What is Menopause?

Menopause is a normal condition that every woman experience as she age. The term “menopause” describes changes women go through either just before or after they stop menstruating, marking the end of their reproductive period.

3 Stages of Menopause

Perimenopause or Menopause Transition:

Perimenopause can begin 8 to 10 years before menopause, when the ovaries gradually produce less estrogen. It usually starts in a woman’s 40s but can start in the 30s as well. Perimenopause lasts up until menopause, the point when the ovaries stop releasing eggs. In the last one to two years of perimenopause, the drop-in estrogen accelerates. At this stage, many women can experience menopause symptoms. Women are still having menstrual cycles during this time and can get pregnant.

Menopause:

Menopause is the point when a woman no longer has menstrual periods. At this stage, the ovaries have stopped releasing eggs and producing most of their estrogen. Menopause is diagnosed when a woman has gone without a period for 12 consecutive months.

Postmenopause:

These are the years after menopause. During this stage, menopausal symptoms, such as hot flashes, can ease for many women. But, as a result of a lower level of estrogen, postmenopausal women are at increased risk for various health conditions, such as osteoporosis and heart disease. Medication, such as hormone therapy and healthy lifestyle changes may reduce the risk of some of these conditions. Since every woman’s risk is different, talk to your gynecologist to learn what steps you can take to reduce your individual risk.

When asked to name symptoms related to the menopause, most women tend to mention three or four of them, such as hot flashes, night sweats and irregular periods, but in reality, there are a total of 34 symptoms.

Here’s a rundown on the 34 symptoms of Menopause that can be categorized into 4 groups;

Common Symptoms, Changes, Pain Related Symptoms and Others.

Common Symptoms

1.Hot Flashes

Hot flashes are a sudden, transient sensation of warmth or heat that spreads over the body, creating flashing or redness that is particularly noticeable on the face and upper body. The experience of hot flashes can range between delicate flashes and a sensation of engulfing flames.

Hot flashes result from changes in hormone levels affecting the body’s temperature control. Not all women experience hot flashes, but more than half do. For some women, estrogen production decreases gradually, producing fewer hot flashes. For others, the ovaries stop estrogen production more abruptly, leading to problematic hot flashes.

2. Night Sweats

Night sweats
cannot be considered as a sleep disorder,
but a common perspiration disorder, leading to severe
episodes of excessive sweating that may soak your nightclothes and occur during
sleep. These episodes of nighttime sweating are caused by hormonal imbalance
combined with environmental factors, such as an excessively warm sleeping
environment, ranging in severity from mild to intense.

For some women, the experience of night sweats is so severe that it disrupts their sleep, and may increase irritability and stress in their waking life. Night sweats can also be caused by underlying medical conditions, so it is very important to get to the root of the issue before seeking treatment options.

3. Irregular Periods

Mostly, all
women experience absent, short, or irregular periods at some point in their
lives. Various conditions can cause irregular periods, though during perimenopause, the most common cause is hormonal imbalance. Periods may come earlier or
later than before; bleeding may be lighter or heavier than usual, and periods may be brief or go on for what
feels like an eternity. Skipping periods and ‘spotting’ (bleeding between
periods) are also common symptoms of hormonal imbalance.

Menstrual irregularity is common in women in their mid-40’s as they approach menopause and the most likely cause of this irregularity is hormonal imbalance caused by changing levels of estrogen and progesterone (a hormone produced by a woman’s ovaries). Irregular periods could also be caused by other medical conditions.

4. Loss of Libido

Even though
everyone experiences peaks and valleys in libido, for women going through
menopause, this sudden drop can be troubling. In menopausal women, the main
cause of loss of libido is hormonal imbalance, predominantly androgen
deficiency.

Loss of libido can also be caused by other menopausal symptoms, such as vaginal dryness or depression.

5. Vaginal Dryness

Vaginal
dryness is usually caused by the disappearance
of the usually moist and soft feeling of the lining of the vagina, leading to
symptoms such as itchiness and irritation. Vaginal tissue becomes drier,
thinner, and less elastic when estrogen levels drop during perimenopause,
resulting in frequent itching, irritation and infection in the groin region.

