Symptoms of Menopause

There are many symptoms of menopause and they can occur during different phases of menopause.
They include:

1. Hot flashes/flushes – are a sudden feeling of feverish heat. They seem to start from the inside out.  I’ve heard them referred to as power surges! Sometimes a red flushed face, neck or chest can go along with them.   Profuse sweating can occur and you might get chilled afterward. They can come at any time. A joke I read said: My internal thermostat has only 2 settings: Hypothermia and Eternal fires of hell!  Approximately 80% of women experience them.  What I hear most often from women is that they are embarrassing and frustrating. Hot flashes are caused by an imbalance in hormones.. As estrogen decreases, the hypothalamus (the gland that is in charge of regulating body temperature) is affected. The decrease in estrogen causes the brain to detect too much body heat. As a response, hormones are released to increase the heart rate, pump more blood and dilate the vessels in the skin.  This is so that you can produce your natural cooling method—sweat! Everyday stress is another cause for hot flashes. While under emotional pressure, your body may release the stress hormones epinephrine (also known as adrenaline) and norepinephrine. These two hormones increase your heart rate and circulation, which raises body temperature.
2. Night sweats – is perspiration during sleep. (Nocturnal hyperhidrosis) Another way to look at it is they are hot flashes during your sleep.  It’s basically waking up in the middle of the night with drenched pajamas and sheets and it’s not because the room is too hot!  Your husband wants to hold you but you can’t stand to have him touch you! Cuddling is out! They are very common in menopause.  You wake up hot, and then you throw the covers off and within a few minutes you’re freezing.  It can sometimes feel like the night sweats are going on all night long. In Traditional Chinese Medicine, 3:00-4:00 A.M. is the most common time for night sweats.  I can attest to this! This is exactly the time mine come on.
3. Vaginal dryness – also known as vulvoganial atrophy. (VVA) or atrophic vaginitis.  It is thinning, drying and inflammation of the vaginal walls due to your body having less estrogen. Really? As if hot flashes weren’t enough! The tissue becomes pale and light in color. It is a chronic progressive condition.  Which means it gets worse with time…not better. Most of the other symptoms of menopause get better with time. There can be a feeling of itching or burning in the vagina because the tissues are losing moisture.  It occurs most often after menopause. It causes painful intercourse and can also lead to urinary symptoms.  Approximately 45% of postmenopausal women suffer from VVA.  Your vagina can feel like the Sahara Desert!
4. Painful sex (dyspareunia) – is persistent or recurrent genital pain that occurs just before, during and after intercourse. The pain can be on the external surface of the vagina or the internal part of the vagina.   It can affect a small portion of the vagina or it can be felt all over the surface. This is not fun!  I’ve heard that it feels like sandpaper or razor blades.  Women might stop having sex at this point and unfortunately if you don’t use it, you’ll lose it. Since women are living longer and staying sexually active longer, it’s important you discuss this with your doctor to see if it’s due to menopause.
5. Incontinence – is when weakened muscles in your bladder can’t hold back urine when you cough, exercise, sneeze, laugh, or lift something heavy and urine leaks out. There’s nothing worse than peeing your pants! It feels disgusting! This is due to hormonal levels fluctuating and pelvic muscles growing weaker.  About 40% of menopausal women suffer from this. Stress incontinence is the most prominent type of incontinence in menopause.
6. Cardiac Effects – estrogen withdrawal has a detrimental effect on cardiovascular function and metabolism and may be a factor in heart disease. Assorted changes in the body occur. Ok, now this sounds serious… Blood pressure starts to go up, LDL cholesterol, or “bad” cholesterol, tends to increase while HDL or “good” cholesterol declines or remains the same. This can lead to a buildup of fat and cholesterol in the arteries that can contribute to heart attack and stroke.  There are other reasons for cardiac issues as well, so please speak with your doctor about this one.
7. Osteoporosis – is a disease that weakens bones and causes reduced bone density. It’s known as the silent disease. It comes on without warning and there are no symptoms and no signs that your bone structure is changing and becoming more porous. Osteoporosis leaves your bones weaker and increases your risk of sudden and unexpected fractures.  After estrogen levels drop it speeds up the process of bone breakdown. This breakdown happens faster than the body can rebuild new bone and the result is a weaker skeleton making you prone to breaking a bone more easily.
8. Dry hair/hair loss or thinning hair – menopause causes androgen levels to increase, which can in turn trigger thinning of the hair on your scalp and can also cause extra facial and body hair. Androgens reduce the diameter and length of your hair on your scalp, but somehow it causes facial hair to grow where it never did before. Great! I now have baby hairs growing out of my chin!   Dryness seems to happen all over our bodies in menopause, not just in our hair.
