Symptoms of Menopause
Perimenopause and menopause can present with a large number of symptoms. Some of the women may sail through menopause with very mild symptoms but some can have quite disabling symptoms. Not all the women will have all of the symptoms and it varies a lot individually.
The symptoms are mainly due to low levels of Estrogen hormone. Estrogen receptors are present throughout most of the body – uterus, vagina, bladder, skin, heart, brain. Hence low fluctuating levels can give symptoms affecting many parts of the body.
Hot flushes and sweats: About 70% of women might experience hot flushes and sweats and can be very severe in nearly 30% of women. During a hot flush, there might be a sudden feeling of intense heat which spreads over whole body. This can last for few secs to much longer. Women can also experience excessive sweating and break out in dripping sweats from face or head. They might also wake up numerous times at night with drenching sweats which can be very disruptive for sleep.
Mood changes: Women may experience many different types of psychological symptoms during perimenopause and menopause. This can range from mood swings, anger, irritability, low mood, lack of motivation or depression, anxiety, loss of confidence, and panic attacks. Many women find these very out of character and distressing. Rarely, women may get clinical depression or even feel suicidal.
Sleep disturbances and Insomnia: Menopause can affect sleep significantly. Women may find it hard to go off to sleep, keep waking up many times during night or even have an early morning wakening. This can be due to inherent effect of oestrogen on sleep or due to night sweats and anxiety.
Poor memory and concentration: Women often complain of brain fog, finding it difficult to find words and poor memory. It might become difficult to concentrate and focus, which can affect work and performance. Our brain also has estrogen receptors, so memory can be affected when estrogen level drop during menopause. Besides, symptoms like lack of sleep, low mood or anxiety can further worsen these.
General aches and pains: Many women suffer from aches and pains all over body. They might have joint and muscle aches and stiffness. Estrogen protects joints and reduces inflammation. Hence, when level of estrogen drops, joint might get painful, and arthritis might flare up.
Tiredness and Fatigue: Women may suffer from lack of energy and motivation. This may be due to low hormone levels, estrogen and testosterone. Also lack of sleep, joint pains, anxiety, and sweats may be contributing factors.
Bladder and Genital Problems: Lack of estrogen has significant impact the health of vagina, labia, urethra (the opening of bladder) and bladder.
Due to lack of estrogen, the lining of vagina and vulva thin out and become fragile and dry. The vaginal tissue loses its collagen and becomes less elastic. Vagina can become very dry and sore, and intercourse can become very painful. There might be itching, burning sensation, change in discharge or odour.
Women may also suffer from many bladder symptoms like urinary frequency and urgency. Women might find it difficult to hold urine and leak with cough or sneeze. Women might also be prone to recurrent urine infections.
This is called Genitourinary syndrome of menopause (GSM). It might sometimes appear few years after menopause and usually becomes worse with time without treatment.
Sexual problems: This is often very common affecting 1 in 2 women. Women might suffer from loss of interest in sex and difficult in achieving orgasm. Combined with vaginal dryness this can have a significant impact on sexual life.
Skin and hair problems: Estrogen is helps maintain the collagen and elastin in the skin. These fibers keep skin strong and firm. It also increases blood supply to skin and maintain its thickness. Hence with low estrogen levels during menopause, skin becomes dry and saggy. It can feel itchy with a crawling or tingling sensation.
Hair can become dry, and brittle and many women may suffer from hair loss.
Headaches and Migraines: Women may note increase in headaches or worsening of migraines during menopause transition.
Simple headaches may be due to lack of sleep, mood changes or anxiety.
Women who used to suffer from migraines may note a worsening of their migraines due to fluctuating levels of hormones during perimenopause. Some women may develop migraines for the first-time during menopause.
General symptoms: Besides the above, women also suffer from many general symptoms. They might have palpitations, sore tongue and gum, dizziness, tinnitus, digestive problems and breast pain.
