By Rachel Lankester, founder Magnificent Midlife Movement
So you want to know about the 34 symptoms of menopause huh! You’re in the right place. Here’s the full list.
Some people say there are even more – yikes! Some people reckon there are a hundred symptoms of perimenopause or menopause. I reckon that’s unlikely!
Why not just throw the kitchen sink in there for good measure! Take a look but don’t get too scared! The most common symptoms have a * next to them.
Hot flushes (UK) or flashes (US) are often the most common change associated with menopause. They are certainly the most well known. These can impact the whole body but usually cause us to suddenly get very hot in the face, neck and chest. Thought to be linked to hormonal changes they can also be triggered by caffeine, alcohol, sugar and spicy food etc.
2. NIGHT SWEATS*
The night-time version of hot flushes, these can be particularly annoying as they can disrupt sleep often when we need it most. Similar triggers to the day time version. These can leave you drenched in sweat and needing to change your clothing at night in the worst instances. Like hot flushes, these are easily managed with diet and lifestyle changes.
3. IRREGULAR PERIODS*
Often one of the first signs that you are heading into the perimenopause years, the time before menopause which is technically when your periods stop. Keeping track of your cycles can be really informative, so keep a diary to give you more of an idea of what’s going on with your body.
Menopause is said to have occurred once you’ve been without a regular bleed for 1 year if you’re over 50 and 2 years if you’re under 50. You may experience, less or more frequent periods and lighter or heavier ones. We all have a different experience. If your periods are a lot heavier, longer or more frequent, get yourself checked out by your doctor.
4. MOOD SWINGS*
If you suffer mixed emotions around your period and/or mood swings during pregnancy, chances are you’ll experience mood swings during perimenopause too. Hormonal changes do that. So don’t be scared of mood swings. All of the work you do to balance your hormones will help with your emotional balance too. And hopefully once you’re through menopause you’ll feel a lot calmer.
5. VAGINAL DRYNESS*
One of the most difficult symptoms to cope with. This often comes as a real shock to women because while we don’t talk about menopause very much, we certainly don’t talk about vaginal issues! As we age, and as our estrogen decreases, our skin everywhere gets dryer. We moisturize elsewhere but we often forget to moisturize our vaginas!
So don’t be scared, and certainly not ashamed, of this symptom either cos that will only make matters worse. Relax, breathe and remember to take sex back to pleasure.
Getting blood flow to the vaginal area is crucial and self-pleasure can help achieve this whether or not you have a partner. A good lube will do wonders. My current favorite is Pjur. Yes also does a range of organic moisturizers and lubricants. Toys can also help to get your juices flowing more easily. Localized vaginal estrogen in the form of pessaries or a cream may also be very helpful and is available on prescription in the UK.
6. DECREASED LIBIDO*
There can be many reasons for decreased libido in midlife. If you’ve been in a relationship for a long time, you could just be bored. Or you don’t like your aging body. Again, try not to worry about it, as that will only make things worse. Follow the advice above for vaginal dryness – toys can be especially helpful if the mind is willing but the body is taking too long to respond.
There’s also a wonderful book which takes the pressure off sex and which I’ve personally found brilliant: My Spouse Wants More Sex Than Me: The 2-Minute Solution for a Happier Marriage. You agree that if your partner wants sex and it can be achieved in 2 minutes, you say yes. I reckon we can all do 2 minues!
This concept has transformed my own sex life and often leads to longer than 2 minutes and always smiles on both our faces. Post menopause you will likely have more testosterone relative to other sex hormones than before menopause. So your libido may be higher then too.
If periods cause you to have headaches, these may increase during perimenopause. Migraines can also be an issue for some women. It’s the hormonal fluctuations again, so anything you can do to balance your hormones will help. Always also remember that dehydration can cause headaches so be sure to keep your water intake up.
8. BREAST TENDERNESS
Another result of fluctuating hormones and similar to what you may have experienced during your period or when pregnant.
9. BURNING MOUTH
This seems a strange one but is also due to hormonal changes. We have estrogen receptors throughout the body and our mucus hormones in the mouth have sex hormone receptors which decrease with a decline in estrogen. With Burning Mouth Syndrome (BMS) you may experience burning, tenderness, heat or numbing in or around the mouth.