9. Mood swings –are an emotional reaction that is inappropriate or disproportionate in relation to its cause or trigger. What? I am NOT in a bad mood! Don’t tell me what I’m feeling! Sound familiar? Estrogen influences the production of serotonin, which is a mood-regulating neurotransmitter.  Symptoms of mood swings include: Irritability, anxiety, depression, aggression, sadness, stress, nervousness, impatience, general lack of motivation.  These are all real feelings that you may experience.  It may also be something more serious, so please talk to your doctor about them. My doctor once told me that they used to put women who were in  menopause in insane asylums in the old days. Can you imagine? Yes, sometimes I can.  I remember being so irrational one time that when I apologized to my husband, I told him “I don’t even like ME right now”! Up to 75% of women experience mood swings as they approach menopause.
10. Decreased libido – you may find that your desire for sex decreases at this time because of the drop of estrogen. Some women are completely okay with this, and others are not so happy. You may notice that you’re not as easily aroused or may be less sensitive to touching and stroking. However, studies have shown that in some cases, women stop having sex because it hurts, not because they have lost desire.  (See painful sex)
11. Insomnia/sleep disorders – there are different reasons that contribute to insomnia. Sleep disturbances include difficulty going to sleep, or falling asleep quickly only to spring wide-awake several times a night or every hour on the hour. Anxiety and worry can prevent us from going to sleep and when we finally get to sleep our night sweats can wake us up again! Our sleep may also be disturbed by having to get up during the night to urinate. We also naturally need less sleep as we age, but I don’t agree. I don’t know about you, but my desire for sleep never ends! I love sleep!
12. Fatigue – being tired all the time is exhausting. It affects your work, your family relationships, and your intimate relationships. Some women get fatigued occasionally, while others live with it 24/7. Your hormones are basically draining you of energy and your body is trying to adapt and re balance on a daily basis without the hormones that it’s been use to.  Dehydration, diet, poor sleep, anxiety and lack of exercise can also contribute to fatigue.
13. Joint Aches – This is one I’d never heard of until about 3 weeks ago! My knees and ankles were absolutely aching and I had no idea it was a symptom of menopause.   Aches, stiffness and swelling around the joint and sometimes heat are typical symptoms of menopausal joint pain.  These may be worse in the morning, improving as the day continues.  Joints which experience high impact such as the hips and knees tend to be most affected by this so called menopausal arthritis.  Estrogen helps to reduce inflammation in the joints, so it explains why it happens during menopause. I’ve realized in the last year that I just can’t do the high impact exercises that I used to do.  I now only do Yoga, swim exercises, hiking, walking and weights.
14. Increase in allergies – the immune system of menopausal women goes into disarray and many become susceptible to allergies during menopause. Some women start getting allergies while others get new or different allergies. Reactions can appear on the skin, in the upper respiratory system or in the digestive system.  I have noticed that I’m allergic to my dog when I was never allergic to any animal before. Immediately my eyes start itching and I get a headache when he is close to me.  ( I still love him though)
15. Body Odor – hormones, food, habits and environment all have an effect on body odor, especially hormones. A dip in estrogen during menopause negatively affects the regulation of body temperature, which often results in symptoms like hot flashes and night sweats. This increased sweating has a direct effect on body odor. Super! Women can have odor under their arms, on other parts of their bodies as well as in their vagina.  I have read that some women say it’s a unique smell, more like a man’s smell.  Others I have heard say it’s more like chicken noodle soup or French fries with ketchup!  LOL
16. Irregular heartbeat – during menopause the most common cause of irregular heartbeat is fluctuations in estrogen levels. They can affect women in different ways, including a skipped heartbeat, faster heart rates or changes in the hearts rhythm. It might feel like your heart is pounding or fluttering in your chest. An irregular heartbeat can also be more serious, so please see your doctor if you feel this symptom.
17. Electric shock sensation – changing levels of estrogen can affect the nerve tissue, causing a woman to feel sensations of electric shocks. The misfiring of the neurons in the nervous system may be responsible for feeling electrical shocks. I actually do experience this sensation.  For me it feels like a sharp shock in the back of my neck.  It has an odd feeling afterward like my neck is weak.   Some women say they experience them before a hot flash, but I’ve never noticed that in my case.
18. Headaches – dramatically fluctuating estrogen levels may be the cause for headaches. Women have used this excuse for years to avoid sex… but it’s true! The two main triggers for hormone related headaches: declining estrogen levels or elevated estrogen levels. Menopausal headaches can incapacitate women who experience them.   Menstrual migraines are hormone related and begin on the first day or two of menstruation and usually subside once menstruation finishes. There are other types of headaches that can be caused by menopause including migraines, migraines with aura, and migraines without aura, tension headaches, and sinus headaches.
