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Lesser-Known Menopause Symptoms

Dr. Michael Green
Medically Reviewed byDr. Michael GreenMD, OB/GYN Chief Medical Officer
Updated12/09/24
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If you are wondering if you are in perimenopause and waiting for the hot flashes or for your periods to completely stop, you may not be using the best methods to really know. There are lesser-known perimenopause symptoms. What about your hair? How’s it doing? Thinner, maybe even bald spots? We get it.

While we know perimenopause and menopause are inevitable, the lesser-known menopause symptoms are not always obvious. Once the symptoms start, there is a lot we can do to prevent them from continuing. If you are like most of us, you expect some hot flashes and a bit of crankiness, but that is about it, right? Wrong.  Let’s talk about the countless other symptoms of peri- and menopause.

Perimenopause and Menopause?

If you’re between the ages of 35-65, and maybe even younger, you are likely suffering symptoms related to aging and decreasing hormones associated with perimenopause and menopause. 

Perimenopause starts as estrogen, progesterone, and testosterone levels drop with age; typically in your late 30s and throughout your 40s and 50s. Perimenopause is when the hormones really start to drop, and you can start to notice symptoms that most of us try to ignore. While ignoring symptoms is a strategy, it won’t help you feel better. By taking hormone replacement therapy (HRT), you can feel and look better. Furthermore, you can prevent some of the chronic medical problems associated with low hormones like heart disease, stroke, and some kinds of cancer. So, it’s worth evaluating your symptoms and making sure your hormones aren’t dropping too low.

During perimenopause, you may notice your periods start to become irregular, along with some other unpleasant physical and emotional changes like weight gain, thinning hair, anxiety, depression, vaginal dryness,  sleep deprivation, and even body odor. We can try to think these things are due to something other than aging and hormones, but it’s worth appropriately attributing the causes. It’s the loss of hormones. Hormone replacement  (HRT) can help with so many of these symptoms, and can help live a happier, healthier life. 

What are Some of the Lesser-Known Symptoms of Perimenopause?

Menopause is spread out over a very long time, for some 20 years or more!  It can sometimes be so gradual that you don’t notice how bad it has become. For some women, menopause comes with many minor symptoms that result in major changes. Some women have only a little discomfort, while others may be slammed with multiple symptoms. Because these symptoms occur and escalate gradually over time you may not even be aware of them – but they may be adversely impacting your life. Most likely, these symptoms are linked to low hormones.

Most menopausal changes are caused by the decline of three hormones; estrogen, progesterone, and testosterone. Progesterone and estrogen, produced by the ovaries, not only prepare your body for reproduction during childbearing years, but also impact the rest of your body’s health, both physically and emotionally. During menopause, testosterone levels also decrease.

The most common symptoms of menopause:

  • Hot flashes and night sweats: Those unexpected moments of intense heat that raise skin temperature and cause flushing are hot flashes. When this happens during sleep, they are called night sweats. Not only do they wake you up but the excess perspiration means you may have to get up and change clothing or even bedding.

  • Mood swings: Depleting hormones affect the production of the critical mood-regulating neurotransmitter in your brain called ‘dopamine.’ The misfiring of neurotransmitters can cause mood swings like depression, panic disorder, and anxiety attacks.

  • Vaginal dryness and atrophy: As estrogen and testosterone decrease, so does the body’s natural lubrication. The vagina tissues will likely become drier, thinner, less elastic, irritated, and itchy. Sex can become less interesting – even painful – which would likely lead to even lowering arousal and libido.

  • Complete end to your periods: After 12 months of missed periods, your ovaries will start to shrink and won’t produce eggs any longer.

Some of the lesser-known menopause symptoms are:

  • Anxiety & mental capacity: Forgetfulness, fogginess and confusion,  and difficulty concentrating. When some hormones drop, others can rise and create new problems. Decreases of estrogen and progesterone impact another hormone, ‘cortisol’ that is the stress hormone. If cortisol is not kept in check, emotions can become erratic, brain fog and slower cognitive skill function are common.

  • Thinning or loss of hair: When hormones are not balanced, some hormones can start to take control. We know that men go bald when there’s too much testosterone. Women suffer the same problem if estrogen and progesterone drop and testosterone isn’t balanced. You may notice bald patches, thinning, and undesirable ‘peach fuzz’ may develop on your face. 

  • Brittle fingernails: The fluctuating hormones can create dry, thin, brittle fingernails.

  • Change in body odor: So many things can lead to this symptom: 1) Urinary or fecal odors arising from incontinence, 2) Pungent perspiration from hot flashes and night sweats, 3) Hormonal fluctuations affecting the vaginal pH and lubrication, producing a ‘fishy’ odor which can cause noticeable, unpleasant smells. All of these things contributions to body odor are associated with a drop in your hormones with age. 

  • Voice changes: As estrogen and progesterone drop and testosterone levels are thrown off, hoarseness, lowered pitch, and menopause voice change can occur. It is often overlooked as a menopausal symptom. For singers, people that speak all day (think teachers), and performers this can be a serious problem. 

  • Sleep problems: Dwindling hormones can trigger sleep disturbances like insomnia, waking up too early, or sleeping too long. This kind of disrupted, uneven sleep can lead to long-term health repercussions. 

  • Joint, bone, and muscle aches: Loss of these hormones can lead to intensified aches, pains, stiffness. It is a part of getting older, and wear and tear of the joints but also because your hormones drop as you get older. Replenishing estrogen, progesterone, and testosterone can minimize inflammation and joint pain.

