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15 Menopausal Symptoms
Menopause. It's not a subject that most women want to talk about, let alone prepare for. The average age for onset of menopause is around 51-55 years of age. That means that most of us have around 50 years of misinformation, or even no information, on this important and natural life transition. With the abundance of discomforts, frustrations, and the variety of symptoms that comes with menopause, any woman can feel stressed about their health. Due to hormonal changes in her endocrine system, rises in body temperature, increases in contracting vaginal infections, extreme mood swings, and a plethora of other symptoms that can present themselves at all three stages of menopause, it can affect their relationships and affect the quality of life for millions of women.
When dealing with symptoms of menopause, women must know how to handle each based on their own personal needs and what they feel is right for them. We must understand the side effects or risk factors of hormone therapy for postmenopausal women, how a hysterectomy can affect the body by removing the uterus during the time of menopause, and even research more natural ways of gaining control. Women's health is a complex thing during menopause between fluctuating cortisol and hormone levels and decreasing fertility at the same time.
What symptoms can be present during the menopause transition that women will have to be conscious of?
Of the nearly 30+ symptoms that women have reported experiencing, these 15 are the most common across the board.
Hot Flashes
Estrogen contributes to the control of many functions in the body, including the ability to regulate body temperature. When estrogen decreases, the areas in the brain responsible for controlling body temperature have difficulty functioning correctly. The result is a sudden rise of body heat; in other words, a hot flash. Hot flashes are the most common menopausal symptom, as 75 percent of women experience them during the height of menopause. Hot flashes can range in severity as well as duration. While some women may only experience 2 or 3 thirty second hot flashes in a day, others may experience up to 20 hot flashes in a day that can last up to 10 minutes.
In addition to the differences in duration, hot flashes can also affect specific areas of the body more than others. The most commonly cited areas are the head, neck, and upper chest. However, some women have also reported feeling this same rush of heat in their shoulders and arms. These areas of the body are affected the most in women because that is where we are naturally the warmest.
Check-in with your healthcare provider about any other health issues as some medical issues like thyroid function problems can exacerbate your hot flashes during this transition.
Mood Swings
Body heat is the most significantly reported area that is affected by menopause. The second most cited issue that menopausal women notice is how quickly their moods change. Mood swings are prevalent throughout all three stages of menopause. On average, mood swings begin during perimenopause and are often mistaken for premenstrual related symptoms. They tend to be acute changes in mood that can feel like a typical hormonal imbalance during a bad period. However, make no mistake; they are signs that more intense mood swings are likely to happen soon. Mood swings can be set off by the smallest things and often present themselves during times of heightened stress as cortisol rises in the body. Whether a woman's greatest source of stress is her home life or her work life, she may find herself taking out her frustrations on others around her without meaning to do so. This does not mean that she is changing fundamentally as a person. She is still the same person she was when she walked in the door. Instead, it means that she is having difficulty regulating the emotions she is experiencing.
Moods that a woman can expect to feel during mood swings include irritability, depression, anxiety, panic, and lethargy. They will often present themselves suddenly and without warning. However, that does not mean that they do not have the capability to increase the number of times they happen in a day. Women can experience mood swings at a lower rate one day and a higher rate the next. The intensity with which these mood swings occur also differs from woman to woman.
Sleep Issues
It may seem shocking, but there is a strong correlation between the decrease in estrogen and the increase in sleeplessness. Sleep problems are one of the menopause symptoms that can lead to others like hot flashes or even fluctuations in mood. The sexual reproductive hormones estrogen and progesterone work together with the hormone responsible for sleep production, melatonin. When these sex hormone levels decrease, melatonin decreases as well. This loss of melatonin production is what causes sleeplessness which can then cause a host of other issues. Sleep problems can affect all women regardless of their age, but it seems to be a particular problem for postmenopausal women. In postmenopause, the ovaries are completely depleted of estrogen and progesterone. The ovaries help regulate hormone balance in the body, so if there is an imbalance in the body they can cause a host of symptoms to occur during menopause. Therefore, when the ovaries are depleted from the important feminine hormones, then melatonin production is incredibly slow. So, women who are over the age of 55 may have more difficulty falling and staying asleep.
