What are the symptoms of menopause?
Menopause is a natural part of our lives, but that doesn't necessarily make it any easier to get to grips with. It can be confusing when your body changes in ways you might not expect. So, we're here to break down the symptoms and signs, why they happen, and the treatment options available to help make this process a bit easier.
Menopause can affect us both physically and emotionally – and not everyone will go through it in the same way. You might find the whole experience daunting, especially if your expectations don’t line up with what your friends or family might be going through. But try not to worry, we all experience it in our unique way, and that’s perfectly normal.
The best way to prepare for this challenging time is to keep an eye out for the symptoms of menopause and learn how to cope as your body gets ready to leave periods behind.
What is the first sign of menopause?
As you transition into menopause, your menstrual flow will become more irregular and eventually stop entirely. Unless there may be another explanation for this, such as pregnancy, irregular periods outside of your normal pattern usually mark the start of your menopause journey, also known as perimenopause. Even though some of us may rejoice at the idea of saying goodbye to the cramps and bloating we’ve dealt with throughout our menstruation years, it can still be confusing when any process in our body changes or stops.
Reaching out for support during this time can make a big difference when you’re feeling overwhelmed by your symptoms. Confiding in trusted friends or family and medical experts about your experience and how it is affecting you can go a long way in easing your mind.
Constantly learning more about the changes that happen in our bodies can also help navigate this journey with confidence. So why not sign up to our newsletter?
What are the physical symptoms of menopause?
Menopause can affect your body in different ways, and no two people will experience it in the exact same way. You may already recognise some of these physical symptoms, while others may be completely new to you. If you're going through this change and you're not sure what to look out for, these symptoms can feel daunting, but many are very common and usually nothing to be concerned about.
During menopause, you might experience these physical symptoms:
- Irregular periods
- Hot flushes and night sweats (sudden changes in body temperature that can make you feel very hot or very cold)
- Vaginal dryness and itching (this can sometimes be painful)
- Discomfort or pain during sex
- Palpitations (that feeling of your heart beating out of your chest)
- Aches and pains in your muscles and joints
- Weight gain
- Headaches and migraines (which can be worse than what you're used to)
- Reduced libido (lower sex drive)
- Difficulty sleeping
- Breast tenderness
- Dry skin (can be anywhere on the body)
- Nausea
Physical symptoms can have a significant impact on your daily life and activities when you’re feeling run down and under the weather at times. If you feel like your symptoms are getting difficult to manage, you can try over-the-counter remedies for some of them, like creams or lubricants for vaginal dryness, or painkillers for aches and pains. If you’re still having a hard time with your symptoms, have a chat with your doctor to see if they can help and find the best treatment options for you.
Which menopause symptoms affect your mental health?
Ever felt anxious one day and irritable another? Perhaps you’re finding it hard to focus on tasks and completing them becomes a challenge – like your brain is navigating some sort of frustrating fog. Well, perhaps unsurprisingly, hormone fluctuations can also have an impact on your mental health. This can be overwhelming to deal with at first, especially when you might not be expecting it. So, awareness is the first step.
During menopause, you may experience some symptoms that affect you mentally:
- Low mood and mood swings
- Depression
- Anxiety
- Low self-esteem
- Brain fog (you find it difficult to concentrate and struggle with memory)
If you notice the quality of your mental health getting affected by menopause, reaching out to friends and loved ones for support or practising self-care in a way that works for you can have a big impact. You can pair this up with professional help from a psychologist and even a psychiatrist, who can help you find ways to cope with these difficult thoughts and feelings. Coping with mental health issues is always challenging, but when you add menopause to the mix, it can be even more of a struggle. Although it can be scary to open up to someone about how you’re feeling, taking that brave step brings you closer to some relief from your symptoms.
What is the most common symptom of menopause?
The most common symptom of menopause is hot flushes, so you’re not alone if you've ever wondered "Is it hot in here or is it just me?". It is so common that as many as 80% of us who go through menopause experience hot flushes at some point. [2]
Hot flushes can be very uncomfortable, especially when you don't know what to expect when the sudden feeling of warmth takes over, so taking the time to understand them a bit more might be helpful. There are a few tips that may come in handy too. For instance, if hot flushes are keeping you up at night, try a bedside fan to help you cool down — or at least crack a window open. You could also wear light, breathable sleepwear (or nothing at all, if you’re comfortable) to help you stay cool during the night.
