11 Common Menopause Symptoms

• Menopause marks the end of a woman’s ability to get pregnant. It usually occurs between the ages of 40 and 52. 
• In the two to eight years leading up to menopause, as well as during and after, hormone levels fluctuate, leading to various menopause symptoms. The most common include hot flashes, night sweats, mood changes, and gynecological changes.
• Menopause symptoms are highly treatable. As women transition they can take steps to prevent health conditions associated with menopause, such as heart disease and osteoporosis. 

Menopause is a natural transition for women in their 40s and 50s, marking the end of their menstrual periods and ability to bear children. While it’s an expected change, it’s not without its symptoms. 

Menopausal symptoms can be minor or severe, depending on the individual. They can disrupt daily life and affect various facets of health, from gynecological health to mental well-being. In one study, women experienced 10 to 11 symptoms on average throughout their years of menopause. Below, we’ve outlined eleven of the most common symptoms, as well as possible treatments and lifestyle changes to help make the menopause transition more manageable.

Menopause is the end of the menstrual cycle, marked by 12 consecutive months without a period. After a woman has reached menopause (sometimes referred to as being postmenopausal) she cannot have children.

The gradual progression to menopause (known as perimenopause) takes longer. Usually, a woman will enter perimenopause two to eight years before her periods end. During this time, hormone levels, mainly estrogen and progesterone, fluctuate. 

While we typically associate hormones with reproductive changes like menopause and puberty, these chemical messengers play a role in many internal processes, including but not limited to:

• Growth
• Metabolism
• Sexual function and libido
• Mood and mental health
• Cognitive health

While the hormone fluctuations are a normal part of the aging process, they impact the reproductive system, induce various symptoms, and increase the risk for certain health conditions, such as osteoporosis and heart disease. 

States of Menopause

There are three distinct time frames during this transition: 

• Perimenopause: The stage leading up to menopause, marked by a period of gradual decline in estrogen, which may lead to symptoms such as irregular periods, mood fluctuations, and vaginal dryness. This period can last between two and eight years.
• Menopause: The period in a woman’s life when she hasn’t had periods for 12 consecutive months.
• Postmenopause: The time period after a woman’s final period.

Symptoms are often the most intense during perimenopause as hormone levels are in flux during this time. For many women, symptoms persist once they enter postmenopause, though they aren’t as severe and often gradually decline as hormone levels stabilize over time. 

Average Age for Menopause

Most women enter menopause in their 40s. The typical range for menopause in the US is 45–58, with menopause itself happening at 52 on average. These numbers, however, are just averages, and individual timelines differ. 

Menopausal Transition Timeline

Despite the average age of menopause being 52, everyone’s timeline is different. You’re more likely to go through menopause around the same age as your mother. Certain life choices, such as having children or not smoking, may also correlate with a later menopause.

If menopause (i.e. the end of the menstrual cycle) occurs between the ages of 40–45, it’s classified as early menopause. If symptoms appear before 40, it’s referred to as premature menopause. This can occur because of primary ovarian insufficiency (POI), which is when the ovaries stop working in your 30s, due to a surgery to remove the uterus or ovaries, or due to some medical treatments, most commonly cancer treatments like chemotherapy. Other times, premature menopause happens without a known cause. 

Health Risks of Menopause

Low levels of estrogen not only lead to menopause symptoms but are risk factors for other health conditions, such as:

• Heart disease: Estrogen relaxes blood vessels and helps manage cholesterol levels. Without as much of this hormone, the risk for cardiovascular disease increases.
• Stroke: Since estrogen helps manage cholesterol levels, the dip in estrogen during menopause increases the risk of cholesterol building up, which in turn means someone is more likely to experience a stroke.
• Oral issues: Menopause can cause dryness in the mouth, increasing the risk of cavities and other oral health conditions.
• Osteoporosis: Estrogen plays a role in bone health. Without it, bone density decreases, potentially leading to osteoporosis, which is when bones are brittle and break easily.
• Alzheimer’s disease: Recent research suggests declining estrogen levels lead to an increased risk for long-term memory issues, mainly Alzheimer’s disease. A decrease in estrogen often results in an accelerated accumulation of amyloid beta plaques and tau tangles, two markers of Alzheimer’s disease.