What are the signs of sleeplessness?
There are a few signs that a woman may be suffering from menopausal or postmenopausal sleep problems.
The first is that it takes more than 30 minutes to fall asleep. If it takes between 30 minutes and an hour for a woman to fall asleep, that means that melatonin is not being produced at a high enough rate. The second sign is waking up periodically throughout the night. How many times do you wake up in a night, once, twice, five times? Waking up more than twice throughout the night tends to be a sign of sleep problems. Third, after waking, the individual stays awake for long periods of time, typically longer than 20 minutes at a time. The inability to fall back asleep is a surefire sign of problems with sleeping. Losing up to an hour of sleep a night can have a negative impact on health.
Sleep aids us with healing our immune systems and storing information into our long-term memory. Without a regular sleep cycle, the health of the brain and the body are impacted.
Keep in mind that lack of sleep can result in numerous health issues like contributing to obesity, a weaker immune system, mood changes that can result in depression, and decrease concentration and alertness. It can also cause high blood pressure, cardiovascular issues that can lead to a heart attack or failure, diabetes, a stroke, and even a lower sex drive.
With the lack of sleep, along with the implications that sleep deprivation can have on women's health, more women are opting for natural treatments like acupuncture. A gentle, non-invasive, and effective way to deal with the symptoms of menopause. Acupuncture helps balance symptoms reducing hot flushes, by keeping hormones fluctuations at bay, helping with sleeplessness, and reducing irritability for better sleep.
Night Sweats
Combine sleep problems with hot flashes, and an entirely new symptom arises, night sweats. Night sweats are precisely what they sound like, uncomfortable bouts of sweating during the night. For most women in menopause, hot flashes are generally accompanied by night sweats. The rise in body temperature caused by hot flashes also forces the body to try to cool itself down. The fastest way to do this is to produce sweat. So, in an effort to cool itself, the body will naturally start perspiring to keep the skin cool.
This produces a number of problems. The first is that while sweat may help keep the skin cool, it doesn't address the internal heat caused by hormonal changes that is produced during hot flashes. The battle between the internal heat and the external cooling results in chills. For menopausal women, this can be especially distracting as they try to fall asleep, which adds to the struggle of dealing with sleeplessness and can keep women up at night until the sweating stops.
Some women go to great lengths to find relief from vasomotor symptoms like taking estradiol, going through hormone therapy, and even taking an herb like black cohosh to alleviate common symptoms of menopause like hot flashes and excessive sweating.
Irregular Periods
The uterus goes through some pretty massive changes. Irregular menstrual periods are generally part of two stages of the transition, perimenopause, and menopause. By the time postmenopause arrives, this no longer becomes an issue. Irregular periods begin to show during perimenopause.
What makes them irregular?
Any number of things could mean that a woman is experiencing an irregular period.
Are the menstrual patterns longer or shorter than usual? Is there more pain or fatigue or bloating? Is there less? Are your menstrual cycles shorter or longer apart? Do they occur two weeks apart? Do they occur two months apart? Do you experience mood swings more intensely? Are you more prone to feeling irritable or depressed during a period than before? All of these questions should be asked when entering menopause.
The uterus is a complex reproductive organ, especially as women age. When it no longer serves for reproduction, it begins to take on a different role that can cause confusion for many women at the time of menopause across the United States. Speak with your healthcare provider about your physical changes and your biological changes as well for transparency about your health and to get a better grip on your life.
Vaginal Dryness
The sexual reproductive system is the most affected in the body when the menopause transition strikes. The natural estrogen that the ovaries produce decreases at a rapid rate. Without estrogen, the tissues lining the vaginal canal cannot produce the natural lubricant that helps keep the vagina moist and healthy. This lack of moisture results in vaginal dryness.
This can cause a number of additional symptoms, pain during sex, irritation when urinating, and a higher number of vaginal infections can all be expected to accompany vaginal dryness. Moreover, vaginal atrophy can occur as a result of vaginal dryness. Vaginal atrophy is the shortening of the vaginal canal, which makes it more challenging for women to engage in sexual activities. Vaginal dryness is an uncomfortable symptom to experience and discuss, especially with doctors and romantic partners. It's important to understand that it is normal to experience vaginal dryness. There are ways that women can work around it without having to feel ashamed of it. Be honest about sexual relations with any romantic partners and tell them upfront about these new circumstances and new needs.
