Menopause can arrive with a host of symptoms. Most women get at least some of these menopausal symptoms, typically when they’re in their late forties or in their fifties. But menopause can start earlier or later. Help is available, so reach out to your doctor if any of these symptoms cause problems for you.
You may have any or all of these symptoms while going through menopause.Everyday Health
1. Hot Flashes and Night Sweats
About 80 percent of women get hot flashes and night sweats during menopause and perimenopause. These symptoms last an average of 7 to 10 years.
Hot flashes are the sudden feeling of intense warmth, usually around your face and upper body. Your face and chest may also turn red, and you can perspire heavily. Some women also notice a rapid heartbeat. When a hot flash ends, you might feel chilled.
Night sweats are similar. You'll wake up sweating heavily, sometimes drenched to the point that you have to change clothes and bedding.
Causes
Experts aren’t sure what causes hot flashes and night sweats. One theory about hot flashes is that changes to the hypothalamus (the area of your brain responsible for temperature regulation) cause it to misread body temperature. As your body cools down by dilating blood vessels, blood flow increases, causing your skin to turn red and sweaty.
2. Slowed Metabolism and Weight Gain
Many women gain weight around the abdomen during menopause: an average of about 1 1/2 pounds per year.
Research shows that excess abdominal fat (also known as visceral fat) can raise your risk of long-term diseases like heart disease, stroke, hypertension, and certain cancers.
Causes
During menopause, estrogen levels drop, which causes fat storage to shift to the belly. The exact way the shift happens isn't clear. More research on people is needed to understand precisely how estrogen affects fat cells and storage, and how it slows down metabolism.
3. Depression, Anxiety, and Mood Swings
Studies show that about 4 in 10 women have mood changes during perimenopause. This can include irritability, low energy, sadness, or trouble concentrating.
Causes
Shifts in estrogen levels can bring on changes to your brain and nervous system that can affect your mood and interfere with sleep. Lack of sleep, in turn, can cause mood swings.
What's more, stigmas against menopause and mental illness may prevent women from getting help during this time of transition.
Recognizing Symptoms of Perimenopause
Sharon Malone, MD, discusses the importance of treating perimenopausal symptoms — from hot flashes to mood swings — as soon as you experience them.
Next up video playing in 10 seconds
4. Insomnia and Sleep Disruptions
Menopause can wreak havoc on your ability to get quality shut-eye. Either you can’t fall asleep, or you wake up several times during the night.
Causes
Research shows menopause can keep you awake for a variety of reasons:
Levels of estrogen and progesterone, sleep-promoting hormones, are dropping.
The sudden flash of heat and soaking perspiration from night sweats wakes you up. It may take a while to get back to sleep, especially if you have to change clothes and strip the bed.
Depression and anxiety can both affect your sleep.
5. Hair Loss and Brittle Nails
Many women have some hair thinning during menopause. Some develop an extreme form of it called female pattern hair loss. Your nails may become ridged and brittle, too.
Causes
Drops in estrogen and progesterone are responsible for hair changes. When these hormones decrease, other hormones called androgens take effect. This may cause hair to grow on places like your chin and upper lip.
Hair and nails are made up largely of keratin, which your body makes less of as estrogen drops. Lack of estrogen can also make your skin and nails dry.
6. Sexual Dysfunction, Desire Issues
Many women get unpleasant sexual side effects during menopause, including painful sex, vaginal tightness during penetration, and a higher risk of tearing and bleeding during sex. Some may have trouble with arousal or orgasm.
Some women also may feel a marked decrease in their libido, along with distress about that decline. This is a condition known as hypoactive sexual desire disorder (HSDD).
Causes
The hormone drop causes vaginal walls to become thin, dry, fragile, and less flexible — a situation known as vulvovaginal atrophy. If your vagina also becomes inflamed (meaning becomes red and produces discharge), that’s known as atrophic vaginitis.
Along with the estrogen decrease, libido can be squashed by stress, depression, poor body image, and frustration over how long it takes to reach orgasm.
7. Bone Loss and Osteoporosis Risk
Women gain most of their bone density by age 30. After age 35, they may develop bone loss. When menopause starts, a process speeds up in which bones lose minerals faster than they can be replaced. This leads some women to develop osteoporosis, a condition that causes brittle, fragile bones.
Causes
One of estrogen’s jobs is to protect bone health. When estrogen depletes, so goes that benefit, leaving bones prone to deterioration.
