Journal / Menopause

What Are the Signs and Symptoms of Menopause?

Nancy L Belcher

Written by Nancy L Belcher Ph.D., MPA

Medically Reviewed by Dr. Green OB/GYN

Last updated March 23, 2023

What Are the Signs and Symptoms of Menopause?

Article Content 8 mins read

  • Am I Menopausal?
  • What is the Menopause Transition?
  • 28 Common Symptoms of Menopause:
  • What is HRT?
  • Conclusion

It can be hard to face the fact that menopause is around the corner or even already looking you squarely in the face. You may even notice early signs and symptoms of menopause. Unfortunately, our society has created a stigma around menopause, even though it’s a completely natural part of each woman’s life. It is commonly seen as a sign of getting old, losing fertility, waning opportunities, worsening health, and more. At Winona, we seek to transform that doomsday mentality about menopause into one where this stage is seen as a new and exciting opportunity for women to finally have control over their hormones and their lives.

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Am I Menopausal? 

The best way to identify where you are in your menopause transition (MT) is to know what signs and symptoms to look for. Women each have their own unique experiences, but there are many common symptoms that most women come across. This article will outline those symptoms and signs so you can better self-assess and then seek appropriate treatment.

What is the Menopause Transition?

The menopause transition comprises the phases of perimenopause, menopause, and postmenopause, and the entire period of time can span more than 20 years. The difference between perimenopause and menopause is whether or not you continue to have your period.

For most women, perimenopause begins in the late 30s - years before menses stops - and it can last from 1-10 years. Typically, women don’t recognize the symptoms of perimenopause until they are about 45, but by then, they’ve likely been in perimenopause for about 5 years. In perimenopause, the ovaries begin releasing less estrogen, progesterone, and testosterone, resulting in myriad symptoms we think of as “menopausal.” Once a woman has gone 12 months without a period, she is considered to be in menopause, and those symptoms will likely increase in severity. The postmenopausal phase is when some menopause symptoms slowly start to subside.

It’s hard to know exactly when a women will begin the menopause transition or move through its phases. The experiences of female family members are not necessarily good indicators of what someone will experience themself. Some begin their MT very early, while others still have a regular period into their late 50s; but on average, a woman reaches menopause at 51.

Whether you are in perimenopause or menopause, you can benefit from the same hormone treatments to address your symptoms. The MT is long, andyou deserve to find the right menopause treatment to provide relief and improve quality of life. In addition to discomfort from symptoms, untreated hormone imbalances can lead to some more serious long-term health complications like osteoporosis, heart disease, type 2 diabetes, and some forms of cancer.

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28 Common Symptoms of Menopause:

  1. Irregular or non-existent periods - During perimenopause, periods can be heavier or lighter than usual, shorter or longer than usual, and occasional spotting is not uncommon.

  2. Hot Flashes & night sweats - Hot flashes are one of the most recognized early symptoms of perimenopause and menopause. The hormones responsible for regulating the body’s temperature are out of whack, so the body can suddenly overheat, and you’ll experience heavy sweating. 

  3. Weight gain - Weight gain, especially around your middle, is caused by the drop in hormones. Replacing hormones, exercising, and maintaining a healthy diet can help combat the accumulation of belly fat.

  4. Anxiety & panic attacks - When estrogen drops, another hormone called cortisol increases. Cortisol is related to stress levels and anxiety. Anxiety affects a third of menopausal women and may contribute to panic attacks.

  5. Sleep problems - Insomnia is common in menopause, partially because of night sweats, and sometimes from anxiety. Dropping progesterone levels specifically can cause sleep disruptions. 

  6. Fatigue - The combination of sleep disturbances, anxiety, and low hormones can create exhaustion and fatigue. Supplementing hormones, especially testosterone, can help you regain energy.

  7. Fogginess, memory lapse, & concentration difficulties - Estrogen, progesterone, and testosterone are crucial for brain activity. As these hormone levels drop, so does the ability to focus and concentrate. Temporary forgetfulness is a common symptom, and memory lapse can be a combination of anxiety, sleep deprivation, and fatigue. Simple things like forgetting a person’s name or mixing up events and memories can be signs. Researchers have identified a correlation between brain fog and menopause, but these symptoms can be improved with hormone supplementation.

  8. Irritability & mood swings - As hormone levels drop, many women experience irritability and changes in mood. While these mood swings can feel similar to those you may have experienced with regular periods, these tend to be extreme and last longer.

  9. Vaginal atrophy, dryness, & painful sex - Vaginal atrophy is the thinning of the vaginal walls that can result from lower hormone levels. Estrogen, progesterone, and testosterone are responsible for vaginal lubrication, and during perimenopause and menopause, the natural lubrication of the vagina starts to wane. In addition to vaginal dryness, it is common for women to also experience burning, itching, and sometimes painful, uncomfortable sex. 