Fatigue
Much like a standard menstrual period, menopause can cause fatigue and at higher intensities. Feeling sluggish, lethargic, or just too tired to concentrate are all signs that a woman may be experiencing fatigue. Menopause can make fatigue happen more frequently and make it feel like it's lasting longer than usual. When estrogen and progesterone decrease in the body, the adrenal hormones, and the thyroid lose the ability to regulate cellular energy. Without these hormones, cellular energy cannot disperse through the body as quickly, causing fatigue. When fatigue hits during menopause, it can be difficult to carry on with the day. Fatigue intensifies in menopause, and it can have an impact on more than just concentration. It can affect sleep patterns and sometimes memory. Taking naps throughout the day to try to get over fatigue can often result in the disruption of the body's natural circadian rhythm. So while women may think they are combatting their fatigue by sleeping for short periods of time earlier in the day, they are actually disrupting their natural sleep patterns, which can increase the likelihood of developing or worsening sleep issues.
Weight Gain
Weight loss goals can be difficult during menopause, especially since menopause lowers metabolism. Weight gain for menopausal women is a common issue. Weight fluctuates depending on hormonal imbalances, genetic markers, diet, nutrition, exercise, and even sleep. However, the changes in sex hormones have an even greater effect on metabolism than women might realize. The relationship between estrogen and female metabolism is not entirely understood. However, there is a noticeable difference in women's metabolisms when estrogen is high and when it is low. When estrogen is low, the rate at which the body converts stored energy into working energy is also lowered. This means that when estrogen decreases, energy stored in fat cells remains stagnant. Stagnant fat cells can not only contribute to experiencing fatigue, but it can also make weight loss more difficult. Regular diet and light exercise can help maintain weight, but weight loss may require more extensive methods. Engaging in more rigorous exercise regimens may be necessary to help increase weight loss. Introducing probiotics into the body can also help activate metabolism in areas of the body that seem particularly slow.
Joint Pain
Joint pain may seem more like a symptom of old age rather than menopause, but menopause can have an effect on joints with just as much impact as the natural aging process. Estrogen acts as more than simply a sexual reproductive hormone. It also acts as an anti-inflammatory. Joint inflammation is common in women of all ages, and women who have arthritis when entering menopause have more difficulty with joint pain.
Joint pain during menopause tends to affect specific areas more than others. For women, these areas include the hips, ankles, knees, shoulders, and wrists. Some women report feeling aches in and around the rib cage. This tends to be the case for women with large breasts.
Anti-inflammatory medications can help reduce joint pain, but there are other things that women can do to help with joint pain. Engaging in certain kinds of exercise can help decrease joint pain and even reduce inflammation. Stretching exercises like yoga, certain Pilates activities, and slower exercises like tai chi can help with joint pain. Other activities, such as walking, cycling, and water exercises, have also been known to help with aching joints.
If these exercises do not provide enough relief, visiting a massage therapist and a chiropractor can help relieve the discomfort of joint pain. Depending on the severity of the pain, visit a chiropractor one to two times every month and make appointments with a massage therapist once a week.
Headaches
Headaches are no strangers to women, menstrual headaches, migraines, and headaches during pregnancy are all common side effects that women experience during their lives. Hormonal imbalances and fluctuations caused by menopause can increase the intensity and frequency of headaches, especially during menstruation in the early stage of perimenopause. Often times headaches will seem worse during ovulation in perimenopausal periods.
During a menstrual cycle, estrogen and progesterone levels fluctuate. Menstruation during perimenopause causes these levels to decrease. So, as levels of estrogen decrease, other chemicals that rely on estrogen for proper regulation trigger pain receptors in the brain. This is what causes menopausal headaches, which are often coupled with feeling a strain in the neck and shoulders.
Taking medications like ibuprofen or menstrual relief pills may work during periods prior to menopause, but they ultimately have very little effect on headaches during perimenopausal periods.
