What Are The 34 Symptoms of Menopause?
When you think of a woman going through menopause, you might think of symptoms like hot flashes, vaginal dryness, or mood swings.
These symptoms receive a lot of attention due to the fact that there are over-the-counter and prescription drug remedies designed especially to target them. However, the symptoms of menopause are actually far more complex than these companies let on!
In total, there are 34 different symptoms that can be attributed to menopause. A woman going through menopause might experience some or all of these symptoms, ranging from mild to severe.
Read on to learn more about the menopause process and how it might affect a woman’s health and well-being.
The 34 Symptoms of Menopause
The average age of menopause is 51. Menopause refers to a period in a woman’s life when she stops having a menstrual period. Many people think that a woman stops having her period overnight when in reality, menopause is a process that can last for years.
The period leading up to menopause is known as “perimenopause.” Most women begin perimenopause in their 40s. Some women may experience so few symptoms that they do not realize they have entered perimenopause (you can also still get pregnant during this time). However, for others, symptoms can be severe and life-altering.
There are a total of 34 symptoms that can signify the arrival of menopause, which range from mild to disabling in nature.
1. Irregular Periods
Irregular periods are often a woman’s first sign that she has entered perimenopause.
A normal period lasts three to seven days and occurs every 21 to 35 days. Periods are considered irregular if they occur more or less frequently than they are supposed to or if your menstrual flow is too heavy.
Your period might be irregular if you:
- Bleed through a regular tampon or pad more often than every two hours (menorrhagia)
- Do not have a menstrual period for at least three cycles (amenorrhea)
- Have menstrual periods that are more than 35 days apart (oligomenorrhea)
Irregular periods may be due to perimenopause, but can also signify other health conditions, so it is important to see a doctor to rule out anything serious.
2. Hot Flashes
Hot flashes plague 75 percent of perimenopausal woman, and last for an average of five years. During a hot flash, you may feel warm, appear flushed, perspire, and/or experience anxiety and rapid heart rate.
Doctors are unsure why women experience these temperature changes during perimenopause, but they probably owe to changing levels in hormones before and after menopause.
3. Night Sweats
Like hot flashes, night sweats are common in the period before and after menopause, leading many menopausal women to wake up in a tangle of soaked sheets. Most likely, night sweats also owe to hormonal changes during menopause.
Rarely, night sweats represent an underlying risk of heart disease or breast cancer. Your doctor can let you know if your night sweats are something to worry about, or simply due to the natural changes of menopause.
4. Loss of Libido
Due to decreasing levels of sex hormones like estrogen, progesterone, and testosterone, a menopausal woman’s sexual function may be diminished.
About 80 percent of menopausal women report experiencing a decrease in sexual desire. Unfortunately, this can have a negative impact on women’s intimate relationships.
Thankfully, certain lifestyle changes, such as using lubrication and starting an exercise program, can boost libido to counteract the effects of menopause.
5. Vaginal Dryness
According to a survey by Menopause Matters, half of all women between the ages of 51 and 60 experience vaginal dryness. Low levels of estrogen during menopause decrease the blood supply to the vagina, which leads to vaginal dryness and atrophy.
Vaginal dryness can make sexual activities painful. In turn, this can make it more difficult to become aroused and even lower libido by creating a neural pathway that links sex to pain.
Using high-quality lubricant and/or vaginal moisturizers can alleviate vaginal dryness to make sex less painful and more pleasurable.
6. Mood Swings
78 percent of women going through menopause experience mood swings. These drastic changes in mood occur because fluctuating levels of estrogen in the body also affect our levels of other neurohormones responsible for regulating mood.
Practicing healthy habits like exercise and good sleep hygiene can help stabilize your mood during menopause.
It’s not uncommon for women to experience increased anxiety during perimenopause and menopause. These mental changes might affect as many as one in three women.
It’s important to note that the increases in anxiety during menopause are typically mild. If you are having severe anxiety, see your doctor.
Therapy and medication, or a combination of the two, can help alleviate anxiety due to menopause or another cause altogether.
8. Panic Attacks
In addition to increased anxiety, some women also experience panic attacks during peri- and post-menopause.
Again, panic attacks due to menopause are often mild. If you are experiencing severe or frequent panic attacks, you should visit your doctor to rule out a full-blown panic disorder.
As with anxiety, therapy and medication can both play a role in alleviating panic attacks during menopause.
9. Brain Fog
Ever forget where you put your keys even though you just had them — or walk into a room only to forget why you went there in the first place?
During menopause, you may find these feelings increasing due to fluctuating levels of estrogen in the body. Estrogen helps support our cognitive functioning, meaning that hormonal changes before and after menopause can make you feel “fuzzy” or forgetful.
