What is menopause?

Most of the symptoms associated with menopause actually happen during the perimenopause stage. Some women go through menopause without any complications or unpleasant symptoms. But others find menopausal symptoms debilitating, beginning even during perimenopause and lasting for years.

The symptoms that women experience are primarily related to a lowered production of the female sex hormones estrogen and progesterone. Symptoms vary widely because of the many effects that these hormones have on the female body.

Estrogen regulates the menstrual cycle and affects the following parts of the body:

  • reproductive system
  • urinary tract
  • heart
  • blood vessels
  • bones
  • breasts
  • skin
  • hair
  • mucous membranes
  • pelvic muscles
  • brain

Your period may not be as regular as it used to be. You may bleed heavier or lighter than usual, and occasionally spot. Also, your period may be shorter or longer in duration.

If you do miss your period, make sure to rule out pregnancy. If you’re not pregnant, a missed period could indicate the onset of menopause. If you do begin spotting after not having your period for 12 consecutive months, make sure to talk to your doctor to rule out any serious conditions, such as cancer.

Many women complain of hot flashes as a primary menopause symptom. Hot flashes can be a sudden feeling of heat either in the upper portion of your body or all over. Your face and neck might turn red, and you may feel sweaty or flushed.

The intensity of a hot flash can range from mild to very strong, even waking you from sleep. A hot flash generally lasts between 30 seconds and 10 minutes, according to the National Institute on Aging. Most women experience hot flashes for a year or two after their final menstrual period. Hot flashes may still continue after menopause, but they lessen in intensity over time.

Most women have hot flashes during menopause. Call your doctor if your hot flashes disrupt your life. They can recommend treatment options for you.

The decreased production of estrogen and progesterone can affect the thin layer of moisture that coats the vaginal walls. Women can experience vaginal dryness at any age, but it can be a particular problem for women going through menopause.

Signs can include itching around the vulva and stinging or burning. Vaginal dryness can make intercourse painful and may cause you to feel like you need to urinate frequently. To combat dryness, try a water-based lubricant or a vaginal moisturizer.

If you still feel discomfort, talk to your doctor. Having sex or other sexual activity involving the female genitals can increase blood flow to that area. This helps keep the vagina more lubricated and also may prevent the vagina from becoming smaller.

For optimal health, doctors recommend adults get seven to eight hours of sleep each night. But during menopause it might be hard for you to fall asleep or stay asleep. You might wake up earlier than you wish and have trouble going to back to sleep.

To get as much rest as you can, try relaxation and breathing techniques. It’s also important to exercise during the day so that you’re tired once you hit the sheets. Avoid leaving your computer or cell phone near your bed as lights can disrupt your sleep. Bathing, reading, or listening to mellow music before bed may help you relax.

Simple steps to improve sleep hygiene include going to bed at the same time every night, taking steps to stay cool while sleeping, and avoiding foods and drinks that alter sleep like chocolate, caffeine, or alcohol.

It’s common for women in menopause to lose control of their bladder. You may also feel a constant need to urinate even without a full bladder, or experience painful urination. This is because during menopause, the tissues in your vagina and urethra lose their elasticity and the lining thins. The surrounding pelvic muscles may also weaken.

To fight urinary incontinence, abstain from too much alcohol, stay hydrated, and strengthen your pelvic floor with Kegel exercises. If the issues persist, ask your doctor what medications are available.

During menopause, some women may experience more urinary tract infections (UTIs). Lowered levels of estrogen and changes in the urinary tract make you more susceptible to infection.

If you feel a persistent urge to urinate, are urinating more frequently, or feel a burning sensation when you urinate, see your doctor. Your doctor will likely ask that you take a urine test and give you antibiotics.

It’s common to feel less interested in sex during menopause. This is caused by physical changes brought on by reduced estrogen. These changes can include a delayed clitoral reaction time, slow or absent orgasmic response, and vaginal dryness.

Some women may have more interest in sex as they age. If your desire is decreased related to another problem, such as painful sex, your doctor may be able to prescribe a medication to help prevent pain. If the decrease in sexual desire bothers you, talk to your doctor.

Vaginal atrophy is a condition caused by the decline in estrogen production and characterized by the thinning and inflammation of the vaginal walls. The condition can make sexual intercourse painful for women, which can ultimately decrease their interest in sex. Over-the-counter (OTC) lubricants or prescription treatments that include localized estrogen therapy, such as an estrogen cream or a vaginal ring, can treat the condition.

Changes in hormone production affect the moods of women during menopause. Some women report feelings of irritability, depression, and mood swings, and often go from extreme highs to severe lows in a short period of time. It’s important to remember that these hormone fluctuations affect your brain and that “feeling blue” is not unnatural.

As you age, you will experience changes in your skin and hair. Loss of fatty tissue and collagen will make your skin drier and thinner, and will affect the elasticity and lubrication of the skin near your vagina and urinary tract. Reduced estrogen may contribute to hair loss or cause your hair to feel brittle and dry. Make sure to avoid harsh chemical hair treatments, which can cause further damage.

Menopause symptoms can last for months or years depending on the person. Schedule regular appointments with your doctor so they can monitor your health and answer any questions you may have about menopause symptoms.


When should you see a doctor about your menopause symptoms?

Anonymous patient


You should see your doctor anytime the signs or symptoms you have are making daily living difficult. Examples may include poor sleep and fatigue during the day, feelings of depression or anxiety, or problems with sexual activity. Anytime you have bleeding after sex, or bleeding after 12 months of no periods, make an appointment to see your healthcare provider. There are women’s health providers that specialize in management of menopausal symptoms.

Kim Dishman, MSN, WHNP-BC, RNC-OBAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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