8 Signs and Symptoms of Menopause

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You know those ambitious, entrepreneur types who like to dabble in just about everything? Well, your hormones are kind of like them. Sure, they're known for their reproductive prowess, but that's not their only role. They influence everything from your brain to your bones, even your heart. When estrogen levels start to fall during menopause, your entire body is affected. Whether your midlife change is smooth sailing or a wild, rollicking ride, menopause can have a wide-reaching effect on both your mental health and physical health. Here are eight common signs that signal you're probably going through "the change."

Medically reviewed in December 2019.

Hot Flashes and Night Sweats

2 / 10 Hot Flashes and Night Sweats

For 85 percent of women, menopause can really heat things up. The exact cause of hot flashes is unknown, but experts think low estrogen triggers a malfunction in the area of the brain that controls body temp. So the brain thinks the body is overheating and tells the nervous system to release body heat ASAP. The result is intense hot spells that can turn you red and drench you in sweat. The quicker you go through menopause, the more intense symptoms may be. Smoking, stress and not exercising raise your risk of hot flashes and night sweats. About 20 percent of women will have hot flashes that impair their quality of life, says JoAnn Manson, chief of preventive medicine at Brigham and Women's Hospital.


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Getting a good night's sleep can be a major challenge for menopausal women. During the menopause transition, production of estrogen and progesterone (a sleep-promoting hormone) decline, which can make falling asleep tougher. Hot flashes, caused by a surge of the energy-boosting hormone adrenaline, can also jolt you awake. The physical discomfort and sheet drenching that often accompany night sweats, along with the stimulating effects of adrenaline, can keep you from falling back to sleep. Add to that the usual midlife stresses, such as work and family, and you can see why sleep may so often evade menopausal women.

Mood Swings

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Just as PMS can trigger chocolate cravings and crankiness, fluctuating hormone levels can cause emotional symptoms, too. "Women may cry at the drop of a hat over something that on a different day wouldn't bother them," says Judith Volkar, MD, of the Center for Specialized Women's Health at Cleveland Clinic. Sadness, irritability, fatigue, anxiety, and aggressiveness are some of the feelings that can crop up along your journey. While most women go through menopause without serious emotional health issues, about 20 percent will experience depression. If you had mood swings before your monthly periods or if you had depression after giving birth, you may be more prone to mood issues during menopause.

Sexual Changes

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Menopause does not mean your sex life is over. A 2007 survey found that most people between the ages of 57 and 85 consider intimacy a vital part of their life. Still, midlife changes can pose new challenges. Lower levels of estrogen can cause vaginal walls to be dry, thin, and fragile, and sex may feel less comfortable. Called postmenopausal vaginal atrophy, the condition affects up to 50 percent of women. Vaginal creams and lubricants can ease discomfort during intercourse. In addition, remember that as you age, your partner's body changes, too. The ways in which you express intimacy and affection may not be the same as when you were 21, but can still be satisfying.

Urinary Trouble

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Feel like you're taking more trips to the bathroom than you used to? Pelvic floor muscles, which are responsible for bladder control, weaken as we get older. In addition, the ovaries begin to stop manufacturing estrogen, which helps protect the lining of the bladder and urethra (the tube that empties your urine). When the body slows production of estrogen, some women may become more prone to urinary tract infections or incontinence. That means you may have a tough time holding your bladder long enough to get to the bathroom (urinary urge incontinence), or you might experience a trickle when you cough, laugh, or sneeze (urinary stress incontinence).

Cardiovascular Changes

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On average, a woman's LDL (bad) cholesterol climbs 10.5 points, or 9 percent, during her midlife change. While a woman's risk for heart disease increases after age 50, it may have less to do with menopause and more to do with getting older, explains Margery Gass, MD, executive director of the North American Menopause Society. "It's really a product of age and lifestyle," she says. However, hormonal changes during menopause can make it harder to maintain a healthy weight and may increase blood pressure—both of which are risk factors for heart disease.

Bone Loss

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Until the age of 30, bones form more quickly than they deteriorate, but by the age of 35, bone loss begins to outpace bone formation. Lower levels of sex hormones, such as estrogen, tend to weaken bones, which is why from the onset of menopause to the age of 60 women lose an average of 25 percent of their bone mass. The more bone you have at the time of peak bone mass, the better protected you'll be once bone loss begins. As your bones become weaker and more porous, your risk of fractures and osteoporosis goes up.

Brain Fog

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Feeling a little hazy lately? The so-called brain fog of menopause is real for some women, Gass says. During the change, between one- to two-thirds of women report forgetfulness and other mental hiccups. Perimenopausal women may have a tougher time staying focused, solving difficult tasks, or retaining new information. But don't despair. According to Gass, some studies suggest that these memory lapses last only as long as menopause. Think of it as pregnancy brain for the menopause set.

Going Forward

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While menopause can be a challenging rite of passage, if you are like many women, you may find there is an upside to this time of life—often marked by a greater sense of confidence, control, and personal direction. There are many things you can do to make navigating menopause easier. Healthy habits and taking care of your physical and mental health—including paying attention to and getting help for symptoms—can make all the difference in how smoothly you pass through this time of change.

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