Breast Pain
There are a number of things that happen to a woman's breasts during her lifetime. During puberty, they begin to grow and take shape. During pregnancy, they expand as mammary glands and ducts grow to make room for milk for breastfeeding. Menopause also has an effect on the breasts. Estrogen, the sex hormone responsible for causing breasts to grow, decreases during menopause. As a result, breasts may shrink in size, change in shape, and begin to droop. Additionally, breasts may begin to feel sore during and after menopause. Why? Breast soreness and breast tenderness during menopause are caused by the shrinking of breast tissue. When the breast tissue shrinks, it pulls the tissues similar to the way muscles are pulled when torn. This pulling sends signals to the brain that the breasts are experiencing tearing, which then triggers a pain response.
The best solution to resolving this problem is to take supplements that help increase estrogen levels to alleviate some of that pain. However, there are other things that women can do to attempt to help repair breast tissue. Upper body exercises are a great way to help build up muscle tissue in the chest. While the actual breast is made up mostly of fat cells, the pectoral muscles that lay underneath them help keep breasts healthy. Pectoral muscles provide support underneath the breasts and can help keep them sag less and potentially help keep breast tissue from being easily prone to tearing. Push-ups and bilateral weight exercises can build up muscle tissue and prevent major tears in breast tissue.
Osteoporosis
Somewhere around 61 percent of women experience postmenopausal osteoporosis. Osteoporosis is a medical condition in which bone density decreases. This causes bones to become more brittle and likely to fracture. The areas that are most often affected by this loss in bone density are the hips, knees, and ankles.
Why does bone density decrease in the postmenopause stage?
Osteoclasts are a type of cell that helps absorb bone tissue during bone growth and bone healing. Osteoclasts are produced with the help of estrogen. Since menopause reduces estrogen, it also reduced the number of osteoclasts produced in the bones, making them more porous and less strong.
When bone tissues become too porous, they lose their strength and their ability to heal quickly. This means that if an older woman fractures a bone during the postmenopause stage, it will take longer for that bone to heal, and sometimes it doesn't heal entirely. Hip and other joint replacement treatments are designed to replace the fractured areas and so that patients still retain motion in the affected areas.
The best things to do to help reduce the likelihood of fracturing bones and combatting postmenopausal osteoporosis are to take supplements, eat nutrient-rich foods, and participate in exercises designed to help strengthen bones.
Weight-bearing and resistance exercises like walking, step aerobics, and resistance band training are all exercises that help promote bone strength. By causing the muscle to pull on bones, you are actually encouraging bones to conserve their tissues. In essence, exercise helps increase bone loss resistance. Of course, exercise can only go so far in reducing large levels of bone loss. Consuming vitamin and nutrient-rich foods can also help reinforce bone tissue and reduce the risk of fracturing, even during postmenopausal osteoporosis. The primary nutrients that bones require in order to reinforce their tissue strength are calcium, vitamin D, proteins, potassium, and magnesium (among others). These five core nutrients help bones maintain their density and help promote tissue healing. Some great sources of these nutrients include foods like cheese, leaf vegetables, cabbage, okra, soybeans, broccoli, and tofu. It's recommended that women over the age of 50 consume up to 1,200 mg of calcium per day.
Brain Fog
The brain is already known as the most complicated and least understood organ in the human body. Research related to the brain has only begun to scratch the surface. That also means that research surrounding menopause's effect on the brain is still trying to be understood. The relationship between female sex hormones and the brain is not entirely understood but there is a noticeable change to the female brain when sex hormones are depleted. Estrogen and progesterone have a number of effects on neurotransmitters in the brain that help control concentration, memory, and even reflexes from time to time. Without the same high levels of both of these sex hormones, women report feeling a "brain fog" throughout their daily lives.
What is brain fog?
For most women, brain fog presents itself in a number of different ways: a lack of ability to focus, not being able to recall information with ease, and temporarily feeling a dissociation between the brain and parts of the body.
Concentration and focus become much more difficult as women age and it's due to a variety of different factors. Mental conditions like dementia and Alzheimer's can present themselves as early as 55 and as late as 80 depending on the health of an individual's brain. Other conditions like ADHD can also increase in severity with age. Menopause's effect on concentration in the brain stems from the lack of interaction of high levels of estrogen and progesterone with other chemicals in the brain.
