Most Common Symptoms of Menopause

Hot flashes, night sweats and difficulty sleeping, headaches, variability of menstrual cycle, decreased bone density, vaginal dryness and thinning, emotional unrest, urinary tract infections, mood changes, anxiety, forgetfulness or problems with focus and concentration. This article will elaborate on the common symptoms and provide some solutions.

Hot Flashes and Night Sweats

Hot flashes are very common among women undergoing menopause affecting up to 85% of women. A hot flash is a feeling of warmth (sudden heat surges) that spreads over the body and is often most pronounced in the head and chest. A hot flash is sometimes associated with flushing usually; lasting from 30 seconds to several minutes, and is sometimes followed by perspiration. Hot flashes can be accompanied by anxiety and palpitations (a fluttering sensation in the chest). Sometimes they’re followed by “the chills”.

Although the exact cause of hot flashes is not fully understood, hot flashes are likely due to a combination of hormonal and biochemical fluctuations brought on by declining estrogen levels. Sometimes hot flashes are accompanied by night sweats (episodes of drenching sweats at nighttime). Hot flashes cause major problems with sleep and daily activities for about 15% of women. This may lead to awakening and difficulty falling asleep again, resulting in un-refreshing sleep and daytime tiredness. The hot flashes often begin before a woman’s periods have stopped.

Hot flashes occur in up to 40% of regularly menstruating women in their forties, so they may begin before the menstrual irregularities characteristic of menopause even begin. About 80% of women will be finished having hot flashes after five years. Sometimes (in about 10% of women), hot flashes can last as long as 10 years. There is no way to predict when hot flashes will cease, though they tend to decrease in frequency over time. On average, hot flashes last about five years.

Urogenital Changes

Dropping hormone levels can affect our vagina, our sexuality and our bladder. The vagina may become drier and its walls thinner. This can lead to discomfort during intercourse. Many women experience a drop in their sexual desire. The inability to hold urine within the bladder until you want to urinate (urinary incontinence) also affects many midlife and older women. There are different forms of urinary incontinence. Stress incontinence is caused by stress on the bladder opening. Urge incontinence (also called overactive bladder) is caused by involuntary bladder contractions. The incontinence can result from a strong, sudden urge to urinate or may occur during straining when coughing, laughing, or lifting heavy objects.

Insomnia is a very common symptom. The fatigue from lack of sleep can also worsen emotional symptoms such as irritability, a depressed mood, and difficulty concentrating. Self-help techniques can be very useful in managing your problems.

Emotional Unrest

Estrogen has been associated with the production of substances responsible for regulating mood in the brain. When estrogen levels change, our mood and thinking, perceiving, and memory (cognitive functions) can be affected. Women in perimenopause often report a variety of cognitive (thinking) and/or emotional symptoms, including fatigue, memory problems, irritability, and rapid changes in mood. It is difficult to precisely determine exactly which behavioral symptoms are due directly to the hormonal changes of menopause. We may have trouble concentrating and feel irritable. Stress can also worsen emotional symptoms, and so it’s a good idea to find ways to ease the stress in your life.

Research in this area has been difficult for many reasons. Emotional and cognitive symptoms are so common that it is sometimes difficult in a given woman to know if they are due to menopause. The night sweats that may occur during perimenopause can also contribute to feelings of tiredness and fatigue, which can have an effect on mood and cognitive performance. Finally, many women may be experiencing other life changes during the time of perimenopause or after menopause. There are responsibilities of children, grandchildren and aging parents and other stressful life events such as money and work that may also cause emotional symptoms.


Osteoporosis is the deterioration of the quantity and quality of bone that causes an increased risk of fracture. The density of the bone (bone mineral density) normally begins to decrease in women during the fourth decade of life. However, that normal decline in bone density is accelerated during the menopausal transition. As a consequence, both age and the hormonal changes due to the menopause transition act together to cause osteoporosis. The process leading to osteoporosis can operate silently for decades. Women may not be aware of their osteoporosis until suffering a painful fracture. The symptoms are then related to the location and severity of the fractures. It lowers estrogen levels, which can worsen symptoms and menstrual problems

The goal of osteoporosis treatment is the prevention of bone fractures by slowing bone loss and increasing bone density and strength. Although early detection and timely treatment of osteoporosis can substantially decrease the risk of future fracture, none of the available treatments for osteoporosis are complete cures for the condition. Therefore, the prevention of osteoporosis is as important as treatment. Osteoporosis treatment and prevention measures include lifestyle changes such as: cessation of cigarette smoking, curtailing alcohol intake, exercising regularly, and consuming a balanced diet with adequate calcium and vitamin D. Medications that stop bone loss and increase bone strength include: alendronate (Fosamax), risedronate (Actonel), ibandronate (Boniva), raloxifene (Evista), and calcitonin (Calcimar). Teriparatide (Forteo) is a medication that increases bone formation.

If You Smoke, Quit

Smoking is perhaps the single worst thing you can do for your health. About 15,000 women die of smoking-related causes in Canada each year. Smoking also has several other negative effects. It increases the risk of osteoporosis, heart disease and stroke, lung disease and many cancers, of such as those of the cervix, lung, mouth, larynx, and bladder. It lowers estrogen levels, which can worsen symptoms and menstrual problems.

Ask your health care provider about ways to help you quit smoking successfully, such as nicotine replacement medications (Nicoderma, Nicorettea, NicotrolB) and support groups in your neighborhood. There is, also, excellent information to obtain through the Heart and Stroke Foundation of Canada, the Canadian Cancer Society, and the Canadian Lung Association.

Other Physical Changes Reported Frequently

Many women report some degree of weight gain along with menopause. The distribution of body fat may change, with body fat being deposited more in the waist and abdominal area than in the hips and thighs. Skin becomes drier, thinner, changes in skin texture, including wrinkles, may develop along with worsening of adult acne because the loss of estrogen leads to a decrease in natural substances important to skin’s appearance. These substances are called collagen and elastin. Long-term sun exposure also plays a major role in skin aging in those affected by this condition. Since the body continues to produce small levels of the male hormone testosterone, some women may experience some hair growth on the chin, upper lip, chest, or abdomen.

Dry skin and aging can be prevented or slowed down by: a) wear a sunscreen with a sun protection factor (SPF) of 15 or more, b)don’t smoke, c) drink plenty of water, and d) stay active. Exercise improves blood circulation and the skin’s appearance.