Menopause Symptoms: 17 Common Signs

After 12 continuous months without a menstrual cycle (assuming you aren’t pregnant or experiencing illness), individuals who normally menstruate enter a natural transition period called menopause. This process can be thought of as a timestamp when the body can no longer become pregnant on its own.

“Menopause is a period of time in a uterus owner’s life where their reproductive system essentially retires,” says Sameena Rahman, M.D., a Chicago-based board-certified gynecologist and specialist in menopause management.

People in menopause stop ovulating, as they no longer have eggs to release, resulting in a decline and eventual end in the production of sex hormones like estrogen and testosterone. “With the end of these sex hormones, everywhere you have tissue that has receptors that respond to these hormones can have an impact on your body and quality of life,” explains Dr. Rahman.

Keep in mind, however, that some people in menopause may not feel intense symptoms at all, and for some, menopause is even viewed as a welcome change as their periods end along with their chances of becoming pregnant unexpectedly.

It’s also possible for menopause to begin earlier than usual, and that can happen in a few ways. Primary ovarian insufficiency, or premature menopause, can happen as the result of genetic or autoimmune conditions. There is also induced menopause, which Helai Hesham, M.D., a New York City-based board-certified OB-GYN specializing in female pelvic medicine and reconstructive surgery explains can happen when an individual has their ovaries removed, undergoes chemotherapy or is taking other medications that stop the release of estrogen, such as hormone therapies for breast cancer.

The list of menopause symptoms is vast and can vary quite a bit, person-to-person.

Kecia Gaither, M.D., a double board-certified physician in OB-GYN and maternal-fetal medicine based in New York City shares this lengthy list of possible menopause symptoms:

• Hot flashes (most common, an estimated 50% to 82% of people in natural menopause in the U.S. experience hot flashes^[1]Management of Menopausal Symptoms. The American College of Obstetricians and Gynecologists. Accessed 12/30/2022. .)
• Vaginal dryness
• Insomnia
• Irregular periods
• Night sweats
• Mood changes
• Weight gain
• Thinning hair
• Dry skin
• Loss of breast fullness
• Tender breasts
• Lowered libido
• Fatigue
• Joint and muscular aches and pains
• Osteoporosis

Other Possible Symptoms

“Let’s not forget some of the big changes in your genital and urinary tract—the genitourinary syndrome of menopause,” says Dr. Rahman.

This symptom can range from vaginal discomfort and dryness to urinary urgency frequency and recurrent urinary tract infections, she explains. “Additionally, menopause can impact your sex life—painful sex and low libido are big issues that come up as well as difficulty obtaining orgasm.”

You may also find yourself feeling forgetful as you go through menopause; decreased levels of estrogen often means unwanted changes in memory.

As unnerving as these symptoms sound, especially listed back-to-back, remember that every body is different. Dr. Hesham points out that not all people experience each possible symptom of menopause. “Many patients will tell me, ‘I haven’t had a hot flash, so I haven’t gone through menopause,’ but not everyone has the same symptoms other than changes in periods,” she says.

The answer here is pretty cut and dry: One full year without a period is how you’ll know you’re in menopause. Before entering this timeframe, you may experience perimenopause, the time period before menopause that comes with its own set of symptoms.

What Age Range Is Typical for Menopause?

For most, menopause begins around 51 or 52 years old. Dr. Rahman adds that Black people may experience menopause at an earlier age.

Menopause treatments can vary widely—what works for one individual may not be the best treatment option for another.

Dr. Gaither shares some treatment options and management tips below, but also highlights the risks associated with some treatments.

• Hormone therapy (HT): Also known as menopausal hormone therapy (MHT), this treatment could help ease menopause symptoms but can also increase the risk of cardiovascular disease and breast cancer for some. This risk is lower, however, for younger people in recent menopause, particularly those at a healthy weight and without any known breast cancer or cardiovascular disease. It’s important to keep this in mind when considering HRT, as it can be a game-changer for qualifying people. While hesitation is understandable, newer research stresses that the risks are low overall, even extremely low for those using estrogen-only HRT.
• Topical hormonal therapy: Topicals, like gels, can be applied for issues like vaginal dryness.
• Non-hormonal medications: These options can include paroxetine and selective estrogen receptor modulators, and may assist in decreasing the symptoms of hot flashes.
• Medications for osteoporosis: Thanks to a swift drop in estrogen levels, people can experience bone loss, typically during the first four to eight years after menopause. This means an increased risk of osteoporosis. Because menopause changes the strength of your bones, exercise and weight-bearing exercise are paramount, says Dr. Rahman.
• Over-the-counter vaginal moisturizers or lubricants: These products can help with vaginal dryness.
• Quit smoking: This decision can help decrease hot flashes and improve other important areas like sleep.
• Weight loss: According to Dr. Gaither, heavier people generally have increased episodes of hot flashes.
• Yoga, Tai Chi or acupuncture: Dr. Gaither suggests these practices for help with symptoms like hot flashes. Some people may find these activities also help improve their mood.
• Soy products and certain herbs: Black cohosh, in particular, is thought to ease menopausal symptoms.