  10. Changes in libido - With the decrease in hormones, especially estrogen and testosterone, women report having decreased interest in sex. 

  11. Depression - One of the most worrisome symptoms of dropping hormone levels is depression. Studies show that women younger than 45 years are less likely to be depressed, compared to those who are older. 

  12. Dry, wrinkly, itchy skin - As estrogen, progesterone, and testosterone levels decrease during menopause, so does the production of collagen and fatty tissue. Collagen is a protein that strengthens your skin, and both collagen and fatty tissue keep skin moist and lubricated. 

  13. Achy muscles & joints - Estrogen and testosterone are responsible for strengthening bones and protecting them from inflammation, so when levels decrease, you can expect increased inflammation. This, in turn, leads to achy muscles and joints. Hormone replacement, yoga, and meditation can relieve stress and help to loosen muscles.

  14. Stress incontinence - The inability to control your bladder when you lift heavy items, laugh, or cough is called stress incontinence. The drop in testosterone, estrogen, and progesterone weakens the bladder and the adjoining muscles, resulting in leaks.

  15. Bloating & digestive problems - Gas, flatulence, bloating, nausea, and abdominal cramps all increase when estrogen drops and cortisol increases. Bloating is a common perimenopausal symptom, especially if it persists beyond the end of monthly menstruation.

  16. Breast tenderness - It is a common symptom of perimenopause to feel soreness in your breasts, similar to the experience during a period or pregnancy. 

  17. Headaches - The hormones released by the ovaries are related to headaches. If you experience(d) headaches during your periods, it is common to also get headaches during menopause. When hormone levels are held steady, headaches are likely to decrease. The hormone fluctuation during the MT explains an increase in frequency and severity of headaches.

  18. Burning tongue - Similar to how reduced estrogen can create dryness in the vagina, it can also reduce saliva production and create dry mouth. A burning tongue can result from this dryness.

  19. Mouth/gum problems - Gum problems during menopause can create a metallic taste in the mouth and decrease the ability to enjoy foods in the same way as before.

  20. Tingling in extremities - The decrease in hormones - especially estrogen - affects the central nervous system, which then relays signals to the rest of the body. The result can be tingling sensations in fingers and toes, as well as burning sensations and some numbness.

  21. Dizziness - Sudden, inexplicable dizziness is scary, but it is common with fluctuating hormones in perimenopause.

  22. Hair loss - While men are commonly known to lose hair as they age, hormonal changes can have the same effect for women. A drop in estrogen can lead to faster hair loss and brittle, dry hair that breaks more easily. 

  23. Brittle nails - Estrogen is responsible for keeping nails strong, but when it declines, nails weaken, which causes brittleness.

  24. Changes in body odor - The scent that you have long recognized as your natural body odor often changes when you reach menopause. This can be due to hormonal changes and frequent sweating associated with hot flashes, as well as skin dryness, vaginal changes, and anxiety.

  25. Allergies - It is common to develop new allergies in menopause, because hormones and the immune system are closely interlinked. 

  26. Irregular heartbeat - Similar to the tingling sensations you may experience during menopause, irregular heartbeats occur because the drop in hormones can cause neurons to misfire. It might feel like a flutter or palpitations. 

  27. UTIs - Decreased hormones make vaginal and urethral tissue lose elasticity and become thinner, which can result in more frequent UTIs.

  28. Osteoporosis - Estrogen maintains healthy and strong bones, so when your estrogen levels decrease during menopause, your bones can weaken and become more prone to fracture. Fortunately, this is preventable. 

While this is a long, daunting list of symptoms, all of them are easily treatable. Hormone Replacement Therapy (HRT) is an option to help make this transition a smooth and positive experience.

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What is HRT?

Hormone Replacement Therapy, is a natural medical treatment to alleviate the symptoms of menopause. In essence, HRT uses bioidentical hormones (functionally indistinguishable from what your body produces naturally) to help supplement your body with what it loses as you age. Because decreasing hormones is the number one cause of many various symptoms, augmenting your hormones is a straightforward way to find comprehensive relief. In addition to being the most recognized method for improving menopause symptoms, HRT also helps prevent future health issues brought on by low hormone levels, like osteoporosis, diabetes, and heart disease.


All women will have a unique experience with their menopause transition, but recognizing and understanding the most common signs and symptoms of menopause can help you manage and control this phase of life. While this is a totally normal development, the MT is not necessarily a smooth and comfortable journey. 

Fortunately, there are ways to treat the often-chronic symptoms that characterize this time. At Winona, we encourage women to think of menopause as a positive beginning that provides the opportunity to take preventive action against major health risks. We support women to try various treatment options to identify what works best for them, whether that be HRT, diet change, lifestyle changes, or all three! 

Let the Winona women’s health care experts work with you to help you feel and stay young and healthy and move through this time of life with grace and confidence.

“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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