Menopause Symptoms: 13 Common Signs

Menopause symptoms, such as irregular periods, hot flashes, and night sweats, usually begin during perimenopause, the lead-up phase before menopause. These symptoms occur as estrogen levels gradually decline.

Menopause symptoms can vary from person to person and most often start between ages 45 and 51, although they may appear earlier or later. Other symptoms may include trouble sleeping, mood changes, vaginal dryness, decreased sex drive, urinary incontinence, poor memory, dry skin, hair loss, and weight gain.

Treatment for menopause symptoms depends on their severity and may include hormone replacement therapy (HRT), lifestyle changes, pelvic floor exercises, vaginal lubricants, and other measures to help relieve symptoms and improve quality of life.

Symptoms of menopause

Some common menopause symptoms include:

1. Irregular periods

One of the first signs that a woman may be entering menopause is irregular periods. Periods may happen more or less often, become heavier or lighter, or last for more or fewer days than before.

This stage, when periods become irregular, is called perimenopause. It is the transition between the reproductive and non-reproductive years, occurs before menopause, and can last for several months or years.

It is important to note that when periods are irregular, it can be harder to get pregnant, but pregnancy is still possible. Women who want to avoid pregnancy should use a birth control method recommended by their gynecologist or other women's health provider.

2. Periods with clots

During perimenopause, which is the transition leading up to menopause, periods can become heavier or more irregular, and some women may notice small clots in their menstrual flow.

However, heavy bleeding, many or large clots, bleeding between periods, or any bleeding after menopause should be evaluated by a gynecologist, as these changes may require treatment.

3. Hot flashes

Hot flashes can occur in some women before menopause. They may start even before periods become irregular and can continue for a few years, including after menopause has started.

Hot flashes can cause a sudden feeling of heat for no clear reason, usually in the face, neck, or chest. The skin may become red and sweaty, and the heart may beat faster for 1 to 5 minutes.

Although hot flashes are a common sign of the menopause transition, not all women experience them.

A woman who has hot flashes but is unsure whether they are related to menopause should see a healthcare provider. Other conditions, such as hyperthyroidism or hypogonadism, can also cause hot flashes.

4. Night sweats

Night sweats are hot flashes that happen during sleep and may be intense enough to wake a person up.

This symptom can vary greatly from person to person. Some women may have night sweats before menopause and continue to have them after menopause, while others may never experience them.

In addition to menopause, night sweats may also be caused by stress or anxiety, diabetes, or even the temperature of the bedroom.

5. Trouble sleeping or insomnia

Waking up during the night, having trouble falling asleep, or having insomnia can happen for many reasons. However, if a woman does not usually have sleep problems, this may be a sign that menopause is approaching.

Sleep may also become lighter or less restful, resulting in daytime fatigue and irritability. Read more about the effects of sleep deprivation and how to manage it.

6. Mood changes

Mood changes, such as irritability, anxiety, excessive tiredness, and low mood, may also suggest that menopause is approaching. These changes may make emotional reactions feel more intense or harder to control.

These symptoms can happen due to the hormonal changes of menopause and may increase the risk of depression.

It is important to see a healthcare provider for depression symptoms or frequent mood changes that last more than two or three weeks. A healthcare provider can help confirm whether the symptoms are due to menopause or another cause that needs more appropriate treatment.

7. Vaginal dryness

Vaginal dryness can happen in some women due to lower estrogen production by the ovaries. This can cause pain or discomfort during sex (dyspareunia), itching inside and around the vagina, or a frequent urge to urinate.

The American College of Obstetricians and Gynecologists (ACOG) states that estrogen helps maintain vaginal lubrication, elasticity, and thickness, and that low estrogen can cause thinning, drying, and inflammation of the vaginal walls.

Vaginal dryness can also increase a woman’s risk of developing yeast infections or cystitis more often, for example.

8. Decreased sex drive

A decreased sex drive, or low libido, can happen for many reasons, such as stress or tiredness. It can also be a symptom of menopause.

This is because hormonal changes during this stage of life can lower interest in sexual activity.

9. Urinary incontinence

Urinary incontinence can happen during menopause because lower estrogen levels also affect the lining of the urethra. The urethra is the tube that carries urine out of the body, and it can become thinner, less flexible, and less elastic, which may lead to ongoing, involuntary urine leakage.

Because of these urethral and vaginal changes, women may also experience more frequent urinary tract infections (UTIs) during menopause. It is important to see a gynecologist if UTI symptoms such as pain or burning when urinating, frequent urination, fever, or pelvic discomfort occur.

10. Poor memory

Poor memory, difficulty learning, trouble remembering words, or difficulty remembering names and where objects were placed may occur during menopause.

This is because during menopause, the ovaries do not produce estrogen, which is an important hormone for concentration, learning, and memory.

In addition, a woman may have problems with organization or planning due to this hormonal change.

However, poor memory can also have other causes, including natural aging or conditions such as Alzheimer’s disease. For this reason, it is important to see a healthcare provider to confirm whether this symptom may be related to menopause.

11. Dry skin

Another common symptom of menopause is skin that becomes drier, thinner, looser, or dull. This happens because estrogen is important for collagen production, which helps keep the skin moist, hydrated, and firm.

12. Hair loss

Menopause can make the hair more fragile, and some women may also experience hair loss. In addition, the hair may become thinner and take longer to grow.

13. Weight gain

During menopause, weight gain can happen because metabolism may slow down, causing the body to burn fewer calories.

Lower estrogen levels can also make it easier to gain weight and may lead to more fat buildup around the waist.

However, other conditions, such as hypothyroidism, can also cause weight gain, so it is important to see a healthcare provider for an evaluation.

Online symptom test

If you think you may be entering menopause, select your symptoms in the test below:

The symptom test is only a guidance tool and does not replace a consultation with a gynecologist.

Confirming a diagnosis

Menopause is usually diagnosed by a gynecologist based on symptoms and the absence of menstruation. According to the Office on Women’s Health, menopause is reached after a full year without a period, including no bleeding or spotting for 12 months in a row.

In some cases, the doctor may order blood tests, such as FSH or estrogen levels, if the diagnosis is unclear, symptoms occur earlier than expected, or another condition needs to be ruled out.

How to relieve symptoms

Some tips that can help relieve, reduce, or prevent menopause symptoms include:

• Dress in layers and remove or add clothing when hot flashes or night sweats occur.

• Try to identify what triggers hot flashes. For some women, triggers may include hot drinks, caffeine, spicy foods, alcohol, stress, hot weather, or even a warm room.

• Avoid drinks with caffeine, such as coffee, black tea, or green tea, as they can make it harder to sleep or cause insomnia, especially when consumed at night.

• Do Kegel exercises daily to strengthen the pelvic floor muscles and improve urinary incontinence.

• Use a water-based vaginal lubricant to help reduce discomfort from vaginal dryness, especially during sex.

• Avoid smoking, as cigarettes can increase hot flashes and trigger early menopause.

• Try relaxation techniques, such as meditation, yoga, or massage, as they may reduce mood changes, stress, and anxiety.

• Practice physical activity regularly because it helps release endorphins, which increase feelings of well-being and pleasure. This may help improve mood or depression.

It is important to consult a gynecologist or other women’s health provider if you notice possible menopause symptoms. They can assess your health, confirm the diagnosis, and, if needed, recommend hormone replacement therapy (HRT).

Maintaining a healthy diet with fresh fruits, vegetables, and whole grains can also help. Limiting canned or processed foods and sugar may ease menopause symptoms and support weight control.