What are The 34 Symptoms of Menopause?

Every woman’s experience of menopause is different yet show a mixture of 34 recognised symptoms, ranging from mild to severe intensity. The majority of people assigned female at birth (AFAB) do not experience all 34 of these symptoms during this time. This article will look at these symptoms of menopause and discuss the advice available on help with their alleviation.

How long does menopause last?

During menopause, the oestrogen levels of a person AFAB decrease, typically between the ages of 45 and 55. The average age at which a British person AFAB enters menopause is 51. Menopause symptoms can begin months or even years before periods stop, during the time called perimenopause. Most menopause symptoms last for about 4.5 years after the last period, but the duration can be much longer for some1.

Recognised Symptoms of Menopause

1. Hot flashes/flushes

Menopausal people experience hot flashes as one of the most common symptoms. This causes them to feel a sudden sense of heat and flushing on the skin, especially in the face, neck, and chest areas. 

2. Night sweats

Hot flashes that only happen at night are known as night sweats. Falling oestrogen levels appear to affect the part of the brain called the hypothalamus, which regulates body temperature. 

3. Irregular periods

It is normal to miss or have irregular periods during the menopausal transition. The menstrual cycle will end when they reach menopause.

4. Mood changes

An unpredictability in mood shifts that has nothing to do with life events; can make someone feel sad, weepy, or enraged out of nowhere. 

5. Breast soreness

Breast tenderness is another common symptom of menopause, although this occurs less frequently as the condition progresses.

6. Decreased libido

Libido, or the desire to have sex, is frequently affected by menopause due to lower testosterone and oestrogen levels. 

7. Vaginal dryness

Female sex hormones ensure that blood circulates freely around the vagina, so a lack of these hormones can reduce blood flow and, as a result, natural lubrication.

8. Headaches

As a person approaches menopause, they may experience more frequent headaches or migraine attacks due to decreased oestrogen.

9. Tingling extremities

Some people experience tingling in their hands, feet, arms, and legs during menopause. This symptom is caused by hormonal fluctuations that affect the central nervous system and typically lasts only a few minutes at a time.

10. Burning mouth

A burning mouth can manifest as a sensation of burning, tenderness, tingling, heat, or numbness in or around the mouth. This is yet another side effect of hormonal changes. 

11. Changes in taste

Some people may notice changes in their sense of taste with more robust flavours. They may also experience dry mouth, which increases their chances of developing gum disease or cavities.

12. Fatigue

Fatigue can be a distressing and sometimes incapacitating menopause symptom. This could be due to a lack of quality sleep as a result of hot flashes and night sweats, or it could be due to hormonal fluctuations themselves.

13. Bloating

As a result of stress, people may experience water retention, gassiness, or slower digestion. They may also experience bloating if their eating habits change around this time.

14. Other digestive changes

Female sex hormones impact the microbes in a persons mouth and digestive tract. This could imply that gut flora changes composition during menopause and so a menopausal person may notice changes in their digestion or a different reaction to certain foods.

15. Joint pain

Oestrogen helps reduce inflammation and lubricate joints. Some people experience joint pain due to decreased oestrogen. Because oestrogen regulates fluid levels in the body, low oestrogen levels increase the risk of joint pain and menopausal arthritis.

16. Muscle tension and aches

Muscle tension or aches are common and caused by the same factors that cause menopausal joint pain.

17. Electric shock sensations

People may experience electric shock-like sensations. It is unclear what causes this, but it could be due to changes in hormone levels in the nervous system.

18. Itchiness

Itching and dryness around the vulva and elsewhere are linked to drops in oestrogen levels, the hormone which is essential in collagen production, which in turn is associated with hydration of the skin.

19. Sleep disturbance

Night sweats may cause people to wake up more frequently, go to bed earlier, or have trouble falling asleep.

20. Difficulty concentrating

A drop in oestrogen levels can cause mental fogginess or inability to concentrate. There is a chance that hot flashes and sleep problems also negatively affect concentration.

21. Memory lapses

Menopause can affect memory in the same way that it can affect concentration and focus.

22. Thinning hair

Another side effect of ovarian hormonal fluctuations during menopause is hair loss or thinning. Hair follicles shrink, which slows hair growth and makes it more likely to fall out.

23. Brittle nails

The body may stop producing sufficient keratin, a protein needed to keep nails strong. Therefore sometimes nails start to get brittle and break easily.

24. Weight gain

Weight gain and reduced physical activity can both be caused by a drop in oestrogen levels. When a person’s mood changes, they may eat more than usual as well.