While menopause is a risk factor for these conditions, they aren’t experienced by everyone, and women in menopause can take steps to reduce overall risk. A balanced diet, regular exercise, not drinking alcohol or limiting alcohol consumption, and taking supplements or medications to prevent osteoporosis may lower the chances of developing these conditions. 

While women experiences menopause differently, some symptoms are more prevalent than others. In one study, 70–80% of women report that symptoms negatively affect their life, work, and/​or health, according to the Menopause Society (previously known as the North American Menopause Society).

The eleven symptoms below are some of the most commonly reported, though other symptoms can occur, too. 

1 | Irregular Periods

Menopause is defined as when periods stop for 12 consecutive months. Before that marker, women experience irregular menstrual periods. Some months, periods may be nonexistent, other months vaginal bleeding may be lighter or heavier than usual or occur at unexpected times, and during others, periods will be normal. It can be difficult to predict when each will happen, though this symptom stops once someone reaches menopause. 

2 | Hot Flashes

Around 80% of women experience vasomotor symptoms, which are symptoms caused by the difficulty in regulating body temperature due to hormonal fluctuations. Hot flashes are the most common in this symptom group. One of the hormones that fluctuates during menopause is estrogen, which the hypothalamus (a part of the brain) uses to help regulate body temperature. The disruption of estrogen means the hypothalamus can’t regulate body temperature like it used to, potentially leading to hot flashes or hot flushes.

These incidents can manifest as a sudden feeling of overheating, reddening skin, and feeling flushed, though they are sometimes followed by chills. 

3 | Night Sweats 

When our body can’t regulate temperature properly, it can also lead to more perspiration or sweating, which is our body’s attempt to cool us down. When hot flashes or sweating happen at night, it’s called ​“night sweats.” Overheating and sweating can be particularly frustrating at night because they may disrupt sleep or make it difficult to fall asleep in the first place.

4 | Vaginal Changes

Estrogen helps maintain the thickness and elasticity of the vaginal lining, which makes sex more comfortable and decreases vaginal dryness. When estrogen levels dip, as they do during the menopausal transition, the vagina shrinks, meaning the lining is thinner, less elastic, and more prone to dryness. As a result, many women report more painful sex. They may also be at a higher risk for vaginal infections, such as yeast or bacterial infections, since vaginal dryness increases the risk of these infections. 

5 | Urinary Problems

Vaginal dryness increases the risk of urinary tract infections (UTIs), which are infections in the urinary tract that disrupt the body’s ability to remove waste and excess water. Menopause isn’t the only cause of UTIs, but women often experience more UTIs during this transition, particularly once they enter postmenopause.

Women experiencing menopause and postmenopause are also more likely to experience urinary incontinence, which is involuntary urination in small amounts throughout the day due to a loss of bladder control. 

6 | Brain Fog

Brain fog is a cognitive state marked by memory lapses, difficulty concentrating, and feeling mentally fatigued faster than usual. This symptom is especially common in the early stages of perimenopause. 

The reason for this symptom is that the hippocampus, the part of the brain responsible for memory, relies on estrogen to help with cognitive functions like verbal memory and processing speed. Estrogen decline can affect these processes, leading to what people describe as ​“brain fog.” Over time, the brain adapts to lower levels of estrogen, leading to fewer postmenopausal women reporting this symptom. 

7 | Weight Gain

Women gain weight as they age, averaging about 1.5 pounds gained per year between the ages of 50 and 60. The decrease in estrogen and other hormones may mean metabolic processes aren’t as fast as they were before, leading to difficulty losing weight and putting on weight faster. 

8 | Emotional Symptoms

33.5% of women between the ages of 45–70 experience depression, and 54.2% report feelings of anxiety. While there are many possible reasons for these conditions to occur during this time (i.e., caring for aging parents, taking on more responsibility at work, helping children transition to adulthood, and the aging process in general), mood changes can be a symptom of menopause. 