What are some less common symptoms of menopause?
Even if you're clued up on the more common menopausal symptoms, there are some that fewer of us will experience and aren't as widely known or talked about. It can be worrying when you start experiencing menopause symptoms that you’re not familiar with, so being aware of as many as possible can give you peace of mind.
Some less common menopause symptoms include:
- Thinning hair
- Changes in body odour (due to increased sweating from hot flushes and night sweats)
- Itchy skin and feeling like something is crawling on your skin
- Brittle nails
- Burning tongue
- Reduced spatial awareness (difficulty telling how close/far away things are from you)
- Voice changes
Even though these symptoms are less common, that doesn’t make them any less challenging to go through. So try to hang in there! And if you’re concerned about something not feeling quite right, reaching out to a medical professional can provide you with the reassurance you need.
What are the symptoms of postmenopause?
Once you haven't had a period for 12 months in a row you enter a stage called postmenopause. The symptoms at this stage can mostly be the same as when you're going through menopause, but you could also find it difficult to hold in some little drops of pee (light incontinence) or experience an increase in Urinary Tract Infections (UTIs).
Additionally, severe vaginal dryness could cause some bleeding or spotting after sex.
If you notice any of these symptoms during postmenopause, it's best to talk to your doctor just to rule out any other health issues that could be causing them. Professional medical help can also guide you towards the right solutions and treatments.
Remember, postmenopause is not all bad news! Once you reach this stage, some if not all of your symptoms might become less intense or maybe even go away entirely, so try to keep a positive mindset!
Why do menopause symptoms happen?
Menopause symptoms begin during perimenopause, when the production of the hormones that control your reproductive cycle (oestrogen and progesterone) starts to decrease, and then eventually stops.[1] This change in hormone levels during perimenopause is what basically triggers your symptoms.
Your symptoms and their intensity don’t have to be overwhelming – making simple lifestyle changes like exercising regularly, improving your diet and having a regular sleep schedule can go a long way feeling some much-needed relief.
How long do menopause symptoms last? Are they constant?
The symptoms of menopause may last from a few months to several years and happen at different stages of your menopausal transition, but some might go away after your periods have stopped.
The timeline of your symptoms will be unique to you. There is no “right time” for any of them, so you may have a different experience from friends who may be going through this experience alongside you, and that’s completely normal.
It is also normal for your menopause symptoms to fluctuate in intensity over time. Some days, you might have acute hot flushes or muscle aches, while other days you might be feeling a bit more anxious than usual. Try to be patient with your body and allow it to do its thing, reminding yourself that it is all part of a natural process of life.
Can you go through menopause without symptoms?
While most of us will go through at least some menopausal symptoms, there are a lucky few who experience very few, and some none at all.
This is because sometimes ovaries still make some hormones, and since menopause symptoms are caused by hormone levels dropping, more hormones equal fewer symptoms.
What are my treatment options for menopause symptoms?
Even though menopause is unavoidable, you don't have to let the symptoms rule your life. Treatment is available to help keep your menopause symptoms under control and improve your quality of life, whether that’s fighting hot flushes and brain fog or managing nausea.
Hormone Replacement Therapy (HRT)
Hormone Replacement Therapy or HRT, as the name suggests, replaces the hormones that your body stops producing naturally during menopause. Since menopause symptoms happen because of the decrease in hormones in the first place, balancing them out with HRT means that they should improve.
You can use HRT in whatever way you decide together with your doctor, they will clarify any doubts and recommend the right type of therapy for you. For oestrogen HRT, they may suggest you take tablets, get an implant put in, or apply skin patches, gels or sprays. If you have a womb, they may suggest HRT with both progesterone and oestrogen, also known as combined HRT. This is because the progesterone in combined HRT is needed to protect the lining of your womb from damage that oestrogen alone could cause. Just like with oestrogen HRT, combined HRT can be used in multiple ways. It comes in tablets, skin patches, or a coil device similar to the contraceptive coil you may already be familiar with.
