What are the symptoms of menopause?

Dr. Jeanne Morrison, PhD
Family Practitioner

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).

Dr. Afua Mintah, MD
OBGYN (Obstetrician & Gynecologist)

Symptoms of menopause might include changes to menstrual cycle. Heavy bleeding may become lighter or light bleeding may become heavier or cycles may become irregular. Women may also start experiencing changes to sleep patterns like difficulty falling asleep, or night sweats disrupting sleep. Women may have daytime hot flushing, vaginal dryness, or moodiness. Some women have no symptoms at all. A woman is in menopause when she has been without her period for 12 months.

Dr. Marina Johnson

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!

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.

Dr. Elissa M. Gretz-Friedman, MD
OBGYN (Obstetrician & Gynecologist)

In addition to the cessation of the menstrual period, the most common symptom of menopause is the hot flash. About 75 percent of women experience hot flashes during the menopause. It is a feeling of heat that lasts a few minutes and may or may not be followed by sweating. Some women have many per day and night. Some women never experience a hot flash. Hot flashes are most common during the transition when you are waiting for the year to see if you will get another period. They last on average 1-2 years, but it varies from woman to woman.

Mrs. Marjorie Nolan Cohn
Nutrition & Dietetics Specialist

Symptoms vary from woman to woman. They may last 5 or more years. Some women may have worse symptoms than others. Symptoms of surgical menopause can be more severe and start more suddenly.

The first thing most women notice is that periods start to change. They become irregular and might occur more or less often. Irregular periods can last for 1 - 3 years before the periods completely stop.

Symptoms of menopause include:

  • Menstrual periods that occur less often and eventually stop
  • Heart pounding or racing
  • Hot flashes, usually worst during the first 1 - 2 years
  • Night sweats
  • Skin flushing
  • Difficulty sleeping

Other symptoms of menopause may include:

  • Decreased interest in sex, possibly decreased response to sexual stimulation
  • Forgetfulness (in some women)
  • Headaches
  • Mood swings including irritability, depression, and anxiety
  • Urine leakage
  • Vaginal dryness and painful sexual intercourse
  • Vaginal infections
  • Joint aches and pain
  • Irregular heartbeat or palpitations
Dr. Gloria J. Morris, MD
Hematologist & Oncologist

Menopause is technically defined as the permanent cessation of menses, and according to breast cancer guidelines, includes the cessation of menses for 12 or more months in the absence of treatment like chemotherapy or some hormonal agents which may otherwise cause the menstrual periods to cease (The National Comprehensive Cancer Network Clinical Practice Guidelines Version 3.2012). However, signs and symptoms of menopause, which may even precede a woman's final menstrual period by several years and are due to hormonal fluctuations, include hot flashes, sleep disturbances, mood swings, and vaginal dryness. In addition, the physiologic decrease in the body's estrogen production can lead to lipid dysregulation and bone loss, and so following these components are necessary health maintenance in following women into their menopausal years.

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


Dr. Mehmet Oz, MD
Cardiologist (Heart Specialist)

In menopause, ovulation and menstruation stop, skin may become drier, scalp hair may thin, facial hair becomes coarser, and abdominal fat may increase. Watch the animation to see how ovaries work and how they age in later life.

The major symptoms of menopause are not menstruating, hot flashes, insomnia, vaginal dryness, anxiety, and depression.

Menstrual changes and hot flashes are two key indicators that a woman is experiencing menopause.

Menopause affects every woman differently. Your only symptom may be your period stopping. You may have other symptoms, too. Many symptoms at this time of life are because of just getting older. But some are due to approaching menopause. Menopause-related symptoms you might have during perimenopause include:

  • Changes in pattern of periods (can be shorter or longer, lighter or heavier, more or less time between periods)
  • Hot flashes (sudden rush of heat in upper body)
  • Night sweats (hot flashes that happen while you sleep), often followed by a chill
  • Trouble sleeping through the night (with or without night sweats)
  • Vaginal dryness
  • Mood changes, feeling crabby (probably because of lack of sleep)
  • Trouble focusing, feeling mixed-up or confused
  • Hair loss or thinning on your head, more hair growth on your face

When you visit your doctor, take along a diary about what's happening with your period. For a few months before your visit, record when your period starts and stops each day, and indicate whether it is light of heavy. Also note any other symptoms you have.

This answer is based on source information from the National Women's Health Information Center.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.