What are the 34 symptoms of menopause and, more importantly, will you experience all of them?
If you've noticed some irregular periods or unexpected hot flashes, then you might be wondering if they're signs of menopause. Whatsmore, if they are signs of menopause, does this mean another 32 menopause symptoms are waiting to wash over you like a midlife tsunami?
During perimenopause (the stage of menopause when period patterns change and your estrogen levels decrease) and menopause (the cessation of your periods), it's natural to feel a little nervous about what lies ahead.
Read on to learn about 34 common symptoms of menopause and how you can prepare for all and any menopause symptoms that come your way.
When will menopause symptoms begin?
The process of menopause typically begins between 45 and 55 years of age. During this time, menstrual periods become irregular and then stop altogether due to reduced levels of estrogen and progesterone hormones.
Perimenopause means that your body is preparing for menopause and that the hormones relating to menstruation and ovulation are decreasing.
Menopause, alternatively, means that you are no longer ovulating and that your periods have stopped. Once you have not had a period for a year, you are considered postmenopausal.
Why does menopause cause so many symptoms?
When reproductive hormones, like estrogen, slow down, it's not just your period and ovulation that are affected. Changes in these hormone levels can lead to a slew of seemingly unrelated symptoms, like sleep disturbances, headaches, and even dry mouth.
This is because estrogen, a hormone produced by the ovaries, doesn't just regulate your reproductive organs. Estrogen affects and helps regulate many, many organs and systems within the body, including the brain, the heart and vascular systems, bones, skin, hair, and breast tissue, to name a few.
While your adrenal glands and fat cells produce small amounts of estrogen, the ovaries contribute the most of this hormone to the body. As such, during menopause, when the ovaries produce less or stop producing estrogen, the entire body can feel the effects.
For many people, the transition from perimenopause to menopause can last between two and eight years, so it's a good idea to both learn about possible symptoms and prepare yourself to manage them!
Who will experience significant symptoms of menopause?
Just because there are many symptoms of menopause doesn't mean you will have all of them! The experience of menopause is unique to each woman, in much the same way that puberty is unique.
Some women will experience a range of symptoms that affect their lifestyles, while others may sail through perimenopause and into postmenopause without a blip.
So, what percentage of women experience no significant symptoms of menopause? According to Jean Hailes, an Australian non-profit that researches women's health issues, around:
- 20% of women will have no menopause symptoms
- 60% experience will experience mild to moderate menopause symptoms
- 20% will experience severe menopause symptoms that impact their daily life
Are there really 34 symptoms of menopause?
What makes 34 the 'magic number' of menopause symptoms? Well, this is a bit of a myth! Some people say there are 34 symptoms of menopause; others say there are 66, and some say there are 100!
The reality is menopause can affect the brain, body, emotions in a myriad of ways. Some we know and study extensively (like hot flashes and insomnia), and some are less understood or not yet pin-pointed as being menopause-related.
While there are at least 34 symptoms related to menopause (which we'll discuss below), research shows three primary symptom areas are proven to relate to menopause. These include:
- Vasomotor symptoms: these are symptoms that relate to the constriction or dilation of blood vessels. Common symptoms include hot flashes, night sweats, blood pressure changes, and heart palpitations.
- Dryness and dyspareunia (painful sex) symptoms: Because estrogen helps maintain vaginal lubrication and elasticity, the reduction of estrogen during menopause can lead to a "dry" vaginal feeling, which can cause discomfort irritation, and painful intercourse.
Interestingly, dryness during menopause does not just affect the vagina. The reduction in estrogen can cause a similar dry feeling on your skin, your mouth, and even your eyes due to a decrease in androgen hormones.
- Difficulty sleeping/insomnia symptoms: Once again, changing estrogen levels are thought to be at the center of these kinds of symptoms. Varying estrogen levels may affect our sleep-wake cycles, and bring about vasomotor symptoms (such as night sweats) and psychological symptoms (like anxiety) that can prevent us from getting a good night's sleep.
34 Symptoms of Menopause
The most common menopause symptoms include:
1. Irregular periods
A hallmark of oncoming menopause is irregular periods. This is because the natural decline in estrogen means that your ovaries may not release an egg every month or may not release an egg at around the same time each month.