Hormone Replacement Therapy can have some positive side effects on your overall health, such as reducing your risk of developing other hormone-related health conditions like heart disease and osteoporosis.
However, just like with most treatments, using any kind of hormone therapy can come with some risks. They will vary depending on exactly which kind of HRT you go for, but try not to worry, your doctor will talk you through the pros and cons. They will let you know which Hormone Replacement Therapy is right for you, offer reassurance, and help you make the best decision for your health.
Tackling individual menopause symptoms
While HRT is an effective treatment for many menopause symptoms, it might not be for everyone. Luckily, other hormone-based and non-hormonal treatments can help.
These treatments could be used by themselves or alongside HRT, just check with your doctor. And remember, there is no one “best treatment plan” out there, it’s all a matter of finding what works best for you!
These treatments include:
- Testosterone gel to increase sex drive
- Oestrogen to relieve vaginal dryness and discomfort
- Non-hormone-based medications to manage hot flushes
- Cognitive Behavioural Therapy (CBT) for mood disorders and anxiety
Not every way to manage symptoms involves a trip to the doctor, there are some simple things you can do in your day-to-day life to make menopause a little bit easier to deal with. Try to practice self-care in whatever way works for you, whether that’s a physical activity like yoga, catching up with friends, or more “me” time with a candle-lit bubble bath. If there are specific symptoms you're looking to find a solution to, we've found a few tips that might help you.
Protection for irregular periods and spotting
As your cycle becomes more unpredictable, you might be slightly on edge about a period or some spotting catching you off guard. To ease your mind, you could try wearing liners to make sure you’re protected, you can even wear them every day if that’s what makes you feel the most comfortable.
Some liners are even specially designed to handle pee drops in addition to blood and discharge, so you can stay dry and confident to matter what your V-Zone throws your way.
Finding hot flush triggers
If you're struggling with hot flushes, finding what sets them off and avoiding those things can be helpful. Common triggers of hot flushes in daily life include alcohol, caffeine, and spicy food, so try to limit them and see if it makes a difference.
Soothing vaginal dryness
Good news: you can find moisturisers specially designed to treat the cause of dry vaginal tissue. Using water-based lubricant during sex or masturbation can also help, and both options are widely available over the counter and as prescription treatments.
Managing weight gain
Sometimes weight gain during menopause can make symptoms harder to manage. It can also affect your confidence if you expect your body to look a certain way. Whether you embrace your new body shape or want to curb menopausal weight gain, regular exercise and a healthy diet are always a good idea to improve both your physical and mental health.
Getting a good night’s sleep
Symptoms associated with menopause can also make it more difficult for you to sleep. Luckily, we’ve found out why that is and put together a list of self-care methods you can use for successful sleep during menopause. Spoiler alert: creating a relaxing bedtime routine, sticking to a sleep schedule, and avoiding hot flush triggers are just some of the ways that you can make sleeping during menopause much less of a nightmare.
Keeping your mind active
If you find yourself forgetting where you've put your keys or that important thing you need to do today, try some mental activities to stimulate your brain. Even something as simple as tackling a tricky puzzle or crossword on your daily commute or just before bed can go a long way in improving memory issues and memory loss caused by menopause.
Navigating the many symptoms of menopause can be tricky, but you don't have to let them stop you from living your life to the fullest. Remember that you’re not alone and the symptoms won’t last forever, menopause is a natural part of life just like puberty is — and hey, you overcame that! So, try a few different options until you find what best helps you through this new life stage.
If you're looking for extra advice and support, you can find out more about how sex drive and intimacy might change during menopause and how to cope with the effects of menopause on your mental health.
Medical disclaimer
The medical information in this article is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. Please consult your doctor for guidance about a specific medical condition.
This article has been reviewed on 19th April 2024 by Karen Joash BSc (Hons), MSc, MBBS, MRCOG PGCert, ILM and MBA, Consultant Obstetrician and Gynaecologist at Queen Charlotte's and Chelsea Hospital and The Portland Hospital for Women and Children. You can find out more about mS Karen on her LinkedIn and X pages.
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