Signs and Symptoms of Menopause Explained 

Physical Symptoms of Menopause

Menopause causes certain bodily changes that you start to notice and experience.

1. Hot Flashes

Have you ever suddenly felt like you’re in a furnace, sweating profusely and your face all red?

• Hot flashes are one of the hallmark symptoms of menopause. They are the sudden waves of intense heat that are usually felt over the chest, face and neck. They are often accompanied by sweating and redness of the face. 
• An episode of hot flashes can range from mild to severe, lasting anywhere from 30 seconds to 10 minutes and disrupting daily life.
• Oestrogen deficiency during menopause leads to abnormal hypothalamic thermoregulatory control, resulting in abnormal vasodilatory response to minor elevations of core body temperature and hot flashes.

Read more about the causes and treatment of hot flashes.

2. Night Sweats

• Night sweats are similar to hot flashes. While hot flashes occur during the day, night sweats occur during sleep.
• Sometimes, you find yourself waking up in the middle of the night with a wet blanket and pillow. 
• These episodes of excessive sweating can disrupt your sleep. It leaves you fatigued and irritable throughout the day. 
• Chronic sleep disturbances can exacerbate other menopause-related symptoms, such as mood swings and anger.

3. Irregular Periods

During the perimenopausal phase (as menopause approaches), your periods often become unpredictable.

• One month, they are heavy, and the other, they are barely there. Sometimes, they show up uninvited or overstay their welcome. They lead to so many variations before ceasing altogether. 
• The irregularity in your cycles is caused due to the decline in hormonal levels during menopause.
• If you’ve hypothyroidism and are nearing menopause, you’re likely to experience heavier periods than usual.

Click here to read more about the relationship between menopause and irregular periods.

4. Vaginal Dryness

Vaginal dryness occurs due to decreased moisture in the vaginal area. 

• The decrease in level of oestrogen and progesterone levels leads to thinning of vaginal walls, making it drier and less lubricated.
• Women can experience vaginal dryness at any age, but it leads to a significant problem during menopause.
• Vaginal dryness can make sex painful and uncomfortable. It hampers intimacy. It causes itching, burning sensation, and irritation. It also increases the risk of vaginal and urinary infections.

5. Breast Tenderness 

Hormonal fluctuations lead to changes in breast tissues. These symptoms often are temporary but can cause significant discomfort.

• It causes tenderness, swelling, or sensitivity of breasts. They also lead to the sagging of breasts.

Not just menopausal women, women in their reproductive age also experience breast tenderness. A study conducted on menstruating midlife women states that the majority of women experience breast tenderness during the premenstrual window, whereas some experience it during ovulation. 

5. Weight Gain

Are you wondering why your belly is increasing in size or you’re gaining weight during menopause?

• The hormonal shifts during menopause lead to a low metabolic rate. When your metabolism is low, your body spends less energy and stores it as fat, causing weight gain.
• Oestrogen plays a major role in fat distribution. It encourages more fat storage, especially on the hips, thighs and breasts, rather than visceral depots.    
• When oestrogen levels decrease during menopause, you may observe more fat deposition in the abdominal area, leading to weight gain.

Emotional and Psychological Symptoms of Menopause

You’re barely coping with hot flashes, sleepless nights and many more - only for your brain to start throwing tantrums, too.

1. Mood Swings

One moment, you’re laughing, and the next, you’re crying. Things that were simple now start to annoy you. You feel vulnerable. Hormonal imbalance can increase emotional sensitivity.

These mood fluctuations drain you emotionally and mentally. They affect your personal relationships and overall well-being.

2. Anxiety and Depression

Anxiety is a mental health condition characterised by persistent fear, worry, or tension. Depression is a mental health condition that causes persistent feelings of sadness or loss of interest for long periods of time. 

Estradiol (a potent form of oestrogen) plays a key role in the neurotransmitter signalling system. It keeps the “happy hormones” - dopamine and serotonin, in balance.

As oestrogen levels decline during menopause, your emotions take a toll, leading to episodes of anxiety and depression.

3. Decreased Concentration

Have you ever walked into your room only to forget why you actually went there in the first place? ‘Brain fog’ is a real thing. All of us experience it once in a while.

Cognitive function tends to decline with age, but during menopause, this decline is often exacerbated by hormonal imbalances.

According to a study, subjective (self-reported) cognitive decline is one of the most frequent complaints of women undergoing the menopausal transition, with a prevalence of 44%-62%.

4. Increased Stress

Menopause itself is stressful, with bodily and emotional changes it brings. 

The hormonal changes increase your body’s response to stress. This leads to higher production of cortisol and adrenaline in your body. 

The elevated levels of cortisol and adrenaline worsen menopause-related symptoms, raise heart rate, and increase the risk of stroke, diabetes, and hypertension.

Long-Term Health Complications

Hormonal fluctuations during menopause can lead to certain long-term health complications.

1. Osteoporosis

Osteoporosis is one of the significant health risks during menopause.