For individuals who qualify for hormone therapy, systemic estrogen alone (if you don’t have a uterus) and estrogen and progesterone can be life-changing, according to Dr. Rahman. “Almost all vagina owners can use vaginal estrogen cream or topical estrogen without fear,” she adds.

She stresses that exercise, lifestyle modifications and changes in diet are essential for managing menopause. For example, Kegel exercises, according to the North American Menopause Society, help strengthen the pelvic floor muscles. People who experience bladder leakage episodes during menopause may find these exercises beneficial.

“It is very important to find a provider that is skilled and up-to-date on the knowledge of menopause,” says Dr Rahman. “Your symptoms should be taken seriously by the doctor or healthcare provider you find.”

Keeping Cool

Simple home remedies may help ease hot flashes, or at least help you prepare for them. Mary Jane Minkin, M.D., gynecologist and clinical professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at The Yale University School of Medicine, suggests wearing layered clothing (lightweight layers, that is) so if you’re feeling hot, you can easily pull off one layer and still have a shell underneath.

Dr. Minkin also encourages people in menopause to keep a clean and dry change of clothes next to their bed so if they wake up sweaty and uncomfortable, they can quickly change and get back to sleep more comfortably.

She also stresses the importance of keeping your bedroom cool at night. If you can, it may be beneficial to go to sleep wearing moisture-wicking fabrics and use cooling sheets on your bed. Keeping a fan on in your room and traveling with a handheld fan are also good ideas.

Avoiding known triggers is another essential part of managing menopause symptoms. For example, Dr. Minkin points out that some people find red wine sets off their hot flashes. For others, it may be spicy foods or caffeine. It may be helpful to keep a journal to track and avoid potential triggers.

Perimenopause is trickier to define than menopause. According to Dr. Minkin, this is often the case because people can experience its symptoms even before they even skip one period. In general, you can think of perimenopause as the period of time leading up to your final menstrual period.

Dr. Rahman tells us the term means specifically “around menopause” and adds that sometimes, perimenopause is more difficult to deal with than menopause itself, thanks to sharp fluctuations in hormones.

According to Dr. Rahman, three types of symptoms tend to predominate perimenopause:

• Blood: Bleeding from menstruation can be shorter, longer and more erratic.
• Brain: Brain fog, cognitive distress, anxiety, depression and mood outbursts can occur.
• Burning: Vaginal burning or dryness, as well as systemic burning with hot flashes can be present.

Other perimenopause symptoms can include:

• Changes in skin (dry skin, wrinkling)
• Weight gain
• Lack of sleep or changes in sleep patterns

Dr. Gaither tells us perimenopause begins a few years before menopause—again, this is the phase in which the ovaries make less estrogen, which may last four to eight years.

The menopausal transition may take anywhere from seven to 14 years, though it’s more likely to be around seven years.

When menopause symptoms are painful and impact your daily life, it’s a good idea to visit your healthcare provider.

According to Dr. Hesham, people who experience menopause earlier in life or have any symptoms that they find disruptive should see a doctor for possible treatment options. “If bleeding patterns become heavy or concerning, they should also see their gynecologist,” she adds.

Dr. Rahman starts the discussion of menopause with patients in their early 40s. “If we have puberty talks and discussions, we should have menopausal talks and discussions,” she says.

She adds that if there are issues around bleeding, brain fog, cognitive distress, sexual pain or vaginal urinary symptoms, it’s important to tell your doctor. “Sex should never be painful and recurrent UTIs in midlife can be prevented. Everyone should have this discussion with their doctor starting in their 40s, and find someone that takes the time to listen.”