  • Weight gain: Estrogen and testosterone decreases prompts fat redistribution to the abdomen (belly) and back. These are places where maybe you never had issues with storing fat before. This redistribution of fat is unhealthy and can lead to heart disease, strokes, some forms of cancer, and diabetes. 

  • Digestive problems & bloating: Constipation, indigestion, and gas can be attributed to too little estrogen and progesterone which increase cortisol which is your stress hormone. During perimenopause and menopause, low hormones can create bloating that is uncomfortable and can feel like weight gain. 

  • Taste changes & burning tongue: This condition, affecting about 40% of menopausal women, feels like metal is in your mouth and can simulate a fiery sensation. It can create difficulties with tasting maybe your favorite foods the same way. Dryness, soreness, and tingling in your mouth are believed to be activated by a drop in estrogen.

  • Urinary and bowel incontinence & frequent urination: The changes in your pelvic muscles with age, and possibly weakened by pregnancy and childbirth, are made even worse with waning estrogen and testosterone. Replacing the hormones can allow you to sneeze, run or even laugh without accidents or frequent bathroom visits.

  • Headaches & migraines: If women experienced headaches before and during menstruation, this may continue throughout perimenopause and menopause. For some women, with dropping hormones, migraines may be a new experience. Headaches often decrease or disappear after hormones are leveled out – whether you had them before menopause or not. Regulating hormones with HRT can prevent these unwanted headaches.

  • Dizziness: When hormones fluctuate you may experience disruptions in the inner ear’s ability to provide balance, which can lead to menopause dizzy spells or vertigo. Sounds crazy, but it’s real. Normalizing the hormones can help.

  • Increase in allergies: Ebbing hormones during menopause can create increased histamine production which is what makes you have an allergic reaction. With the drop in hormones, you can start to notice worsening allergies or even new allergies as you age

  • Itchy, wrinkling skin, rash: Lubrication lost through lowered estrogen, testosterone and progesterone can spread throughout the body, contributing to dry skin, wrinkling skin, chafing from fabrics, and unpleasant reactions to soaps and perfumes (even contact dermatitis).

  • Breast sensitivity and pain: Hormonal changes can cause fluid build-up in the breasts, resulting in tenderness, swelling. See your doctor if this is a persistent problem.

  • Irregular heartbeat and palpitations: Some women call it a flutter, and they are often precipitated by hot flashes. They are definitely frightening sensations and can cause many women to be concerned that they may be getting heart disease. If this worsens, medical intervention could be necessary.

  • Electric shocks: Often, these are precursors to hot flashes and radiate from your head or extremities (fingers and toes). Some believe that these mild to severe jolts of pain may be due to hormonal imbalances leading to neurons misfiring in the nervous system. If this worsens, medical intervention could be necessary.

  • Tingling sensation throughout the body: Sensations like prickling, stinging, ‘pins and needles’, ‘crawling’ feelings, or numbness are experienced and are linked to the lubrication lost through estrogen drop.

Chronic Low Hormones Can Cause Serious Conditions, including:

  • Diabetes: Uncontrolled diabetes can be life-threatening. Disrupted hormonal balances can lead to blood sugar level chaos, weight gain, and diabetes. Diabetes complications such as heart attack and stroke may follow.

  • High cholesterol: Waning hormones can lead to a boost in harmful cholesterol and decreases in good cholesterol, inviting a fatty buildup in the arteries. This can lead to stroke and heart attack.

  • High blood pressure & stroke: Blood pressure (BP) generally increases with menopause. Some think this increase in BP is due to shifting hormones related to menopause. Others think weight gain and an increase in body mass index (BMI) in menopausal women is the cause. Either way, hormones are a part of the solution.

  • Irregular heartbeat: Moderate symptoms include fatigue, dizziness, weakness, and shortness of breath. More severe cases can trigger stroke, heart disease.

  • Osteoporosis: With the drop in hormones your bones become thinner, fragile, and more brittle, and can lead to fractures and breakage.

  • Some cancers: We now know that some forms of breast cancer and uterine cancer can be reduced with hormone replacement therapy.

How Can Winona Help?

All of these symptoms can adversely impact a woman’s life, but effective menopause treatments, like hormone replacement therapy (HRT), are available to help you to embrace this stage as a positive beginning. We encourage you to take this phase of your life seriously and to look for the lesser-known perimenopause symptoms. 

While we know perimenopause and menopause are inevitable, the lesser-known menopause symptoms are not always obvious. With menopause support from Winona, you have the opportunity to take preventive action against health risks associated with the ever-decreasing hormones as we age. It can be done by using natural remedies for menopause symptoms in the form of HRT and other natural remedies.

There are ways to treat the often-chronic symptoms with hot flash medication and remedies for vaginal dryness. Winona encourages women to try various treatment options whether HRT, diet, or lifestyle changes to identify what works best for them. Perimenopause and menopause can be viewed as positive beginnings, with the opportunity to take preventive action against major health risks associated with the decreasing hormones associated with menopause.

Hormone replacement is a safe and physiologically natural way for you to regain your vitality, and HRT can restore proper hormone levels using substances that are bioidentical to those produced by your own body. Winona’s healthcare platform is a place to safely connect with a healthcare provider to receive care, to ask sometimes difficult and maybe even embarrassing questions.

The decision to treat and whether to prescribe a product available through Winona is up to the patient and their Winona-affiliated providers who are all licensed, and board-certified. We believe that if women embrace their evolving bodies by providing the nutrients their body needs they can move through this sometimes precarious phase with grace and wellness.

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.