What are the symptoms of menopause?

There are many signs and symptoms of menopause, the time when a woman's body produces less estrogen, a sex hormone. The reduction in the estrogen hormone brings on menopausal symptoms. These symptoms include hot flashes, fatigue, worsening premenstrual syndrome, vaginal dryness, irregular periods, mood swings, breast tenderness, and difficulty sleeping.

Other symptoms include a decreased interest in sex, headaches, forgetfulness, urine leakage, achy or painful joints, and heart palpitations (irregular heartbeat).

Menopause occurs, on average, around age 51, and has many signs and symptoms that stem from ovarian atresia and, thus, hormonal fluctuation. Watch for these signs and symptoms of menopause, including irregular periods, decreased fertility, vaginal dryness, hot flashes, sleep disturbances, mood swings, increased abdominal fat, thinning hair, and loss of breast fullness.

The first symptoms at menopause are “withdrawal” symptoms because the body is reacting to the fact that estrogen is low so it starts sending out “distress” symptoms. These include hot flashes, insomnia, fatigue, brain fog, dizziness, anxiety, depression, irritability, crying spells, and urinary frequency. Some symptoms may even go away as the body compensates to the loss of estrogen. Many women mistakenly think that if they just suffer with the hot flashes till they’re gone, they can go back to their normal life!  Instead of putting back the missing estrogen, women commonly take antidepressants, sleeping pills and tranquilizers.

The next set of problems occurs when vital tissues literally start falling apart because of estrogen deprivation! Some like sexual dysfunction and urinary frequency or incontinence occur within six months, but others like dementia, heart disease, osteoporosis and Alzheimer’s disease can take years to develop!

Menstrual changes: Many women experience irregular periods due to the changing hormone levels and the decreased frequency of ovulation (egg release). The changes may be subtle at first and then gradually become more noticeable. Common changes include short cycles (less than 28 days), bleeding for fewer days than usual, heavier than usual bleeding, lighter than usual bleeding, and missed periods.

Although menstrual irregularities are expected during menopause, menstrual changes can also be caused by conditions such as fibroids or pregnancy. Women who experience heavy bleeding (usually with clots), periods that come more often than every three weeks, spotting between periods, or bleeding after intercourse, should see their doctor or other healthcare provider.

After menopause, women no longer menstruate. Any woman who experiences vaginal bleeding after menopause should see her doctor or other healthcare provider. Hormone treatments can sometimes cause vaginal bleeding to resume.

Changes in the body during menopause are called climacteric symptoms. They include hot flashes, skin and hair changes, and vaginal changes.

Other changes: Other changes that may occur during menopause includes: loss of bladder tone resulting in stress incontinence (leaking urine when coughing, sneezing, laughing, or exercise); headaches; dizziness; loss of some muscle strength and tone; increasing loss of bones, increasing the risk for osteoporosis; increasing risk for a heart attack when estrogen levels drop (however, the addition of estrogen as a prescribed medication after menopause can lead to an increase in heart attack and stroke); emotional changes associated with menopause such as irritability, mood changes, lack of concentration, difficulty with memory, tension, anxiety, and depression; and insomnia that may result from hot flashes that interrupt sleep.

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There are several symptoms and signs of menopause, including:

• Irregular Periods: About four to eight years prior to natural menopause, typically in a woman's late 40s, menopause-related changes may begin. One of the most common and annoying symptoms you may notice during your 40s is that your periods become irregular. They may be heavy one month and very light the next. They may get shorter or last longer. You may even begin to skip your period every few months or lose track of when your periods should start and end. These symptoms are caused by irregular estrogen and progesterone levels.
• Changes in Hormone Levels: Levels of hormones vary erratically and may be higher or lower than normal during any cycle. For example, if you don't ovulate one month -- which is common for women in their late 40s -- progesterone isn't produced to stimulate menstruation, and estrogen levels continue to rise. This can cause spotting throughout your cycle or heavy bleeding when menstruation does start.

One note of caution: Although irregular menstrual periods are common as you get closer to menopause, they can also be a symptom of uterine abnormalities or uterine cancer. See your healthcare professional as soon as possible if your periods stop for several months and then start again with spotting or heavy bleeding; if you have irregular spotting; if you have bleeding after intercourse or if you start bleeding after menopause. Be sure to mention any menstrual irregularities during regular checkups. Uterine biopsy and vaginal ultrasound are the only ways to evaluate these symptoms and determine whether they are caused by abnormalities in the uterus. Irregular spotting can also be a symptom of cervical cancer, which may be picked up by a Pap test.

Other changes and signs of menopause include:

• hot flashes (sudden warm feeling, sometimes with blushing)
• night sweats (hot flashes that occur at night, often disrupting sleep)
• fatigue (probably from disrupted sleep patterns)
• mood swings
• vaginal dryness
• fluctuations in sexual desire or response
• difficulty sleeping