10 JOINT PAIN
Estrogen has a role to play in keeping our joints lubricated and reducing inflammation in the body. As it declines, if we’re not doing anything else to help with our joints and reducing inflammation we may experience more join pain. If you’re highly stressed and producing too much cortisol, that is also associated with inflammation and can contribute to distracting our adrenal glands from their important role of producing the estrogen that is needed for healthy joints.
Similarly if you’re not hydrated enough that could cause pain. Diet is crucial as is some form of stretching exercise like yoga. See any joint pain as the body telling you that you need to take a bit better care of it!
11. DIGESTIVE PROBLEMS
As we go through perimenopause we may be less able to tolerate certain food and drink that previously we were fine with. Our gut flora changes and so does what we can comfortably eat and drink. Keep a food and drink diary to see if you can identify problem items.
12. ELECTRIC SHOCKS
There may be various reasons why these occur more during perimenopause. If in doubt blame hormonal fluctuations! They can be particularly prevalent after a hot flush/flash.
13. MUSCLE TENSION
This is mainly due to the same reasons as the joint pain above. Starting a regular yoga practice is definitely going to help. Muscle tension can also manifest as restless legs or cramps particularly at night. This may be because you need to stretch out your muscles more or you may have a vitamin deficiency.
Taking a magnesium supplement can be really helpful. You can also get magnesium from eating lots of leafy green veg, nuts and seeds, pulses and grains. An Epsom Salt bath will also give you a great magnesium boost and is very soothing.
14. GUM PROBLEMS
You may experience a metalic taste in your mouth or greater sensitivity in your gums. Keep up your dental hygiene and get a checkup with your dentist.
15. TINGLING EXTREMITIES
Again due to dropping estrogen levels. Some women report tingling in their fingers and toes and also a burning sensation or some numbness. There shouldn’t be anything to worry about but if you are concerned, check in with your doctor.
16. ITCHY SKIN*
When estrogen drops our skin gets dryer. As it gets dryer it can get itchier and more sensitive. Again our body is often telling us that it can’t tolerate something as well as it did before. I have had to go as natural as I possibly can with soap and skin products. I now make my own whipped organic shea butter which works really well on my dry itchy skin.
Keep a diary again to see if you have any particular triggers such as certain foods/personal and domestic cleaning products. By going natural/organic with everything, you are also helping to reduce the toxic load on your body exacerbated by the ingredients in products and the pesticides and hormones in foodstuffs.
A very common symptom of perimenopause. With so much change going on in the body, fatigue is it’s way of telling us to relax and take things a bit easier otherwise we may exacerbate our symptoms further. Stress will make fatigue worse as will sleep interrupted by night sweats and hormonal insomnia.
Take time to rest if you can, your body will thank you for it. Anything you do to balance your hormones will help with fatigue.
Hormonal fluctuations mean that anxiety can be a common issue during perimenopause. If you are generally quite an anxious person, you may find it worse during this time. Again, don’t be scared of it cos that will just make it worse.
There’s also a lot going on in midlife in general to make one anxious, not to mention a global pandemic at time of writing! Take steps to understand what’s going on, what may be triggering it and try to manage it. Meditation, mindful breathing and a journaling practice can all help with anxiety.
19. DISRUPTED SLEEP*
Just when we need the best sleep, many of us find it is awfully disrupted. This is very much related to fluctuating hormones so again, try to balance your hormones as much as possible.
20. HAIR LOSS
Hair loss can be one of the most distressing symptoms associated with menopause and if probably due to changing hormones although stress is always a contender for blame too.
21. BRAIN FOG*
When we can’t remember things or just get rather confused for no apparent reason. Another distressing issue because when it happens we often have no idea why and we jump to the conclusion that we must have early onset Alzheimer’s. But no it’s just those hormones changing again. If you’ve ever been pregnant and experienced pregnancy brain, you may remember something similar.
Recent research has shown these brain changes are temporary for most of us and post menopause we’ll get back to our pre-brain fog selves. Stress will make it worse, so when it happens, try not to stress about it! Easier said than done, but make a joke of it if it happens in public, rather than feeling ashamed.
22. DIFFICULTY CONCENTRATING*
This is very closely related to brain fog above. Balancing our hormones, getting enough exercise and good sleep are all going to help with our powers of concentration. Luckily many women find themselves more able to focus on things post menopause when we are no long subject to hormonal cycles.
23. WEIGHT GAIN*
Menopause gets blamed for many things and dropping estrogen levels may be responsible for weight gain, but it’s more likely to be lifestyle and ageing that are the main culprits.