Other changes to your period may include:
- Heavier or lighter bleeding
- Skipped periods
- Getting periods at irregular intervals (even if your period used to arrive every 28 days like clockwork).
Learn more about irregular periods and menopause here.
2. Hot flashes
More than 80% of women will experience hot flashes brought on by menopause. Hot flashes are sudden sensations of warmth, heat, sweating, flushing, anxiety, and chills lasting around 1-5 minutes (though much longer for some people).
Even though hot flashes can be uncomfortable and may interfere with a woman's sleep and daily activities, studies show that only one in four women with menopausal hot flashes seek medical help.
Learn more about hot flashes and how hypnotherapy can help manage them here.
3. Night sweats
Night sweats are hot flashes that occur at night. Also known as 'sleep hyperhidrosis,' night sweats are generally benign but can affect the quality of your sleep.
During a night sweat, your body temperature rapidly increases, then is followed by excessive sweating. When you wake from a night sweat, you may feel chilled instead of hot, as the intense sweating can soak bed sheets.
Learn more about night sweat causes and management tools here.
Insomnia means that you may have trouble falling asleep or staying asleep long enough to have a restful night.
Over 50% of perimenopausal and menopausal women experience insomnia. One study even suggests that one in four women with sleep difficulties deal with severe enough symptoms to impact their daytime functioning.
Learn some healthy sleep hygiene tips that may help insomnia symptoms here.
5. Vaginal dryness
Vaginal dryness can be a common symptom of changing hormones during menopause. While this irritating symptom is not frequently discussed, it affects more women than you might think!
A study completed by SWAN, which included data from over 2,400 women over 17 years, showed that around one in five women aged 42-53 years old and over, and one in three women aged 57 to 69 years experience vaginal dryness.
Learn more about vaginal dryness and sexual health in menopause here.
6. Mood swings
Just like you may have experienced with premenstrual syndrome, sudden changes in emotions, also known as mood swings, can also be common during menopause.
Many factors can affect your mood during menopause, including changes in hormones or fatigue brought on by menopausal insomnia.
Learn healthy sleep hygiene tips that may help keep mood swings at bay here.
7. Weight gain
Between 45 and 55 years old, women typically gain about half a kilo (a little over a pound) a year. While hormone fluctuations may contribute to weight changes, hormones alone are not to blame.
A drop in muscle mass as we age can also slow your metabolism. In fact, muscle mass is said to decline by 3% to 8% every decade after our 30s.
Learn more about staying healthy during menopause here.
Common psychological symptoms:
8. Memory lapses
Can't remember where you put your keys or is your neighbor's name stuck at the tip of your tongue? Don't worry, memory lapses are a common symptom of menopause (and pregnancy, for that matter!).
Hormones are once again at the heart of this symptom as reduced levels of estrogen can affect brain functioning and cause lapses in memory.
Menopause can increase your risk of depression as well as clinical depressive disorders.
It's not uncommon to feel depressed during this stage of life, especially when you're juggling a busy life alongside difficult vasomotor symptoms (hot flashes/night sweats), sleep problems, and hormone fluctuations.
Depressive symptoms during menopause may also be linked with your family history of depression.
If you're feeling depressed during menopause, there is no reason to go it alone. Reach out to a friend, family member, or professional to talk about your feelings and get help.
Changes in estrogen and progesterone levels during menopause may also lead to feelings of anxiety.
Feelings of fear, dread, or nervous anticipation are common (even about things that may not actually happen!). These anxious feelings usually go away in time without medical intervention.
If you start to feel extreme levels of anxiety, however, then you may want to seek professional help.
11. Panic disorder
Unlike mild anxiety, sudden heightened periods of extreme anxiety might be a sign of a panic disorder, also known as 'panic attacks.'
Symptoms of a panic attack include chest pain, dizziness, heart palpitations, and shortness of breath. Physical symptoms can be accompanied by feeling "out of control" or that you're "losing your mind."
Occasionally, panic attacks can be triggered by hot flashes. There are many ways to manage panic disorder symptoms, including stress reduction, counseling, and/or certain medications.
Feeling irritable during menopause? It's understandable. Even if you're not feeling depressed or anxious, it's natural (and pretty normal) to feel easily irritated during menopause.
One reason for this is that another common menopause symptom, insomnia, is linked with changes in mood such as increased anger and irritability.