Vaginal dryness can be one of the most emotionally distressing menopause symptoms, making it important to seek treatment if it begins to affect quality of your life.

6. Mood Swings

Mood swings
are hard to cope with but are particularly common in menopausal women. Women
experiencing mood swings may feel like they are on a rollercoaster of emotions:
one minute they are up and the next minute they are down. Mood swings can be
sudden and intense, although the experience of them may differ from woman to
woman.

Mood swings
are primarily caused when production of the hormone estrogen drops along with
the production of mood-regulating neurotransmitters. Other menopause symptoms
can also have a negative influence on mood, such as fatigue. Hence,
targeting the underlying hormonal imbalance is one of the most effective ways
of reducing menopausal mood swings.

7. Fatigue

Fatigue is
defined as an ongoing and persistent feeling of weakness, tiredness, and
lowered energy levels. A phenomenon which comes on suddenly, leaving a woman
devoid of energy and unable to continue her activity, fatigue is one of the
most common menopause symptoms. Rather than just sleepiness or drowsiness the
characteristics of fatigue include apathy, irritability, and decreased
attention span.

Fatigue in menopause is caused by hormonal changes and can have a drastic impact on daily life, putting a strain on relationships, work productivity, and quality of life. Therefore, treating the underlying hormonal imbalance is essential to restore energy levels.

8. Hair Loss or Thinning

Hair loss is
one of the most physically noticeable menopause symptoms. It is caused by
estrogen deficiency since hair follicles need estrogen to sustain hair growth.
Hair loss can be sudden or gradual and manifest as thinning hair on the head or
other parts of the body. Hair may also become drier, brittle and may fall out more while in the shower.

Gradual hair loss or thinning of hair without any accompanying symptoms is common; however and is a visible sign of aging. There are various ways to treat the underlying hormonal imbalance in order to stop hair loss during menopause. However, hair loss that is accompanied by general poor health requires medical attention.

9. Sleep Disorders

Sleep
disorders connected with menopause include insomnia (sleeplessness), waking
many times during the night, and tossing and turning during sleep. Generally,
women going through menopause may find their sleep is less restful and that
getting to sleep becomes increasingly difficult. In most cases, women begin to
experience restless sleep as many as five to seven years before entering
menopause.

It was believed that interrupted sleep was a consequence of night sweats, but recent studies state that problems with sleep are not always connected to other menopause symptoms. Sleep disorders are a symptom of menopause in their own right, but it is important to distinguish if sleep disorder is actually caused by hormonal imbalance or some other factor.

10. Concentration Difficulty

Many women
are concerned to find they have trouble remembering things, experience mental
blocks, or have difficulty concentrating before or during the periods of menopause. This can be depressing and can
have a negative impact on all aspects of their lives. The major reason behind these problems is hormonal imbalance,
specifically estrogen deficiency.

However, not getting enough sleep or sleep disruptions can also contribute to memory problems, causing concentration difficulty. Targeting and treating the underlying hormonal imbalance will help women overcome this problem.

11. Memory Lapses

Women
approaching menopause often face memory loss, memory lapses and an inability to
concentrate. Skipped appointments, Misplaced car keys, forgotten birthdays, and
missed trains might seem like insignificant occurrences, but these can be
extremely distressing for women who have never experienced it before. However,
these memory lapses are a normal symptom of menopause, associated with low
levels of estrogen and with high-stress
levels.

Even though memory loss affects most people in one way or another, it is advisable to seek medical advice to treat the causes that include hormonal imbalance, stress, or other more serious conditions.

12. Dizziness

Dizziness is
a term used to describe a range of sensations, such as feeling faint or weak
that may be accompanied by a feeling of lightheadedness or unsteadiness, as
well as the inability to maintain balance upon standing or while walking. It
can last for as little as a few seconds
but can leave a woman feeling out of sorts for an extended period of time or
may even lead to falls, impacting her daily home and work life.

Generally, dizziness is a symptom of many medical conditions; however, it is also a possible symptom of menopause, caused by fluctuations in hormonal levels such as estrogen.