The societal stigma of menopause symptoms, adjusting to other symptoms of menopause, and/​or estrogen’s role in mood regulation are three possible culprits for any mental health symptoms. 

9 | Changes in Libido

Mood changes, discomfort from hot flashes, and painful intercourse due to vaginal dryness may decrease a woman’s desire for sexual intercourse. Lower hormone levels can also decrease overall sex drive or may result in a longer arousal time. 

10 | Difficulty Sleeping

Night sweats combined with mood changes can lead to trouble sleeping or difficulty staying asleep. 47% of women in perimenopause and 60% of postmenopausal women report sleep problems. 

11 | Skin and Hair Changes

While not as common as the other ten symptoms, some women experience changes in their hair and skin during menopause. Dips in hormone levels mean the skin can’t repair as easily from environmental factors, like sun exposure or pollution. Skin symptoms include aging signs like wrinkles, drier skin, and poor wound healing. 

Hair symptoms include reduced hair growth on the scalp or unwanted facial hair. Hair growth patterns often change due to drops in estrogen, which plays a role in typical female hair growth patterns (i.e., less hair on the face and longer, thicker hair on the scalp). 

Managing menopause symptoms may involve lifestyle changes. Evidence suggests, for example, that not exercising and eating a poor diet can make menopause symptoms worse, while choosing a healthy lifestyle may help manage symptoms and improve women’s health overall. The most common lifestyle changes include:

• Maintaining a healthy weight through eating a balanced diet and exercising regularly
• Lifting weights to improve bone density and maintain muscle mass
• Practicing good sleep habits, such as sleeping in a cool, dark room and limiting distractions at bedtime
• Dressing in layers if experiencing hot flashes
• Avoiding or limiting spicy foods, alcohol, and caffeine
• Lowering stress levels with relaxation techniques, like yoga or breathwork
• Joining a menopause support group for solidarity and community
• If sex is painful, consider using a water-based lubricant or other vaginal lubricant

Medical treatments can also help, such as:

• Hormone replacement therapy: sometimes called ​“estrogen therapy,” replaces depleted hormone levels to create a more stable, gradual decline instead of the more unpredictable, natural dips and increases experienced during perimenopause. 
• Nonhormonal medications: can address a specific symptom, such as hot flashes, mood changes, or urinary incontinence.
• Supplements: Some supplements may help alleviate specific symptoms. For example, a supplement with vitamin D may support bone health and reduce brain fog, while one with red clover may help with hot flashes. 
• Therapy for mental health symptoms

When to consider menopausal hormone replacement therapy?

Menopausal hormone therapy is when you supplement hormone levels via a pill, skin patches, or vaginal creams. Some hormone replacement therapies only replace estrogen, while others replace estrogen and progesterone levels. These therapies are generally safe and effective and prescribed during perimenopause, though not everyone is a good candidate for them.

You should not consider hormone therapy if you:

• May be pregnant
• Experience vaginal bleeding outside of menstrual periods
• Have had some types of cancer
• Have liver disease
• Have had a heart attack or stroke
• Have blood clots or a history of blood clots

If you believe you are a good candidate for these therapies, discuss these options with a healthcare provider. 

When women begin to experience menopause symptoms, they should see a healthcare provider, such as a primary care provider or a gynecologist. Menopause is typically discussed during annual wellness check-ups or routine gynecological appointments.

During regular health check-ups, a healthcare professional can:

• Assess and manage symptoms
• Provide advice on whether hormone treatments are a good route to try
• Perform blood tests and other diagnostic tests for conditions that are associated with menopause
• Help you improve your overall quality of life while undergoing menopause

If symptoms are severe or interfering with your day-to-day routine, you may want to make a separate health appointment to discuss menopause specifically. When symptoms are severe, women may be referred to a specialist, such as an endocrinologist or a gynecologist with extensive training in menopause.