Some women may have trouble with focus as a result of feeling increased fatigue that starts during perimenopause. Why do women feel this increase in fatigue, even when they're not on their period? Low levels of estrogen cause fatigue in women during menstruation and during menopause. Additionally, lowered progesterone levels cause a decrease in melatonin production, the neurotransmitter responsible for falling asleep. As a result of this decrease in melatonin, sleeplessness increases for women in menopause. Without an adequate amount of sleep, women are more likely to feel intense fatigue during menopause.
Loss of Libido
Of the major symptoms that women cite experiencing during menopause, this is one that is often reported for being the most uncomfortable to discuss. Sex drive and sexual arousal are not the most straightforward aspects of female sex lives. Men are known for having high sex drives, but what people tend not to realize is that women can have even higher sex drives than men, especially during their 20s. However, as women age, their libidos decrease. In menopause, it can become extremely difficult for women to experience arousal even in a romantic setting. Why? It's because of the decrease in estrogen and progesterone.
These sex hormones help prepare the body for conception in a number of ways. One of those ways is by causing the lining of the vaginal wall to become moist and produce natural lubricants during sexual intercourse. This works in tandem with sexual arousal by increasing blood flow to the vagina and raising body temperature. The phrase "hot and bothered" accurately reflects this sensation and its all thanks to the sex hormones.
So, when sex hormones decrease, women can expect to experience these symptoms when trying to make themselves feel sexually aroused. There will be no rise in body temperature. It will become challenging to naturally secrete vaginal lubricant. You might experience fatigue in trying to make yourself become sexually aroused.
Remember, don't beat yourself up if you don't become sexually aroused instantly. It is perfectly natural to withdraw from sexual activity during menopause. There are things that women can do to help increase their libido and inspire sexual arousal even during menopause. Find ways to spice up the bedroom. Sometimes the sexiest thing is something you haven't done before. Be open to creativity, experimentation, and don't be afraid to talk about it with romantic partners, therapists, and doctors.
Vaginal Infections
As we've discussed the decrease in the sex hormones estrogen and progesterone can cause the vaginal canal to shrink, otherwise known as vaginal atrophy. Not only does this make sexual intercourse more painful but it can also lead to an increase in contracting certain vaginal infections. Urinary tract infections, yeast infections, and bacterial vaginosis are common for women to contract during menopause.
Vaginal atrophy is the shrinking of the vaginal canal that's caused by a lack of natural moisture produced in the vaginal wall lining. Because of this, when women engage in penetrative sexual activity, the friction against the vaginal walls can not only make sexual intercourse painful, but it can also increase the spread of infections. Yeast infections are the most common kind of infection to be produced after having sex. Candida fungus naturally occurs in the bacteria that coats the membrane of the vagina.
During sexual intercourse, particularly penetrative acts, candida is pushed further up into the vaginal canal. When this happens, it can build up to unhealthy levels and begin attacking the body. The result of this buildup includes quite a few symptoms: itching, burning during urination, discomfort when sitting down and inserting period products like tampons and period cups into the vagina. Urinary tract infections also become more common for women going through menopause. UTIs are caused by the introduction and spread of bad bacteria called Escherichia coli, (E. Coli). This kind of bacteria can be found throughout the digestive tract and even in the kidneys if UTIs become severe enough for them to travel back upward into the body. Again, because the vagina begins to experience vaginal atrophy during menopause, this makes it more likely for these kinds of bacteria to build and spread in the vaginal canal.
Similarly, bacterial vaginosis is caused by an increase in vaginal bacteria. This can cause inflammation in the vaginal canal, making it painful to urinate, increasing an itching sensation, having a foul "fishy" odor emitting from the vagina, and thin discolored vaginal discharge ranging from gray-white to green. Bacterial vaginosis has three primary causes: having multiple sexual partners, douching, and having a natural lack of lactobacilli bacteria.