13. Weight Gain

Weight gain,
especially a thickening around the waist, is another sign of changing hormone level
during menopause. While some studies suggest that menopause has nothing to do
with weight gain, hormonal changes during menopause influence weight gain and
redistribution of fat. For example, fewer circulating estrogen hormones lead
the body to retain more fat cells as an alternative source of components of
estrogen.

Usually, menopause onwards women need fewer calories daily; therefore, women who continue to eat as before will gain weight by default. Also, low testosterone levels lead to a decreased metabolic rate. Hence, changes in diet and exercise are crucial in revitalizing the body’s metabolic rate and prevent weight gain during menopause along with treatments to target the underlying hormonal imbalance.

14. Incontinence

Incontinence
during menopause n can be divided into 2 categories; Stress Incontinence and
Urge Incontinence.

Stress
incontinence is the accidental release of urine while laughing, coughing,
sneezing or due to over-exertion. It occurs when
the internal muscles fail to work effectively, because of age, surgery or
childbirth.

Urge
incontinence happens when the bladder
develops a “mind of its own,” contracting and emptying whenever full despite an
individual’s conscious efforts to resist.

Women going through menopause may experience any of these types of incontinence and it can be worrying as well as embarrassing for them. However, practical treatments are available for this common condition.

15. Bloating

Most women experience bloating throughout their lives, due to digestive issues or as a part of Premenstrual Syndrome (PMS). Bloating is characterized by a swollen belly, a feeling of tightness and discomfort or pain in the stomach area.

16. Allergies

Hormones and
the immune system are inseparably linked, so hormonal changes during menopause
can lead to an increase in allergies among menopausal women. Many women
experience increased sensitivity to allergies, while others may suddenly become
allergic to something that never bothered them before. This is particularly the
case with hay fever, asthma and dermatitis.

Allergies can be a frustrating menopause symptom, as they can impair daily life. Most women only experience “mild” symptoms such as rashes, sneezing, and itchy eyes, but in the case of extreme allergy symptoms such as swelling, dizziness, and cramping, it is important to seek urgent medical treatment. Mild symptoms could be avoided by making simple lifestyle changes, as well as by treating the underlying hormonal imbalance.

17. Nail Disorders

Nail
appearance tells a lot about a person’s general health and habits. There are
various nail changes that occur during menopause that could indicate an underlying
problem, most commonly brittle nails or nails that are softer, crack, split, or
break horizontally across the top of the nail.

Apart from brittle nails, other nail disorders common in menopause include convex or spoon-like nails, ridges in the nail plate, and infection of the nail bed and cuticle. Persistently painful or inflamed fingernails or toenails require the attention of a doctor.

18. Changes in Body Odour

Changes in body odour can make the menopausal women experiencing them self-conscious. Menopausal hormonal changes cause an increase in sweat production, in response to physical menopause symptoms such as hot flashes, night sweats, anxiety and panic disorder. This increase in sweat production can lead to increased body odour, even while maintaining a good personal hygiene regimen.

Changes in body odour may also be due to genetic predisposition. Although changes in body odour are normal in menopausal women, they can still be bothersome. Simple changes to lifestyle, such as choosing clothes with natural, breathable fabrics, may help reduce body odour.

19. Irregular Heartbeat

Irregular
heartbeat is one of the more concerning menopause symptoms. Bouts of pounding,
rapid heartbeat scare many women because of their sudden onset and the
difficulty in calming them. One of the causes of these symptoms during
menopause is hormonal imbalance. Estrogen
deficiency can over-stimulate the nervous and circulatory systems, causing
irregular heartbeat and palpitations.

As with any heart condition, this symptom could signify something more serious, so it’s important for women experiencing it to consult a doctor. Stress, anxiety, and panic disorder are all other causes of this symptom which should be explored before considering a treatment option. Other triggers of irregular heartbeat to be avoided include caffeine and nicotine.

20. Depression

Low mood and feelings of depression can be very common symptoms of the menopause and perimenopause. If you have had postnatal depression in the past, or a history of Premenstrual syndrome (PMS), then it is more likely you will experience these types of symptoms during your menopause. This is because your body is more sensitive to changing levels of hormones.