19. Brittle nails – again, the most likely cause for women of menopausal age is hormone fluctuation, particularly estrogen. One of the fundamental causes of weak or brittle nails is dehydration or lack of moisture in the body.  The hormone fluctuations can cause nails to feel dry, break, split or chip easily, sink in appearance, curl around the fingertip, or change the color of the ridges on the nail.
20. Breast /Nipple pain – (Mastalgia) When you near menopause, you may also have sore breasts. It’s due to fluctuating estrogen and progesterone levels.  Pain can last a few days to more than several days a month.  You may feel tenderness, swelling, pain, and/or lumpiness.  Women describe it as dull, heavy or aching feeling.  I can tell you that I had severe breast pain at different times during perimenopause.  The pain in my nipples was excruciating, and my breasts felt very heavy and full.  It lasted some months for 2-3 weeks! It was so painful that I couldn’t hug people or get close for fear of extreme pain.  Any changes with your breasts should be discussed with your doctor. It could be something more serious.
21. Panic attacks – you might feel shortness of breath, chest pain or tightness, trembling, shaking, heart palpitations, rapid heartbeat, unusual intense energy, and hyperventilation. Women can start experiencing panic attacks, possibly even developing panic disorder. Panic attacks are periods of intense, severe anxiety that are so powerful they cause the  person to feel intense doom, as though their health is in jeopardy and they may be about to die.  Some people describe it like they are having a heart attack or a nervous breakdown. They can last as short as 15 seconds and as long as 10-30 minutes.  Panic disorder is a psychiatric disorder in which debilitating anxiety and fear arise frequently and without reasonable cause.  I have experienced panic attacks and they are frightening.  I have learned to calm myself down with deep breathing exercises and meditation.
22. Weight gain – No kidding!? Hormonal changes might make you more likely to gain weight around your abdomen than around your hips and thighs. Ever heard of the menopause middle? Weight gain is usually related to aging, as well as lifestyle and genetic factors. Our muscle mass decreases and muscles turn to fat. Our metabolism often changes so it’s imperative we start exercising more, eating less and eating the right foods. We may also be stressed and producing excesses of the hormone cortisol which is associated with the flight or fight responses. High cortisol levels often cause us to put on weight especially around our waists. Stay away from sugar! The only weight loss program that I would feel good about recommending is Weight Watchers because other diets don’t stand the test of time. You may lose initially, but fad diets are not sustainable. I would also recommend walking as much as possible. Definitely speak with your doctor about this because they may want to put you on an individual eating program.
23. Irregular periods – this may be the first symptom you notice when you are entering menopause. You may have irregular bleeding or spotting. Some months, your period may be longer and heavier. Other months it may be a little bit of spotting.  You may miss periods or sometimes feel like you’re dying because you are bleeding through your clothes.  This being said, you could miss your period because you are pregnant.  Ever heard of menopause babies?  If you miss it, get a pregnancy test to be sure.  When my periods were irregular,  I took several pregnancy tests to make sure I wasn’t pregnant.  There were some months where my period was almost nonexistent and then the following month I felt like I was having a miscarriage.  I would even have a period for three weeks and then stop for one week and have another one!
24. Dry / itchy skin – collagen loss begins early but is most rapid in the first few years of menopause, leading to dry, flaky and itchy skin. I’m starting to have itchy skin on my back and it seems to itch where I can’t reach it! When estrogen levels drop during menopause, the skin gets wrinkled, because it loses the ability to hold water. These changes can cause the skin to thin, lose its elasticity and impair its ability to repair itself.  Women who live in dry climates may notice it more.  The changes to your skin can start as early as perimenopause and they’re permanent.  Easing the itch and combating the dry skin associated with menopause lies in your hands. Find a good moisturizing body and face lotion. Always use sunscreen and lotionize!
25. Lack of concentration – there are neurotransmitters in the brain which regulate cognitive function, including heightened memory and ability to concentrate. If there is a shortage in those neurotransmitters, there may be a decrease in cognitive function, leading to difficulty concentrating. Estrogen has an effect on the production of these neurotransmitters. Examples are: Losing your train of thought, disorientation, forgetfulness, fuzzy thinking, anxiety, memory lapses, lack of focus, attention span issues, etc. I actually suffer from this terribly.  I’ve noticed I can’t have background noise when I work on the computer or when I drive a car.  Too much noise gives me anxiety!
26. Dizziness/lightheadedness – as levels of hormones change they can have an effect on circulation and blood vessels, resulting in bouts of dizziness as blood pressure fluctuates. Other symptoms that can make you feel dizzy or lightheaded are anxiety, hot flashes, and stress or panic attacks.