10. Difficulty Concentrating
In addition to impacting memory, menopause can also reduce your attention span and attention to detail.
Estrogen prompts the brain to burn glucose as energy. Declining levels of estrogen during menopause mean the brain no longer works as hard. In turn, you may find it more difficult to focus on your tasks.
During the period before and after menopause, you may find that you have a “shorter fuse” than usual. You might snap at your loved ones or lose your patience sooner than you once did.
Irritability during menopause often occurs due to, you guessed it, hormonal changes — but can also result from sleep problems during menopause. Practicing good sleep hygiene can improve the length and quality of your sleep to help promote a healthy, stable mood.
Compared with women under age 45, post-menopausal women are four times as likely to suffer from depression. When a woman is predisposed to depression, these feelings of sadness can become a full-blown depressive episode.
If you are experiencing severe or persistent symptoms of depression — such as low mood, fatigue, sleep disruptions, or suicidal ideation — you should always talk to your doctor.
13. Hair Loss
As you enter menopause, you may find that your hair becomes thinner, breaks more easily, or falls out more often than it used to.
The sex hormones estrogen and progesterone promote hair growth. Reduced levels of these hormones before and after menopause may lead to hair loss or thinning.
Unfortunately, hair loss during menopause is difficult to counteract. While it can impact a woman’s confidence, doctors do not consider hair loss during menopause worrisome.
During the period before and after menopause, you might feel more tired than usual. A persistent lack of energy and/or feelings of excessive tiredness is known as fatigue.
Fatigue might result from changing hormone levels, but can also be related to sleep disruptions during menopause. Menopause itself can keep you from getting a good night’s sleep — and symptoms like night sweats certainly don’t help!
15. Sleep Problems
According to the National Sleep Foundation, women report the most sleep problems from peri- to post-menopause. As many as 61 percent of menopausal women report symptoms of insomnia, the inability to fall or stay asleep.
Menopause itself may keep you up at night, but so can unpleasant symptoms of menopause like anxiety and hot flashes. Treating these symptoms can help you get a better night’s sleep, as can practicing good sleep hygiene.
Unexplained dizziness and/or vertigo frequently occur in women before and after menopause. These symptoms may occur due to the drop in estrogen levels, or due to symptoms like hot flashes and anxiety.
It’s important to note that dizziness can also signify the presence of other medical conditions. Visit your doctor to rule out dangerous health problems, such as hypertension, that can also cause dizzy spells.
Many women experience increased bloating during perimenopause.
As hormone levels fluctuate during perimenopause, higher levels of estrogen than usual can lead the body to retain water. This can lead to bloating. Thankfully, while it can be uncomfortable and embarrassing, bloating is usually not cause for worry.
18. Weight Gain
It’s normal for our bodies to change as we age. You might gain weight during perimenopause or menopause, as decreased levels of estrogen can slow your metabolism.
Women may especially notice increased belly fat during this time. Since excess belly fat can raise your risk of health conditions, such as cardiovascular disease, it’s important to pay attention to nutrition and exercise from peri- to post-menopause.
19. Stress Incontinence
Aging, childbirth, and decreased muscle mass can all weaken the pelvic floor muscles. As a result, menopausal women may experience stress incontinence: urine leakage that occurs when you laugh, sneeze, cough, or lift.
Kegel exercises to strengthen the pelvic floor may help combat stress incontinence during menopause. If your stress incontinence is severe or interferes with your quality of life, you may also consider pelvic floor physical therapy.
20. Brittle Nails
You may notice that your nails become more brittle or break more easily before and after menopause.
The body produces less keratin, collagen, and elastin — the three main substances that make up our nails — as our estrogen levels decrease. Lower levels of keratin, collagen, and elastin can result in dryness all over the body, but especially in the fingernails.
21. Irregular Heartbeat
Some women experience changes in their heartbeat, especially during perimenopause. These changes can include arrhythmias, increased heart rate, and palpitations.
For most women, these changes are non-threatening. However, they can also be caused by life-threatening cardiac conditions, so it’s important to visit your doctor if you experience noticeable changes in your heartbeat during menopause.
Sex hormones and the body’s immune system are closely linked. As a result, you might develop allergies to substances you never had a problem with before during menopause.
Keeping a food diary of the things you eat and the symptoms you experience can help you identify which foods might be triggering unpleasant reactions.
23. Body Odor
“What’s that smell?” is never a question you want to be asked, but changes in body odor during menopause should not be a cause for concern or embarrassment.
Some menopausal women find that they sweat more than usual or experience changes in their body odor. This occurs as a result of hormonal changes and is perfectly natural.
24. Headaches and Migraines
Aches and pains are common in the period surrounding menopause — especially headaches and migraines. Drops in estrogen before a woman’s menstrual period can trigger menstrual headaches or migraines, and fluctuating levels of estrogen during perimenopause can do the same.