21. Anxiety

Anxiety is a
vague or intense feeling caused by physical or psychological conditions,
typified by feelings of agitation and loss of emotional control. Anxiety during
menopause is caused by the sudden drop in estrogen levels circulating in the
body, which reduce the production of neurotransmitters responsible for mood
regulation, such as serotonin and dopamine.

The frequency of anxiety can range from a one-time event to recurrent episodes. Early diagnosis may aid a quick recovery, prevent the disorder from becoming worse and possibly prevent the disorder from developing into depression. Hence, it is important to seek medical treatment for anxiety symptoms.2

22. Irritability

Irritability
is a spreading “bad mood” characterized by feelings of stress, reduced patience
and tolerance, lashing out in anger or frustration over matters that may seem irrelevant
to others. Irritability during menopause is most often caused by hormonal
changes, whereby low levels of circulating estrogen have an adverse effect on
the neurotransmitters in the brain that are responsible for regulating mood.

Many menopausal women feel irritable many times due to the added stresses of other symptoms of menopause, such as hot flashes and sleep disorders. If irritability persists for more than a week and is adversely affecting job performance and relationships with family, friends, and co-workers, seeking the advice of a medical practitioner is highly recommended.

23. Panic Disorder

Panic disorder
comprises significant and devitalizing emotional episodes characterized by
sudden and overwhelming fear and anxiety. These feelings can be intense and caused by physical or psychological
conditions. An episode of panic disorder may result in rapid heartbeat, feeling
of dread, shallow breathing, nervousness and feelings of extreme terror. These
panic attacks can range in frequency from a single episode to regular
occurrences.

Panic
disorder can be extremely scary for women who experience it. If a woman’s
quality of life is disrupted by this symptom, it is important to seek the
advice of a doctor.

24. Breast Pain

Typically,
breast pain is characterized as a generalized discomfort or pain associated
with touching or applying pressure to the breasts. Breast pain, soreness or
breast tenderness in one or both breasts is symptomatic of hormonal changes.
The specific imbalance of hormones that causes breast pain is unique to each
individual woman, so breast pain might occur at different times or at different
intensities in individual women.

Woman should consult a doctor if the pain is severe or persists for two months or more, as well as if the breast pain is accompanied by a breast lump, nipple discharge or any other unusual symptoms.

25. Headaches

Many women with regular menstrual cycles get headaches or migraines just before their periods or at ovulation. These headaches, sometimes called “menstrual migraines”, occur when estrogen levels plunge during the menstrual cycle. So, when the body begins slowing down its production of estrogen due to menopause, a woman may experience more and worse headaches. Severe headaches that are accompanied by confusion or high fever can indicate a serious health condition and require the immediate attention of a doctor.

26. Joint Pain

Joint pain
is one of the most common symptoms of menopause. More than half of all
postmenopausal women experience varying degrees of joint pain. It is an
unexplained soreness in muscles and joints, which is unrelated to trauma or exercise, but may be related to the effects of fluctuating
hormone levels on the immune system. Estrogen helps prevent inflammation in the
joints, so low levels of estrogen during menopause can lead to increased
instances of inflammation and therefore increased joint pain.

It is not wise to ignore these aches and pains. Early treatment can often bring about a cure, preventing the development of arthritis.

27. Burning Tongue

Burning
mouth syndrome is a complex, vexing condition in which a burning pain occurs on
the tongue or lips, or throughout the whole mouth, without visible signs of
irritation. It is usually accompanied with other symptoms such as bad breath or
a bad taste in the mouth. Burning tongue generally occurs after the age of 60,
but it may occur in younger people as well.

The disorder has long been associated with a variety of conditions, including menopause. In menopause, low estrogen levels are thought to damage bitter taste buds in the mouth, setting off the surrounding pain neurons. Women who have persistent pain or soreness in their tongue, lips, gums or other areas of their mouth should seek the advice of a doctor.

28. Electric Shock Sensation

This symptom presents a peculiar “electric” sensation, like the feeling of a rubber band snapping in the layer of tissue between skin and muscle. When it appears as a precursor to a hot flash, it is often felt across the head. Electric shocks usually occur for a brief moment, but it can still be quite an unpleasant sensation. The cause of electric shock sensation in menopause is thought to be related to the effect of fluctuating estrogen levels on the cardiovascular and nervous systems.

