction time, slow or absent orgasmic response, and diminished or absent vaginal lubrication. There are many over-the-counter and prescription treatments that can help menopausal women with decreased libido continue to live a satisfying sexual life.

Read about other causes of decreased libido.

Vaginal Atrophy

A decline in the production of estrogen can cause the vaginal walls to thin out and to become inflamed. This condition is called vaginal atrophy. It can make sexual intercourse painful, which in turn can lead to a lowered interest in sex. Fortunately, vaginal atrophy can be successfully treated with either over-the-counter lubricants or, in more severe cases, prescription treatments that include localized estrogen therapy, such as an estrogen cream or vaginal ring.

Depression and Mood Swings

The unpredictable hormone fluctuation that comes along with menopause, along with life stresses, concerns about body image, sexuality, and aging can cause instability in a woman’s mood as she goes through menopause. Menopausal women may experience periods of irritability, or go from extreme highs to severe lows in a short period of time. Women going through menopause may also experience long period of “feeling blue,” or even become depressed.

Learn about other causes of mood swings and depression. 

Skin and Other Tissue Changes

Your skin often becomes drier as you age. You may experience loss of fatty tissue and collagen under your skin as well as in areas near your vagina and urinary tract. Your skin may look looser and thinner as a result. Thinning hair is also a common change.

Read about other causes of dry skin.

Forgetfulness

Some women experience problems with memory and focus during midlife, but recent studies suggest that forgetfulness or “fuzzy thinking” are not directly connected to menopause.

Learn about other causes of forgetfulness.

Other Potential Symptoms

• abdominal bloating
• anxiety
• breast pain/tenderness
• chills
• cold sweats
• depression
• dizziness
• excessive and unpredictable sweating (diaphoresis)
• faintness
• headache
• night sweats
• thinning hair

Other Potential Causes of Menopausal Symptoms

Chemotherapy and Radiation Therapy

Cancer therapies can induce temporary menopausal symptoms during treatment or within three to six months. Chemotherapy can cause a loss of estrogen production, leading to the thinning and inflammation of the vaginal walls (also known as vaginal atrophy) and vaginal dryness. Some doctors may prescribe estrogen replacement therapy (also called hormone therapy) to reduce these effects. Women with breast or ovarian cancer, which can be hormone sensitive, should discuss this type of treatment thoroughly with their doctors.

Primary Ovarian Insufficiency (POI)

This condition can occur when a woman’s body does not produce normal levels of reproductive hormones (estrogen), resulting in menopause-like symptoms. Approximately one percent of women experience POI and most of these women are infertile. However, all women and girls who go through POI still have immature eggs in their ovaries. Therefore, though POI may cause symptoms similar to menopause, it is not the same as premature menopause. Women with primary ovarian insufficiency may have irregular periods for years, and may even get pregnant.