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Fatigue during menopause can be the result of changing hormone levels, such as estrogen and progesterone, and changes to thyroid and adrenal hormones.
In a 2007 study, over 85% of postmenopausal women and 46% of perimenopausal women reported feeling physical and mental exhaustion compared with just under 20% of pre-menopausal women!
14. Brain Fog
Around 60% of women report experiencing "brain fog" or "brain fades" once they reach menopause. Unlike sudden lapses in memory, like forgetting someone's name, brain fog is often described as a "spaced out" feeling whereby you can't concentrate properly or maintain your train of thought.
Brain fog may be caused by changes in estrogen, which in turn can impact cognitive function. Changes in cognitive function may also be exacerbated by poor sleep and other social stressors common during this stage of life.
Sexual health changes:
15. Decreased libido
Decreased libido (also known as a reduced desire for sex) can happen during menopause. This can be caused by lower levels of estrogens and androgens, which can decrease sexual arousal.
Decreased libido may also be a side effect of other menopausal symptoms, such as reduced vaginal lubrication, dyspareunia (painful sex), or low mood, which can all (understandably) make the idea of sex less appealing.
Learn more about sex and menopause here.
Other physical symptoms:
16. Paresthesia (Tingling or 'pins and needles')
Though less common than hot flashes, another symptom of menopause is paresthesia, also known as an unusual tingling or prickling sensation (sometimes called 'pins and needles'). Paresthesia is frequently felt in the extremities, such as the arms, hands, legs, and feet.
While this tingling sensation can be unnerving, menopause-related paresthesia is usually benign but in some cases can be a sign of an underlying condition, so be sure to speak to your healthcare practitioner.
17. Burning mouth
A bizarre and frustrating symptom of menopause includes burning mouth syndrome. As you might have guessed, this condition is defined by a burning sensation within the mouth, similar to a burning feeling you might get after drinking a scalding hot cup of tea.
The scientific community is still learning about this condition and how best to manage it during menopause. It's commonly treated with pain relief and numbing agents.
18. Electric shock sensations
In addition to tingling feelings, women going through menopause sometimes report electric shock sensations. While this symptom needs more research to be fully understood, it's believed that these "electric" jolts occur due to hormonal changes affecting your nervous system. Talk to your doctor as there could be underlying conditions.
Itchy skin, also known as pruritus, is a common symptom of menopause. Once again, it's thought that changing levels of estrogen may be the cause of this irritating menopause issue.
Estrogen helps maintain healthy skin, so when hormone levels drop, it reduces the skin's ability to produce natural moisturizing oils, which leads to an itchy feeling.
Aches and pains:
20. Joint pain
Menopausal status is associated with the experience of achy or stiff joints. This kind of pain is most often felt in the hands, knees, elbows, or neck and can cause old injuries to begin aching again.
Joint pain can happen during menopause because estrogen helps reduce inflammation in the body. So, as estrogen levels decline, joint inflammation can increase and cause pain or discomfort.
21. Muscle tension and aches
It's normal to feel a little bit of muscle soreness or tension from time to time at any age; however, it can be particularly common during menopause with 1 in 6 women reporting daily aches and pains.
This can be due to many factors, including poor sleep, heightened stress or anxiety, and reduced estrogen levels.
22. Breast tenderness
Tenderness or breast pain (also known as mastalgia) is common throughout many stages of a woman's life — it can appear as a sign of premenstrual syndrome, pregnancy, or menopause.
Painful or tender breasts during menopause can feel different from breast pain you've felt before and may be experienced as an aching feeling, tenderness, a burning sensation, or even sharp stabbing pain.
It's worth noting that breast pain or tenderness is not often associated with an increased risk of breast cancer. That being said, if you do notice any changes in your breasts, make sure you check in with a doctor.
Headaches or migraines are a common side-effect of menopause. This is because estrogen and progesterone not only regulate your sex organs they also affect chemicals in the brain that can spark a headache.
Additionally, headaches during menopause may be brought on or worsened by other symptoms of menopause, including poor sleep and stress.
24. Food sensitivities/IBS (Irritable bowel syndrome)
Menopause may be linked to new food sensitivities or even IBS (irritable bowel syndrome).
Animal studies suggest that IBS symptoms may start during menopause due to changes in hormone levels. Estrogen is said to help manage visceral sensitivity (the sensitivity of the digestive tract) and intestinal function, so as levels drop, changes within your gut function may occur.