Although this symptom is relatively harmless, it can be uncomfortable. It can be easily resolved by treating the underlying cause – hormonal imbalance. If the symptom becomes intense, it is advised to consult a doctor.

29. Digestive Disorders

Digestive disorders
are defined as changes in gastrointestinal function with symptoms like excessive
gas production, gastrointestinal cramping and nausea. There are a couple of
reasons why menopausal women might be experiencing more digestive problems than
previously: hormonal imbalance disrupts the natural transit of food in the gut
and stress has an adverse effect on the normal functioning of hormones.

Digestive disorders could also be because of a change in diet or even lactose intolerance (the body’s rejection of dairy products such as cow’s milk and its byproducts) due to the decreasing production of the digestive hormone lactase with age. Women who experience gas and stomach pain for more than three days or whose pain is more severe than before should see a doctor immediately.

30. Gum Disease

Gum disease
is common among menopausal women; although these could be due to poor dental
hygiene, they are also caused by menopausal hormonal changes, mainly estrogen
deficiency. The most common of the gum problems experienced in menopause is gingivitis, or inflammation and bleeding of the
gums. Left untreated, gum problems can lead to tooth loss, infections and heart
disease, so it is important to seek treatment for gum problems in menopause.

Bleeding and sore gums are easy to reverse if they are caught before they get too severe, through a combination of dental hygiene methods and tackling the underlying hormonal imbalance through healthy lifestyle changes and natural supplements. If the problem continues, it is important to seek advice from a doctor or dentist.

31. Muscle Tension

Muscle
tension is when muscles, especially the ones in the neck, shoulders and back
feel tight or strained or when there is a general increase in aches, pains,
soreness and stiffness throughout the body. It is a common symptom of
menopause, because low estrogen levels lead to a rise in cortisol, known
primarily as the stress hormone. Continued high levels of cortisol cause the
muscles in the body to tighten and become fatigued.

Women who are generally fit and healthy are less prone to muscle tension than women suffering from poor nutrition and who do not do sufficient exercise. Menopausal women suffering from muscle tension should tackle the root of the problem – hormonal imbalance – as well as practice relaxation techniques.

32. Itchy, Crawly Skin

When
estrogen levels reduce during perimenopause, collagen production also slows
down. Collagen is responsible for keeping skin toned, fresh-looking, and
resilient. So, when the body starts running low on collagen, it shows in the
skin, as the skin gets thinner, drier, flakier and less youthful-looking. Skin
dryness leads to itchy skin, a frustrating symptom that can disrupt both
women’s sleeping and waking lives.

Itchy skin is one of the first menopause symptoms to appear because collagen loss is most rapid at the beginning of menopause. These skin changes can also make a woman look and feel a little older than she used to. To be able to overcome itchy skin symptoms, women need to address their hormonal imbalance.

33. Tingling Extremities

Tingling
extremities is where menopausal women experience a “creepy-crawly” feeling all
over their skin, a burning sensation like an insect sting or super-sensitivity
in their hands, arms, legs, and feet. In most cases, tingling is harmless; however,
in menopausal women, tingling extremities is likely caused by the effect that
low estrogen levels have on the central nervous system.

Tingling
extremities can also be a symptom of other diseases, including anxiety, poor
blood circulation, diabetes, heart disease, stroke or a tumour. Any unexplained tingling that affects one side of the body
or is accompanied by muscle weakness needs immediate medical attention.

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34. Osteoporosis

Osteoporosis
is a degenerative bone disease, characterized by thinning and weakening of the
bone and a general decrease in bone mass and density. Menopause negatively
affects bone growth. Generally, bones go through a process whereby old bone is
replaced with new bone cells, but the body’s ability to handle this process
changes with age. By around the age of 35,
there is less bone growth than there is bone removal.

Estrogen is
involved in the process of calcium absorption into the bones. Due to the drop
in estrogen levels, women will experience reduction in bone density from
perimenopause onwards.