That third cause is the most prevalent for women experiencing menopause. Why? Well, lactobacilli bacteria are bacteria that line the gut and help promote gut health. They help in the production of lactic acid, which can prevent the spread of harmful bacteria from spreading in the intestines. Menopause reduces the body's ability to produce lactobacillus naturally. As a result, it becomes easier for bad bacteria to thrive in the body because it makes the body more hospitable for it to live in. So, with all of this information, what can women do to help decrease the likelihood of contracting such unpleasant vaginal infections as they go through menopause?
First, consume foods and supplements with good bacteria like lactobacillus bacteria. Yogurt, tempeh, kimchi, kefir, sauerkraut, miso, and kombucha are all excellent sources of lactobacillus bacteria. Increasing the consumption of these foods during menopause can help increase good bacteria in the gut and prevent bad bacteria from developing in the stomach, intestines, kidneys, and vagina.
Second, avoid douching. Despite popular belief that douching helps keep the vagina clean, it can actually be more harmful than helpful. Douching causes bacteria to be pushed further into the vagina, and therefore further into the body. This can cause bacteria to find more hospitable environments to colonize and multiply in. The vagina naturally keeps itself quite clean by producing discharge. The best thing to do to help promote cleanliness, on top of its self-cleaning abilities, is to wash the area with warm water and nothing else. Do not use scented soaps, body washes, or shampoos to clean the vagina. Water of a high enough temperature is enough to kill bacteria and inhibit it before it spreads.
Third, practice safe sex. When engaging in sexual intercourse (particularly penetrative sex) avoid glycerin lubricants, spermicides, and be sure to use condoms if you're unsure of your romantic partner's/partners' medical history. Glycerin lubricants are notorious for causing yeast infections in women. This is because glycerin promotes the production of yeast in the vagina, yeast feeds off of glycerin. So, if you engage in sexual intercourse, use water-based non-glycerin lubricants to help moisten the vaginal canal. The same goes for spermicides, the chemicals in spermicides can aggravate bacteria in the vagina, not that women in menopause need to worry about becoming pregnant but conception during perimenopause is not entirely unheard of and can happen in a small percentage of women.
Finally, use condoms when interacting with a new sexual partner. Whether a sexual partner is unaware of any conditions they have or they are unwilling to share sexual medical history, using condoms to help prevent the likelihood of vaginal infections is vital. Preventing pregnancy is not their only use. Condoms help prevent sexually transmitted diseases and that also includes bacterial infections that can cause irritation and discomfort in the vagina.
The list goes on
While this may be a long list of symptoms, remember, there are others that are specific to the individual and all of these symptoms can be impacted by personal medical conditions and family medical history. Of the 30+ symptoms that women may experience during all three stages of menopause, determining which symptoms you are experiencing is crucial to helping you understand how best to treat them. Be mindful of your body. Understand how it reacts to your symptoms. Talk to a general care provider about your discomfort and don't be afraid to talk about it with loved ones.
You also want to be informed about all the possible treatment options like hormone therapies or even natural menopause solutions like probiotics. Speak with your healthcare provider for what's best with your body and your health. Menopause symptoms should be handled in a smart way. Ask your doctors and research ways to prevent unfavorable things like heart disease and breast cancer, and ovarian cancer or even the implications of a hysterectomy or chemotherapy would have on the body during menopause. Stay informed of your hormonal imbalances, your menopause symptoms, and your overall menopause transition and what you need to help you keep healthy.
Lifestyle changes can also help with menopause symptoms as you go through the menopause transition. Regular exercise, proper food intake of a nutritious diet, and leading an overall healthy lifestyle can help regulate symptoms. Regular hospital visits to get mammograms, regulate things like blood pressure and blood sugar levels.
More and more women are being informed about more natural ways of handling their vasomotor symptoms and others in their menopause journey without the use of hormone therapy. Lifestyle changes, like changes in physical activity, seeking medical advice from natural healthcare providers and choosing natural treatments like acupuncture, herbal medicines, and even taking probiotics to alleviate their symptoms can be very beneficial for women's health initiative. It is advised that if you have any serious health conditions, talk with your doctor about the proper way to care for your health. Neglecting your overall health or more specific conditions could put you at a higher risk of more severe health issues.