27. Bloating – is a feeling of extreme fullness, tightness or swelling in your abdomen and other parts of your body. No…I’m not pregnant!  I actually had someone in the grocery store ask me that one day. Water retention and gas retention may be causes of menopausal bloating. Increased estrogen levels can cause water retention, which can in turn cause bloating.  Other factors include consuming too much salt or eating your food too quickly. There are also certain foods that can make these symptoms worse. Be cognoscente of what you’re eating when you feel bloated and make changes accordingly. You could be allergic to something you’re eating. i.e. dairy
28. Acne – one of the strongest of the androgens, testosterone, often triggers skin conditions that result in menopausal acne. As testosterone levels rise, the skins sebaceous glands go into overdrive, producing excess sebum, an oily substance that can block pores. So estrogen declines and androgen levels, the male sex hormone, remain constant.  If you’re noticing inflamed cysts around your lower face, especially your chin and jaw line area, you can bet it’s probably hormonal.  Hormonal breakouts tend to pop up in the same place each month as well.   Stress can also bring them out.  Cortisol, the stress hormone, can affect all of your hormones, causing them to be all-out of whack. They tend to be more painful cysts than blackheads and whiteheads.  I have recently started breaking out with sebaceous acne on my forehead and it’s very frustrating. I feel like I’m in my teens again.  Talk to a dermatologist about ways to treat because you don’t treat it the same as a teenager would.
29. Digestive problems – symptoms usually include bloating and excessive gas, which is completely linked to a hormonal imbalance. There are also cramps, constipation, and diarrhea to worry about.  Women are twice as likely to suffer from digestive problems as men are. Again, it’s the fluctuation in estrogen and progesterone that cause it.
30. Gum problems – hormone fluctuations can affect many oral tissues including the gums, salivary glands, joints and jawbones. Dental and gum problems during menopause include: gum disease (gingivitis or periodontisis), gum tissue loss or recession, gum bleeding, bone loss or osteoporosis in the teeth and jawbone, burning tongue, gums and mouth, dry mouth, changes in taste and menopausal gingivostomatitis.  I have noticed recession in my gums over the last few years as well as aching teeth from time to time. Make sure you have regular dental visits to your dentist to make sure there’s nothing else wrong.
31. Memory Lapses – forgetfulness often surfaces during menopause. Experts differ about why.  Some point to declining estrogen levels and others to increased stress levels. You may experience fleeing periods of retaining or recalling information.  Another way to define it is brain fog.  A good example for me is I live on a hill, and sometimes I will drive down to the bottom on my way to the store and think “Where am I going?
32. Muscle Tension – a menopausal symptom that is closely related to stress and anxiety. Muscle tension is the feeling that muscles are always tight or strained, sometimes to the point of frequent pain, or even persistent and ongoing pain.  Symptoms may include tightness in the back, shoulders, neck and abdomen.  Muscle tenderness, fatigue, tension headache, stress, anxiety, muscle spasms, muscle pain and soreness are all symptoms of menopause.
33. Tingling extremities – (paresthesia) is characterized by a feeling of numbness and pins and needles sensations in the arms, legs, hands, feet, fingers, and toes. Your limbs can temporarily “fall asleep”.  In other cases, a burning sensation can take over as nerves are pinched or joints compressed.  The reduction in estrogen fluctuates and has a complex effect on the central nervous system.   Please check with you doctor if you are concerned about this symptom. From time to time I do feel tingling in my extremities.
34. Dark circles under eyes/puffy eyes –   puffiness can be caused by too much salt intake and eating too many processed foods.  Lack of sleep due to night sweats can also contribute to eye issues.  I’ve noticed that the skin under my eyes is thinning and contributing to dark circles. I also have puffiness (bags) under my eyes when I wake up in the morning.

With all the possible symptoms of menopause, it’s a wonder how we would ever feel good! Hot flashes/night sweats account for up to 80% of women’s complaints. Vaginal atrophy (dryness) and painful sex come in second for most number of complaints.

Women have a life expectancy of approximately 82 years.  Post menopausal vasomotor symptoms like hot flashes, cold or night sweats usually improve over time, but dyspareunia (painful sex) and vaginal dryness can persist throughout post menopause

I am not a doctor.  Some of these symptoms can mimic other disorders, so please see your doctor regularly and don’t rely solely on my information.  I am versed on Menopause because I have been a pharmaceutical rep for over 20 years and have specialized in women’s and men’s health care.  I have a lot of information that I’ve acquired and want to share it with my readers; however, again I am not a doctor so check with yours.