25. Stress incontinence

Stress incontinence refers to the inability to control the urge to urinate when under stress. This is a common symptom occurring due to the bladder and pelvic muscles weakening.

26. Dizzy spells

Menopause's hormonal changes affect insulin production, making it more difficult for the body to keep blood sugar levels stable. This is a major cause of dizziness in some people during the perimenopause and menopause periods.

27. Allergies

This occurs because histamine levels can rise during menopause. Histamine is the chemical responsible for allergic reactions.

28. Osteoporosis

A decrease in oestrogen can also result in a loss of bone density. In severe cases, this can result in osteoporosis, a condition in which the bones become more fragile and break easily.

29. Irregular heartbeat

Some people may develop an irregular heartbeat or arrhythmia. 

30. Body odour

Menopause symptoms such as hot flashes and night sweats can lead to an increase in body odour. When a menopausal person is under high stress or anxiety they may notice that they are perspiring more than usual.

31. Irritability

People may become agitated due to hormonal fluctuations or the influence of other menopause symptoms. It is also possible that stress or insufficient sleep are factors.

32. Depression

Hormonal imbalances can lead to depression in some people. Depression, on the other hand, is more likely to be transient and not last after the menopausal period.

33. Anxiety

Anxiety is another mood-related symptom. It may worsen at night or only occur intermittently as hormone levels fluctuate.

34. Panic disorder

People can suffer panic attacks, which can be a sign of panic disorder if they occur suddenly. This can be due to hormonal changes or anxiety.  

Simple Lifestyle Changes that Can Help

  • Avoid food triggers: avoid alcohol, spicy foods, sugar and caffeine, as they can worsen hot flashes. Consider swapping morning coffee for a healthy herbal tea.
  • Quit smoking: smoking can intensify symptoms of hot flashes. If you smoke and are experiencing uncomfortable hot flashes, reducing or eliminating your smoking habit may help. You can also ask for a 'stop smoking service' at a pharmacy or GP surgery if you find it challenging to do it yourself. 
  • Regular exercise: it can help relieve a variety of symptoms like stress, fatigue, extra weight, and low mood. You can find the physical activity guideline on the NHS website to check the recommended amount of exercise time. 
  • Weight loss: being overweight can worsen pre-existing menopausal symptoms and cause new ones. Losing weight can also help reduce your risk of breast cancer and heart disease, both of which become more common as you get older. Check out more 'weight management programs' online to help you. 
  • Enough sleep: lack of sleep can make these symptoms worse. You can start to learn some relaxation techniques to help you sleep better, aiming for between seven and eight hours of quality, uninterrupted sleep per night.
  • Other habits: dress in layers so that it is easier to cool down when a hot flash occurs. Carry gentle cleansing wipes to freshen up while on the go.
  • Natural supplements: take calcium and vitamin D supplements daily to maintain bone health. 

Get a Blood Test

You can perform a finger-prick blood test at home to see if you are menopausal. The blood test detects FSH (follicle-stimulating hormone), a hormone found in higher concentrations during menopause.

 You should not take this test if you are taking the pill because the contraceptive alters your natural FSH levels. Because your hormones fluctuate so much, to get a more accurate picture, it's often recommended that you repeat the test 4-6 weeks later, if your first FSH level is elevated. If your FSH levels are elevated in both cases, it may indicate that you are menopausal.

 On the other hand, a blood test can also rule out other conditions that cause menopausal symptoms, such as hypothyroidism and hyperthyroidism. 

When to Consult Your Doctor 

  • If you are experiencing symptoms of menopause before 45 years of age.
  • If simple lifestyle changes do not improve your menopause symptoms, or if they appear to be getting worse over time.
  • If those menopause symptoms are causing distress or disruption to your life.
  • If you have a high risk of osteoporosis and want to start taking action to reduce the risk.
  • Similarly, you can simply keep up with routine check-ups and speak with your doctor about risks and concerns. 

References:

  1. Avis N, Crawford S, Greendale G, Bromberger J, Everson-Rose S, Gold E et al. Duration of Menopausal Vasomotor Symptoms Over the Menopause Transition. JAMA Internal Medicine. 2015;175(4):531. https://pubmed.ncbi.nlm.nih.gov/25686030/

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Yuting Jiang

Master of Science in Pharmacy - UCL (University College London)
Dynamic Master of Pharmacy student driven by a passion for providing high-quality patient care. Engaged in rigorous programmes of professional development, refining a myriad of skills, including data, analytical, and numerical. Gained excellent multi-lingual communication skills used to great effect in developing strong, multidisciplinary relationships and in the confident presentation of research findings both verbally and in writing.

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