• Oestrogen helps regulate bone remodelling (development of new bones). During menopause, oestrogen levels decline, reducing bone density. It increases the risk of fractures and bone-related injuries.
• The decrease in bone density affects the weight-bearing joints, such as the knee joints, back, and neck.
• A study states that, by the age of 70, bone mass would have decreased by 30-40%.

2. Heart Disease

Menopausal women are more susceptible to cardiovascular conditions. 

• Oestrogen is responsible for increasing the level of ‘good fat’ (high-density lipoproteins) and decreasing ‘bad fat’ (cholesterol and low-density lipoproteins). Thus preventing the formation of plaques (sticky materials) inside the blood vessels.
• As oestrogen levels drop, it leads to unfavourable changes in cholesterol levels, blood pressure and blood vessel health. 

3. Urinary Issues

• A decline in oestrogen levels weakens the muscles of the pelvic floor, urethra, and urinary bladder. 
• These weakened muscles cause frequent urination and urinary incontinence or increase the risk of urinary tract infections (UTIs).
• You may feel a persistent urge to urinate, a burning sensation while urinating or urinating more frequently.

4. Sleep Disturbances

• During menopause, it might be hard for you to fall asleep or stay asleep. You might wake up earlier than you wish and have trouble going back to sleep.
• According to a study, around 40-60% of women experience sleep difficulties in the years leading up to menopause.

Other Symptoms of Menopause

1. Hair and Skin Changes

• A drop in oestrogen and progesterone during menopause affects the hair follicles. This causes variation in the hair growth cycle, leading to thinning, shedding, loss of texture or increased dryness.
• A decrease in oestrogen and progesterone increases the male hormones (testosterone and dihydrotestosterone) in the body. The male hormones are responsible for the shrinking of the hair follicles, causing your hair to become thinner and finer.
• Loss of fatty tissue and collagen will make your skin drier and thinner.

2. Headache and Migraine

Headaches are fickles in nature. What triggers one person may be a cure for another. 

• Many women who experience hormonal headaches find relief during menopause. Other women may notice an uptick in headaches during this phase.
• Oestrogen withdrawal is the common trigger for menopause headaches.

3. Joint and Muscle Pain 

• Joint pain and muscle stiffness are signs of ageing, as well as hormonal fluctuations.
• Oestrogen produces collagen (connective tissue), that keeps your joint lubricated and flexible. As oestrogen levels decline, the production of collagen reduces. It causes inflammation, stiffness and pain in the joints. 
• Some women also experience muscle pain during the menopause transition due to oestrogen deficiency.

Coping Strategies for Menopause Symptoms

Menopause can be a daunting experience. So, what do you do about that? First, take a deep breath. It’s a natural process, and you’re not alone. 

Here are some strategies that you can rely on to manage menopause symptoms effectively.

1. Lifestyle Modifications

Adapting to a healthy lifestyle is the best gift you can give your body. Trust me, your body is going to thank you later.

• Exercise is your best friend. It keeps you fit, increases your metabolism, elevates your mood, and helps with sleep. Include activities such as walking, cycling, and swimming in your day-to-day to improve your physical and mental health.
• Consume a balanced and nutrient-rich diet that includes whole grains, fruits, vegetables, good fats, and lean proteins. Including calcium and vitamin D in your diet helps improve bone health during menopause.
• To combat dry skin and improve energy levels, hydrate! If drinking water is a solution, you can also consume water-rich fruits and vegetables such as watermelons, pears, and cucumbers.

2. Stress Management

Try keeping your stress levels low. 

• Prioritise on self-care! Yoga, meditation and breathing exercises help in relaxation and keep the mind calm.
• Did you know having a hobby helps reduce stress? Engaging in hobbies that you enjoy helps release ‘happy hormones’ - endorphins and dopamine, that elevate your mood. 

Click here to learn more about stress management during menopause.

3. Hormonal Replacement therapy (HRT)

If you are suffering from severe menopause symptoms, hormone replacement therapy can be effective. 

• HRT mainly focuses on restoring hormonal balance. An oestrogen-only therapy helps reduce most of the menopausal symptoms. 

Before considering HRT as a treatment option, carefully discuss the benefits and risks with your healthcare professional.

4. Over-the-Counter Remedies

Some women often find relief in menopause symptoms with natural supplements and remedies.

• Black cohosh is a herbal supplement that helps reduce pain and fatigue during menopause.
• Vitamin E supplements help improve the texture of your skin.
• Calcium and vitamin D supplements improve bone health.
• Flaxseed oil helps reduce vaginal dryness and improves heart health.

5. Consulting Healthcare Professionals

Keep in touch with your doctor. A regular health checkup and monitoring of menopause symptoms always keeps you on track. They can also help you assess long-term risk factors. 

Wrapping Up

Menopause is nothing to shy away from; the key is to understand what is happening, be prepared, and know you are not alone in this journey. 

With the right mindset, support, and a little self-care, you’ll handle menopause like a queen.

Our experts at Nirva Health are dedicated to helping women in navigating a smooth menopause transition.