What menopause does do is re-distribute where we store fat in our bodies so that our body shape can change with weight clinging to our tummies where previously it might have accumulated elsewhere. That’s why we can often thicken around our middles if we don’t make changes in the way we live.
24. DIZZY SPELLS
Hormonal changes can affect how our body produces insulin and make maintaining blood sugar levels more challenging. This can sometimes result in dizzy spells.
If we work backwards and start with working to balance our blood sugar levels, our adrenal glands can focus on producing estrogen which they take over doing from the ovaries as we go through menopause. If our blood sugar levels are not balanced, the adrenal glands will focus instead on producing stress hormones because the body is perceived to be under stress.
The end result of imbalanced blood sugar levels and stress on the body is that menopause issues can get worse. Balancing blood sugar levels and managing stress during the perimenopause years and beyond are the cornerstones of good hormonal balance.
This may be directly related to hormonal fluctuations or specifically to our bodies being less able to process certain foods and drink as we age and go through menopause. Keep a food diary to track what is causing bloating.
Key culprits for bloating could be gluten, dairy, certain vegetables like onions, processed foods and sugar. You may need to try eradicating certain things to see if that helps. Get help from a nutritionist if this is a big problem.
26. STRESS INCONTINENCE
Declining estrogen doesn’t just cause a dry vagina, it can impact the entire pelvic floor and lead to stress incontinence. But it may be common but is not normal! 1 in 3 women will suffer from stress incontinence but 84% can be cured with just 6 treatments with a pelvic health physio.
So get help. Do not suffer. Incontinence pads and pants are not the answer and will lead to other issues if used long term.
27. BRITTLE NAILS
Declining estrogen may lead to weaker keratin and brittle nails. You’ll likely find supplements which may be worth trying in your local chemist.
We become more sensitive to many things as we go through menopause and you may find yourself becoming allergic to things your body could tolerate before. This is particularly the case with the ingredients in personal products as mentioned above and certain foods.
29. IRREGULAR HEARBEAT
This can be a worrying issue but is not uncommon. It is probably caused by dropping estrogen but also remember that stress will pay a role here too. If you are stressed and anxious then you may also experience heart palpitations.
That’s where meditation, mindful breathing and other stress reducing techniques can be so useful. If this is more than temporary and causes concern, be sure to get yourself checked by a doctor.
30. BODY ODOUR CHANGE
Disconcerting when you notice that you smell different but it does happen. Not usually something to worry about, just a fact of life as our hormones change and we age. Just because you smell it doesn’t mean anyone else can!
There is so much going on in midlife to make us irritable including all the hormonal changes. We can find outselves angrier than before and that can be scary both for ourselves and those around us. But menopausal irritability and even anger doesn’t have to be a bad thing.
Without estrogen, which I like to call the biddable hormone, keeping us nurturing and thinking about everyone else we can become less accepting of the status quo. If it’s getting out of control, try your stress relieving techniques. But also think about channeling any anger (passion) into something new and exciting. Anger can be a positive force for change when used well.
Many women go to the doctors when they start feeling off around perimenopause and are prescribed anti-depressants when what they really need is advice on how to balance their hormones. Hormonal turbulence is definitely to blame here as it is for mood swings around our periods.
But there is also a lot else going on, managing difficult teenagers maybe, caring for elderly parents, coping with ageism kicking in at work. Not to mention fighting all the negative narratives around being an older woman and menopausal, that society has been feeding us all our lives. Go easy on yourself. Menopause is a time of big change like puberty in reverse.
Balancing your hormones through diet and lifestyle changes is a good place to start. Remember that alcohol is a depressant and exercise will usually help you to feel better. Leaning in to the menopause transition rather than fighting it is also going to make it much easier. But please get help if you are suffering badly with depression. ,
33. PANIC DISORDER
Related to anxiety and depression we can often become overwhelmed by what’s going on and panic can set in. Try the calming techniques already discussed but get help if it’s seriously impacting your life.
Menopause doesn’t cause osteoporosis but as we lose the protective aspect of estrogen, our bones can lose density and become more susceptible first to osteopenia and then osteoporosis. Diet and exercise become ever more important the older we get. Smoking and too much alcohol are bad for bone health but a good healthy diet is going to help protect your bones.
We need calcium and vitamin D. Weight-bearing exercise becomes crucial – something with impact, such as running or jumping or even hopping to keep our bones strong. In a TV documentary they measured the bone density of three groups of post menopausal women, a group that did no exercise, a group that did mainly yoga and a group that ran. The yogis had stronger bones than those who did no exercise, but the runners were way ahead in terms of bone density.