Learn more about menopause and IBS here.
25. Food Cravings
Feel like something sweet or can't stop thinking about carbs? Just as you may have experienced during PMS, fluctuating hormone levels can lead to you craving 'pick-me-up' foods in the form of refined carbs or sugars.
This may be due to changing hormone levels, as research shows high estrogen levels in the brain are linked with feelings of fullness and satiety after eating.
26. Changes in taste
During menopause, you may notice changes in how certain foods taste. This isn't in your mind!
Research suggests that there may be a significant reduction in how postmenopausal women perceive the taste of sugar (sucrose) due, in part, to reduced saliva production and dysesthesia (burning sensation in the mouth).
Changes in taste may also lead to an increased preference for sweeter foods.
While bloating may be caused by diet and lifestyle choices (such as drinking carbonated drinks or being sedentary), bloating has also been associated with menopause.
One reason that you might experience bloating is that fluctuating levels of estrogen and progesterone are known to increase fluid retention, which, in turn, is known to increase bloating.
28. Thinning hair
More hair on your brush and less luscious locks on your head? This could also be a sign of menopause. Hair can thin during this transition period due to lower levels of estrogen and progesterone and higher levels of testosterone.
If you've noticed thinning or breaking hair, you're not alone. Research shows that by the time women are 70 years old, over 1 in 3 will experience female-pattern hair loss.
29. Brittle nails
Just as your hair can change during menopause, women may also notice that their nails become soft, dry, or brittle (easily breakable) during this time of life.
In addition to estrogen changes affecting moisture levels in nails, menopause is also linked with calcium deficiencies, which can also cause nails to become brittle.
Research into women over 60 years of age shows that over a third have brittle nails.
30. Bladder incontinence
During menopause, you might start to notice bladder incontinence (an involuntary release of urine), especially when you cough, sneeze, or laugh.
If you're experiencing bladder problems, there's no need for embarrassment! In fact, over 50% of postmenopausal women will experience bladder incontinence.
The cause of bladder problems during menopause can be due to lower levels of estrogen thinning out the lining of your urethra, weakening pelvic floor muscles, or reduced elasticity of the bladder, which can lead to an 'overactive' bladder.
31. Dizzy spells
While dizziness is a common symptom of menopause, exactly why this happens is unknown.
One study, looking at the cause of dizziness in menopausal women in Japan, linked dizziness with menopausal anxiety.
While uncommon, some women find that new allergies may appear, or old allergies may worsen, during menopause.
Menopausal allergies have been linked with lower estrogen levels leading to increased histamine production.
A condition commonly linked with menopause is osteoporosis, in which bones reduce in density and can fracture more easily.
During menopause, women will, on average, lose around 10% of their bone mass. Again, lower estrogen may be at the heart of this problem, as when estrogen levels drop, the body breaks down more bone than it creates.
34. Irregular heartbeat
Another symptom of menopause can be heart palpitations (a fluttering sensation or the feeling of your heart pounding faster than normal).
While the sensation of a fluttering heart might be unnerving, heart palpitations during menopause are not thought to be dangerous.
How to manage menopause symptoms without HRT during menopause
While many symptoms of menopause are caused by changing hormones, you don't necessarily have to start hormone replacement therapy (HRT) to find relief.
Hypnotherapy has been clinically proven to manage some of the more troubling symptoms of menopause, like hot flashes, anxiety, and insomnia. Some women choose to use hypnotherapy alone to soothe symptoms, while others prefer to use it as a complementary management tool to accompany hormone replacement.
While hypnotherapy might be less well known than HRT, it is remarkably effective. Hypnotherapy for menopause has been shown to improve symptoms and has been proven to reduce hot flashes by up to 74%.
Learn more about hypnotherapy and how it can help you manage menopause symptoms here.
The Wrap Up
While some people believe there are 34 definitive signs of menopause, there may actually be more! Estrogen affects multiple bodily functions and organs, and as such, science is still learning about all the ways the body reacts and changes during menopause.
To find relief from menopause symptoms, some women may choose medical interventions, such as hormone replacement therapy. However, if you're looking for a drug-free or a combination management plan, you may wish to look into other effective management tools, such as hypnotherapy.