The top 12 symptoms of menopause

The entire menopause transition can last for years, which means you might be dealing with menopause symptoms for a long time. Some of these changes are mildly uncomfortable or annoying — like dry eyes or having to pee more often — while others can be more serious, creating a ripple effect on your health and quality of life. Here, find info on the most common signs of menopause, some of which may be a bit surprising.

Not only is this a symptom of perimenopause, it’s often the symptoms women notice first since estrogen levels determine your menstrual schedule and rate of bleeding. Periods may be shorter or last longer than they have before, they may happen more or less frequently, or you might experience heavier or lighter bleeding.

Up to 80 percent of women will experience hot flushes and night sweats at some point during menopause, and 10 percent will have them very frequently (think: more than seven a day). They occur because estrogen is involved in the body’s temperature regulation. When hormone levels change wildly, as they do during the menopause transition, that can lead to sudden and intense temperature shifts.
Dive deeper into hot flushes.

Estrogen helps maintain the elasticity and thickness of the vaginal lining, and promotes lubrication, in addition to prompting a healthy balance of bacteria within the vagina. So when estrogen levels drop during menopause, you may experience itching, burning, and painful sex as your vaginal tissue loses moisture.

Emotions like stress, anxiety, tearfulness, and irritability can become more intense during menopause — partly due to there being estrogen receptors in your brain affected by the lower hormone levels and partly due to other factors like disrupted sleep.

"Handling different emotions during this time can feel overwhelming, especially as you address the physical effects happening at the same time," says Dr. G. Thomas Ruiz, M.D., lead OB/GYN at MemorialCare Orange Coast Medical Centre in Fountain Valley, CA. "However, being more proactive with healthy behaviours may ease some of those emotional impacts."

With night sweats causing you to lurch awake at 3 a.m. in soaked pajamas, it’s no wonder many women report poor sleep during menopause. Sleep difficulties may be prompted by other issues as well, such as stress, anxiety, and depression. Menopause also impacts melatonin production, which then can cause changes to your sleep/wake cycle.
Understand more about menopause and sleep.

Estrogen helps maintain the strength of the bladder and its surrounding tissue, so when levels decline, it can lead to bladder weakness. The result: feeling like you suddenly need to urinate or having leakage while exercising, laughing, or sneezing. You may also notice you have to use the bathroom more often and get more urinary tract infections.

"One of the most notable changes during menopause can be weight gain, particularly in the abdominal area," says Dr. Kecia Gaither, M.D., an OB/GYN and director of perinatal services and maternal fetal medicine at NYC Health + Hospitals in New York City. This happens, in part, because aging prompts a downshift in the metabolism, which allows for more fat to accumulate. Why the belly, though? It's mainly about the hormones, Gaither adds. Reduction in your estrogen and progesterone production causes fat to be stored around the waist more frequently compared to other body areas like the hips or thighs, she says.

More than a third of women in perimenopause or menopause report sexual challenges, from lack of interest in intimacy to trouble climaxing. In part, this is physical, since you’re experiencing reduced blood flow to your genitals while lower estrogen levels in the brain affect release of dopamine — the hormone connected to reward and pleasure. There can be a psychological component as well, since mood changes and bodily changes might make you feel less desirable.

You walk into a room to get something and then forget why, or it takes you longer to remember the name of a childhood friend. This is indicative of "brain fog," which is characterised by challenges with concentration, recall, and problem-solving. Menopause can prompt this issue since some parts of the brain that are involved with verbal memory rely on estrogen receptors.

Find out more about menopause-related brain fog.

Hormonal changes don't just affect what's going on inside your head — they can also affect what's happening on the outside of it. Estrogen is involved in stimulating your hair follicles, so menopause can lead to thinning, loss of volume, and changes in hair texture.

You may notice your joints and muscles feel aching even if you haven't worked out, or you could experience stiffness or weakness you haven't had before. Much like other menopause symptoms, issues with joints and muscles are often tied to declining estrogen, according to Dr. Natasha Trentacosta, M.D., sports medicine specialist and orthopedic surgeon at Cedars-Sinai Orthopaedics in Los Angeles, CA. That's because estrogen plays a role in protecting the cartilage in joints and keeping inflammation in check. When estrogen drops, the joints lose some of their "shock absorber" protection, which can affect muscles as well.

Estrogen plays a role in regulating heart rhythm, so you may feel a sensation like a fluttering or pounding in the chest, or that your heartbeat feels more noticeable than it has before. These palpitations can also be brought on by anxiety or the temperature spikes of hot flushes.

“On their own, palpitations are not considered dangerous, especially if they happen only occasionally or are connected to a symptom like hot flushes, which tend to last for only a few minutes each,” says Ruiz. “However, if they’re happening frequently or seem to be getting worse, it's important to check in with your doctor.”

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