If you suffered from headaches or migraines during your period, you might be more likely to experience them during perimenopause, too. Luckily, these pains tend to improve after menopause, when estrogen levels become more stable.
25. Breast Pain
Breast tenderness is another symptom many women deal with as a result of fluctuating estrogen levels throughout the menstrual cycle — or during menopause. Women may also find that their breasts appear less full after menopause when estrogen levels decrease.
Whether your breasts feel sore or you go down a bra size, breast changes surrounding menopause are not usually a cause for concern. However, if you are worried about breast pain or notice accompanying changes in your breast tissue, it never hurts to have it checked out by a doctor.
26. Joint Pain
Joint pain is common as we age. However, studies show that some women experience a special type of joint pain known as “menopausal arthritis.” This type of arthritis affects women at the onset of menopause and causes swelling, primarily in the fingers and wrists.
27. Burning Mouth
Estrogen plays an important role in the formation of saliva. As a result, some women develop Burning Mouth Syndrome (BMS) in response to decreased estrogen levels after menopause.
BMS can cause the sensation of a burning tongue or a metallic taste in your mouth. BMS can be caused by other conditions besides menopause, so you should visit your doctor if you experience symptoms.
28. Electric Shocks
Some women experience sudden, unpredictable shock sensations in the period surrounding menopause, especially at the onset of a hot flash.
Because estrogen plays an important role in the nervous system, it is thought that these electric shocks result from the misfiring of neurons in response to decreased levels of estrogen in the body.
29. Dental Problems
Dental problems affect an estimated 10 to 40 percent of women before and after menopause. Perimenopausal women are at higher risk of bone loss due to decreased levels of estrogen in the body. As a result, they may also experience receding gums and tooth decay.
Speaking of bone loss, women are also at higher risk of osteoporosis, especially after menopause. Some women experience a drastic 20 percent loss of bone density after menopause in response to lower levels of estrogen in the body.
Osteoporosis can be prevented by practicing weight-bearing exercises, eating a balanced diet, and, if okayed by your doctor, taking calcium and vitamin D supplements.
31. Digestive Problems
The digestive system is not immune to the effects of decreased estrogen during menopause. In response to lower levels of estrogen, the body produces more of the stress hormone cortisol.
Increased cortisol levels can cause digestive upset, including bloating, indigestion, abdominal pain, acid reflux, diarrhea, and constipation. Thankfully, good nutrition can support healthy digestion during menopause, and help ward off the worst of these symptoms.
Remember how we talked about increased dryness in the body due to lower levels of keratin, collagen, and elastin during menopause? In addition to affecting your fingernails, this process can also affect your skin.
Menopausal changes affecting collagen levels make your skin thinner and dryer. Unfortunately, this can also cause a persistent and uncomfortable sensation of itching all over your body.
33. Tingling Extremities
Unexplained tingling in the arms, legs, feet, and hands — known as paresthesia — can sometimes affect perimenopausal women. This sensation can be scary and uncomfortable but usually disappears after menopause.
While it is not usually a cause for concern, you should see a doctor if you experience paresthesia at any point. It can also be a symptom of more serious conditions affecting the nervous system.
34. Muscle Tension
Some menopausal women may feel like their muscles are tight or strained. Muscle tension surrounding menopause may be mild — or it may persist to the point of chronic pain. While muscle tension may relate to lower levels of estrogen, since estrogen regulates muscle cell energy, it is also closely linked to stress and anxiety.
✔️ Medically Reviewed by Banafsheh Kashani, MD, FACOG
Banafsheh Kashani, M.D., FACOG is a board-certified OB/GYN and specialist in reproductive endocrinology and infertility at Eden Fertility Centers, and has been treating couples and individuals with infertility since 2014. Prior to joining Eden Centers for Advanced Fertility, she was practicing as a top fertility specialist at Kaiser Permanente in Orange County and Reproductive Fertility Center. Dr. Kashani has received numerous awards throughout her years of study and medical training.
Dr. Kashani has conducted extensive research in female reproduction, with a specific focus on the endometrium and implantation. Additionally, Dr. Kashani has authored papers in the areas of fertility preservation, and fertility in women with PCOS and Turners syndrome. She also was part of a large SART-CORS study evaluating the trend in frozen embryo transfers and success rates.
Dr. Kashani is a fellow of the American Congress of Obstetricians and Gynecologists. In addition, she is a diplomat of the American Board of Obstetrics and Gynecology and an active member of the American Society of Reproductive Medicine (ASRM) and Pacific Coast Reproductive Society (PCRS). She is also a member of the Society of Reproductive Endocrinology and Infertility (SREI).