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What Are the Signs and Symptoms of Menopause?

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Dr. Michael Green
Medically Reviewed byDr. Michael GreenMD, OB/GYN Chief Medical OfficerRead Bio
Written ByNancy BelcherPhD

Menopause is a natural phase in every woman's life that is often accompanied by apprehension, societal stigma, and for many a lack of knowledge or comprehension about what is occurring in the body. There are more than 100 symptoms associated with this stage of life, and many women may not recognize that what they’re experiencing is related to menopause. This article will explore how to identify this transition and discuss some of the more common real symptoms of menopause.

Understanding Menopause and the Menopause Transition

Menopause represents the cessation of a woman's menstrual cycles and therefore her fertility. This occurs on average around age 50-51 as the result of the steady decline in reproductive hormone production. This threshold is situated within something called the menopause transition (MT) that comprises three stages: perimenopause, menopause, and postmenopause.

The entirety of the MT can span as many as 20 years. When the hormones estrogen, progesterone, and testosterone begin to decline in the late 30s and early 40s, women enter perimenopause. This is generally when symptoms begin to present, and irregularity in menstruation is a main marker of this stage. The duration of perimenopause varies anywhere from 1-10 years. Menopause itself is identified as the point at which a woman has gone 12 consecutive months without a period. The remaining time following this milestone is considered postmenopause. 

Predicting the onset or duration of the menopause transition is challenging, as experiences differ among individuals, and familial patterns are not definitive indicators. For some women, perimenopausal symptoms intensify or diversify with menopause and improve in postmenopause. For other women, postmenopause doesn’t necessarily mean relief from symptoms. In addition to the symptoms being unpleasant, untreated declining hormones and hormonal imbalance can lead to long-term health concerns. That’s why treatment like hormone replacement therapy is beneficial for both symptom relief and preventive health.

While women's experiences may vary, there are several prevalent indicators that many women do encounter during the MT. The following are some of the more common symptoms that result from the decline of the reproductive hormones; recognizing these real symptoms of menopause can enable individuals to conduct a self-assessment of where they are in this transition and subsequently pursue suitable treatment options for relief and improved quality of life.

28 Common Symptoms of Menopause:

1. Irregular or non-existent periods: In perimenopause, periods may become heavier, longer, shorter, or intermittent. Menstruation eventually ceases entirely, marking the threshold of menopause.

2. Hot flashes and night sweats: Sudden and intense feelings of heat, often accompanied by excessive sweating, are common symptoms caused by hormonal fluctuations that affect the body’s ability to regulate temperature.

3. Weight gain or redistribution: Hormonal changes during menopause can contribute to weight gain, particularly around the abdomen.

4. Anxiety and panic attacks: Fluctuating hormone levels, particularly a decrease in estrogen, can contribute to increased anxiety and may lead to occasional panic attacks.

5. Sleep problems: Disrupted sleep patterns are very common during the MT, due to night sweats, increased anxiety, and other factors. This can lead to difficulties falling asleep or staying asleep and insomnia.

6. Fatigue and exhaustion: Hormonal imbalances, sleep disturbances, and psychological factors can contribute to feelings of fatigue and low energy levels during menopause.

7. Brain fog: Hormonal changes can impact cognitive function, resulting in difficulties with memory, concentration, and mental clarity.

8. Irritability and mood swings: Hormonal fluctuations affect neurotransmitters in the brain, which can lead to irritability, mood swings, and emotional instability.

9. Depression: Fluctuating hormone levels can affect the brain and contribute to feelings of sadness, hopelessness, and depression during menopause.

10. Vaginal atrophy, dryness, and painful sex: Declining estrogen levels can cause thinning and dryness of vaginal tissues, leading to discomfort, itching, and painful intercourse.

11. Changes in libido: Hormonal changes during menopause can impact sexual desire and arousal, thereby decreasing libido and sexual interest.

12. Urinary tract infections (UTIs): Declining hormone levels can affect the urinary tract, causing thinner and drier tissues and increasing the likelihood of UTIs.

13. Stress incontinence: Weakened pelvic floor muscles from declining hormones can result in stress incontinence, causing leakage of urine during activities like coughing, sneezing, or lifting.

14. Bloating and digestive problems: Hormonal imbalances can affect digestion and result in symptoms like bloating, gas, abdominal cramps, and changes in bowel movements.

15. Skin changes: Decreased estrogen and collagen can result in a loss of skin elasticity, dryness, increased wrinkles, and itching.

16. Joint pain: Hormonal changes can contribute to muscle and joint pain, inflammation, and increased susceptibility to aches and discomfort.

17. Breast tenderness: Hormonal fluctuations can cause breast tenderness or sensitivity in menopause, similar to that experienced during the menstrual cycle or during pregnancy.

18. Headaches: Hormonal changes can trigger headaches or migraines, which may increase in frequency or severity during menopause.

19. Burning tongue: Reduced estrogen levels can lead to dry mouth and a burning sensation on the tongue.

20. Mouth and gum problems: Hormonal changes can contribute to inflammation and bleeding of the gums, as well as altered taste sensations.

21. Tingling in extremities: Hormonal fluctuations may affect the central nervous system, leading to tingling sensations, burning, and numbness in the fingers and toes.

22. Dizziness: Fluctuating hormones can cause dizziness or lightheadedness, often attributed to changes in blood pressure and circulation.

23. Hair loss: Decreased estrogen levels can interrupt the hair growth cycle and quality of hair, resulting in thinning dry hair and increased hair loss.

24. Brittle nails: Hormonal changes can lead to weakened nails, causing them to become brittle and prone to breakage.

25. Changes in body odor: Hormonal shifts during menopause can actually alter natural body odor, potentially resulting in changes in scent perception.

26. Allergies: Hormones and the immune system are interconnected, and hormonal changes during menopause can lead to the development of new allergies or changes in existing allergies.

27. Irregular heartbeat: Hormonal imbalances can impact heart function and contribute to irregular heartbeats or heart palpitations.

28. Osteoporosis: Decreased estrogen levels during menopause can accelerate bone loss, increasing the risk of osteoporosis and fractures. Regular bone health assessments are crucial during this stage.

It's important to remember that menopausal symptoms can vary in severity and duration among individuals. Seeking medical advice can provide personalized treatment options and support for managing these symptoms effectively.

Hormone Replacement Therapy

Hormone Replacement Therapy (HRT) is a scientifically-supported medical approach for managing menopausal symptoms. It involves the use of bioidentical hormones, which are structurally identical to the hormones naturally produced by the body. By supplementing declining hormone levels, HRT effectively alleviates a range of menopause-related symptoms.

Besides symptom relief, HRT plays a crucial role in preventing potential health complications associated with low hormone levels, such as osteoporosis, diabetes, and heart disease. As the leading and widely-recognized method for addressing menopausal symptoms, HRT offers comprehensive relief and promotes long-term well-being. 


Understanding and recognizing the common signs and symptoms of menopause is crucial for women to effectively manage and navigate this unique phase of life. The symptoms discussed above range from commonly known, like hot flashes, to more unexpected, like dizziness or heart palpitations. That being said, all of these symptoms are understood to be commonly associated with declining hormones during the MT.

Because hormone imbalances in menopause come with more than discomfort, contributing to potential long-term health risks, it’s important to find the right treatment. Fortunately interventions like HRT are available to address the often-chronic symptoms associated with hormone imbalance in menopause and protect long-term health well beyond this transition.

“This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.”

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