The right supplements can help you navigate perimenopause. Read our comprehensive guide on the best supplements for perimenopause to find products that may help soothe your symptoms and support your overall health. Talk with your doctor before starting a new supplement, though.
8. Dry Skin and Other Skin Problems
Menopause can cause skin to become dry, slack, thin, and easily irritated. That increases the chance of easy bruising, acne, rashes, or wounds that heal much more slowly.
Causes
Once again, this comes down to lower estrogen. It causes skin to thin, which leaves it vulnerable to bruising. Skin also loses the ability to hold onto moisture. The wrinkling, jowls, and slackness are due to skin losing collagen, a protein that gives skin its elasticity.
Women’s skin loses about 30 percent of its collagen during the first five years of menopause. After that, you lose about 2 percent each year for the next 20 years.
9. Dry Eyes and Dry Mouth
Some women can get dry, inflamed, irritated eyes during menopause due to the lack of lubrication on the tissue that covers your eyeball. It's also possible to get a dry mouth, and a lack of saliva can lead to a higher risk of cavities, periodontal disease, and gingivitis.
Causes
The connection between dry eyes and menopause is somewhat unclear. But some researchers think that a decline in androgen hormones can lead to dryness of the meibomian glands in your eyes, which produce the oil layer of tears.
A drop in estrogen also can lead to the drying of the oral mucosa in the same way it dries out the vagina.
10. Memory Issues and Problems With Concentration
Many women in menopause find that words are harder to retrieve. They may forget why they walked into a room. And they might have trouble concentrating on tasks. As it happens, brain fog, focus and attention issues, and trouble making decisions are often due to this life transition.
Causes
Lower estrogen is once again the cause, but that’s not the whole story. Disrupted sleep, depression, and hot flashes can also play roles.
The Takeaway
Menopause can cause a variety of changes to your body that can lead to symptoms like hot flashes, weight gain, dryness, thinning hair, bone loss, and mood changes, among others.
Other lesser-known symptoms can also happen during menopause, such as brain fog, dry mouth, and dry eyes.
Menopause symptoms can range from mild to debilitating, but some women don’t seek help for relief due to stigma or lack of menopause awareness.
If menopause symptoms are interfering with your quality of life, talk with your healthcare provider, who can provide lifestyle tips and guidance on treatment options.
The right supplements can help you navigate perimenopause. Read our comprehensive guide on the best supplements for perimenopause to find supplements that will help soothe your symptoms and support your overall health.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Kuryłowicz A. Estrogens in Adipose Tissue Physiology and Obesity-Related Dysfunction. Biomedicines. February 24, 2023.
Treating the Mental Health Side of Menopause. UCLA Health. October 24, 2023.
How to Protect Your Brain Health During Menopause. NewYork-Presbyterian. November 4, 2022.
Barber K et al. Barriers to Accessing Effective Treatment and Support for Menopausal Symptoms: A Qualitative Study Capturing the Behaviours, Beliefs and Experiences of Key Stakeholders. Patient Preference and Adherence. November 15, 2023.
John Paul McHugh, MD, is an obstetrician-gynecologist and lifestyle medicine specialist in southern California. He has always placed wellness at the center of his work, in both delivering babies and improving practice standards. Dr. McHugh believes that bringing lifestyle medicine to the center of health and wellness empowers patients to make the change they seek and enjoy the benefits of true wellness.
He is a graduate of Harvard Medical School and the Massachusetts Institute of Technology and a fellow of the American College of Lifestyle Medicine. He served as a department chair at Scripps Mercy Hospital in San Diego and is now the chair-elect for the American College of Obstetricians and Gynecologists for California.
He has published several articles in the American Journal of Lifestyle Medicine and served as a peer reviewer for many articles. He contributed to the first textbook of lifestyle medicine in women's health: Improving Women's Health Across the Lifespan.
Beth Levine is an award-winning health writer whose work has appeared in The Washington Post, The New York Times, O: The Oprah Magazine, Woman's Day, Good Housekeeping, Reader's Digest, AARP Bulletin, AARP The Magazine, Considerable.com, and NextTribe.com. She has also written custom content for the Yale New Haven Hospital and the March of Dimes.
Levine's work has won awards from the American Academy of Orthopaedic Surgeons, the Connecticut Press Club, and the Public Relations Society of America. She is the author of Playgroups: From 18 Months to Kindergarten a Complete Guide for Parents and Divorce: Young People Caught in the Middle. She is also a humor writer and in addition to her editorial work, she coaches high school students on their college application essays.