What a long list huh! Quite scary too. You are UNLIKELY to suffer the majority of these. If you do suffer badly, then it’s your body telling you something needs addressing.
You may experience these ‘symptoms’ for a few months, several years, or NO TIME AT ALL! I question whether these are really symptoms of menopause at all.
You see, the only actual symptom or sign of menopause is the end of your menstrual cycle. All the others on that big scary list are symptoms ASSOCIATED with menopause.
They can all be triggered by changes in our hormones. But there’s probably an underlying cause to the symptoms which is revealed once the protection of our reproductive hormones starts to drop. If they were symptoms OF menopause, most woman would likely get them, but we all go through menopause very differently.
These issues are common but not normal! If they were normal symptoms of menopause we’d all have them and we don’t. Some women barely notice anything. Some have a really bad time. If your menopause experience is bad be sure to get the help you need.
I urge you to think of menopause symptoms as the canary in the coalmine, warning you that you need to make diet and lifestyle changes to stay healthy long term. I prefer a natural approach, but HRT may be exactly what you need to get you back to being able to function as you would like.
You will still benefit long term from getting healthier overall, even if you decide to take hormone therapy to help. I see this early warning system as a real gift of menopause.
Is menopause really to blame?
It’s easy to attribute all these changes to menopause but actually it could also be because our bodies are just getting older. For example, sadness might come because we’re languishing in the happiness U-curve which bottoms out at 47, or we’re fed up with the life we have and relationships that no longer fulfill us and make us irritable.
Maybe we’ve bought into all the negative narratives about midlife, menopause and getting older as a woman (as I did at 41 which is when I was told I’d gone through early menopause), and that’s causing us to be both anxious and depressed. We may also have an overload of unnatural toxic products in our lives that are causing our bodies to be hormonally challenged.
Menopause gets blamed for a lot and it’s not necessarily at fault. Weight gain may speed up around menopause with hormonal changes, but fundamentally it happens because our metabolism slows down as our muscle mass naturally declines with age. If we make sure to do weight lifting to maintain our declining muscle mass, we can reverse that trend.
It’s just that no one talks about menopause, it’s still taboo, we’re not prepared for it, we don’t know how to take better care of ourselves and it can all go on for rather a long time!
Just for clarity, I’m talking here about symptoms associated with a natural menopause. If yours has come very early or been caused by illness or surgery in particular, then the sudden change in your hormones may lead to more of these symptoms occurring – but also not necessarily.
One woman I know had a hysterectomy in her mid 50s and the only symptom she suffered afterwards was trouble sleeping which she fixed with tapping meditation.
Embracing your menopause
When it comes to menopause, don’t expect the worst but also don’t suffer in silence. Get the help you need. The real trick is to embrace menopause as a natural process that actually empowers you. We’ve been working with our wombs all our lives. Midlife is not the time to start fighting them and the essence of our feminine power.
Many women can get a bit stuck thinking menopause is the end of meaningful life. That’s what the media and society seems to want us to believe. If that’s how you’re feeling, JUST STOP THAT RIGHT NOW!
Be more whale – the only other creatures to go through menopause, who then become leaders of their pods! When we go through menopause, we become more valuable to our communities as leaders than as breeders.
If you want to hear more about the magic of menopause listen to my podcast interview with the amazing Darcy Steinke who was the first to alert me to whales becoming leaders post menopause. She wrote the book Flash Count Diary.
At Magnificent Midlife we’re all about challenging stereotypes and changing perceptions. We see midlife and menopause as a time of re-evaluation and regeneration as we embark on the exciting second half of our lives. I hope you agree.
Good luck! Don’t hesitate to get in touch if I can help you further. You can find out more about my work at magnificentmidlife.com
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Rachel Lankester is founder of the Magnificent Midlife Movement, host of the Magnificent Midlife Podcast, a midlife mentor and editor of the Mutton Club online magazine. After an initially devastating early menopause at 41, she dedicated herself to helping women vibrantly transition through the sometimes messy middle of life, helping them cope better with menopause and ageing in general, and create magnificent next chapters. She’s been featured in/on BBC Woman’s Hour, The Huffington Post, Thrive Global, Authority Magazine, The Age Buster, Woman’s Weekly, Prima Magazine, eShe, Tatler HK and Woman’s Own amongst others. She believes we just get better with age.