Menopause, or more accurately perimenopause, is the time when your body begins to react to dropping levels of estrogen and other hormones. Every woman will experience this differently, so your menopause may not be the same as your friend’s. But some menopause symptoms are very common, some are less common, and some are serious and should not be ignored. Here's a list of things you may notice as you enter menopause.
Common Menopause Symptoms
Often the first symptom of impending menopause is a change in the length of your cycle. It may be longer between periods, shorter between periods, or a combination of the two.
Hot Flashes & Night Sweats
A hot flash is the sensation of “flushing,” or a sudden feeling of heat, often accompanied by sweating. When this occurs during sleep, it's called night sweats. Hot flashes are the menopause symptom most often mentioned by women: about 75% of women will experience them as they go through menopause.
As estrogen and progesterone decline, some women describe themselves as “emotional.” They report being more easily triggered into strong emotional responses such as sadness, anger, irritability or delight. Because they see themselves as suddenly unpredictable, women find this unsettling, and are likely to seek help for this symptom.
Both migraine and tension headaches may increase during menopause. Since migraine headaches are vascular in nature, and since the vascular system is more unstable during menopause, migraines can become more frequent and difficult to manage.
Many women report a greater tendency to be wakeful. Sometimes this is due to night sweats and sometimes due to neurological excitability, both of which are more common during menopause. Once awake, they find it difficult to go back to sleep, and can suffer from sleep deprivation as a result.
Vaginal Dryness & Urinary Problems
This symptom is also one for which women seek help. As estrogen is less available, the walls of the bladder, urethra and vagina become drier and less flexible. This makes the tissue more easily damaged and more prone to infection.
Your metabolism will slow with age, so weight gain is common in menopause. The combination of changing patterns of fat deposit, less muscle mass and a slower metabolism can give you a larger abdomen and “flabby” arms and legs that send you off to the gym for help.
Memory & Cognitive Changes
This symptom, too, is one that is distressing for women. While some loss of memory is normal with aging — especially word retrieval and short term memory — if cognitive changes interfere with your ability to do everyday things, it’s a good idea to get them checked by your health care provider.
Some women experience a profound fatigue during menopause, though fortunately it's usually temporary, and is your body’s adjustment to lower estrogen. If fatigue prevents you from doing your daily activities, however — or if it lasts more than two months — see a health care provider to rule out other causes.
Many women notice that their sexual desire lessens when they become menopausal. Sometimes this is a temporary response to hormone shifts, while sometimes it's a reaction to other things like stressors or difficult life situations. If you notice that you desire sex less often or don’t seem to enjoy it, and this creates problems in your life or relationships, talk to your doctor or provider about possible treatments.
Serious or Dangerous Menopause Symptoms
See your physician or medical provider if you experience any of the following serious symptoms:
If you find that your periods are increasingly heavy and that you have to change your super tampon or maxi pad more than once an hour for eight hours, your bleeding may be damaging your health. Heavy bleeding can be a sign of fibroid tumors, uterine polyps or uterine cancer. It can also cause you to become anemic and should be evaluated by a medical professional.
High Blood Pressure
Check your blood pressure every few months, and if it becomes higher than 140/80, make an appointment to have it evaluated. High blood pressure can put you at risk for heart disease or stroke, and may be a sign of more serious medical problems.
Some occasional heart palpitations or irregular beats can be normal during the time around menopause. But if they are happening frequently, or are accompanied by troubled breathing, fainting, chest pain, anxiety, or nausea, they could be signs of heart disease or a heart attack.
Menopause is a time of changing moods and grief over life’s losses. If you are finding yourself sad most of the time, or if you feel hopeless, irritable, have lost pleasure in things you used to enjoy or think about dying or hurting yourself, make an appointment to see whether you are clinically depressed. Some treatments for depression are also effective for other menopausal symptoms.