When you talk with other menopausal women, you likely hear similarities in their stories. But no two women experience menopause the same. If you understand all the different potential symptoms, it’s much easier for you to identify them if they do arise.
Knowing what to expect opens up opportunities to find relief and learn ways to find menopause solutions & manage symptoms on your terms. We put together this guide for the 20 most recognized menopausal symptoms, why they happen, and what you can do about them to maintain intimate wellness during menopause. Some of these symptoms are more common, while others are less talked about. We recommend bookmarking this list for reference and pass it along to the women in your life to build awareness.
What Is Menopause?
Menopause is the stage in life that marks the end of your reproductive years. Menopause is divided into three stages: perimenopause, menopause, and post-menopause. These stages are often lumped together, but they each have definable changes.
Perimenopause: Perimenopause is considered menopausal transition. This stage can begin eight to 10 years before menopause when the ovaries begin to produce less estrogen over time. Your estrogen decline accelerates in the last two years of perimenopause up until the ovaries stop releasing eggs. However, you will still have menstrual cycles, although they can be irregular, and during this stage you can still get pregnant.
Menopause: Menopause is when the ovaries have stopped releasing eggs and producing most of their estrogen. Menopause is diagnosed when you haven’t had a menstrual period for 12 consecutive months.
Post-menopause: This is the stage after you haven’t experienced a period for an entire year — and is the stage you’re in for the rest of your life. During this stage, menopausal symptoms may ease up, but some women continue to experience menopausal symptoms for a decade or longer after the menopause transition.
At What Age Do Women Experience Menopause?
Many factors affect what age women will experience menopause. The most relevant factor may be the age your mother began experiencing menopausal symptoms. Though menopause has a genetic link, this isn’t a universal truth for all women. Some women reach menopause long before their mothers with no known genetic reason.
You may find a more reasonable prediction by looking at all the women in your family. If your mother, aunts, and sisters all started near the same age, this could give you a close calendar date. Other factors such as lifestyle (smoking is a big one), chemotherapy, and ovarian surgery may also determine when menopause starts.
Women typically experience symptoms of menopause between the ages of 44-58, with an average age of 51. However, women in their 30’s and 60’s may also experience their first symptoms.
What Are The 20 Symptoms of Menopause?
Irregular periods. This is among the earliest and most common perimenopausal symptoms. You may experience spotting between periods, abnormally heavy or light bleeding, dark blood, or shorten cycles.
Why it happens: During this stage, your estrogen and progesterone hormones fluctuate. These shifts can affect ovulation, cause thinning of the uterine lining, or excess uterine thickness.
What you can do: Always be prepared. Keep feminine hygiene products stocked and with you at all times. Try to include products for heavy days, regular days, and light days. You can also use a period tracking app to identify common patterns and symptoms throughout the months. Your healthcare provider can gain insights from this data, so share it during your appointments.
Dryness. Skin can become less plump, and you may notice more dryness, dullness, sagging, and breakouts. You may also experience brittle, thinning hair and nails. Some women experience hair loss or slower growth. Additionally, lower estrogen levels may cause the vulvar tissue and vaginal lining to become thinner, drier, and less elastic. This condition is known as "vulvovaginal atrophy."
Why it happens: Both estrogen and collagen levels lower during menopause. These hormonal shifts may cause drops in your natural moisture levels.
What you can do: It’s time to up your skincare routine. Apply a quality moisturizer and sunscreen regularly and look for pH-balanced ones to suit your skin. Lifestyle changes can help reduce the effects of menopausal dry skin, such as quitting smoking and increase healthy fat intake. You can also increase natural lubrication using our vFit Device along with the Photonic Gel. Finally, try using revitalizHER on your face, elbows, feet, and vulva—you will love it.
Hot flashes. One of the most talked-about perimenopausal symptoms, these sudden heat surges can cause skin burning, face flushing, and sweating. Some women never get them, while others can have them for a decade or longer.
Why it happens: Although the exact causes of hot flashes haven’t been pinned down, researchers think there are two factors. The first is fluctuations in estrogen levels. A sudden drop in estrogen levels confuses the hypothalamus (which is your internal thermostat). The second factor is your circulatory system. The brain may send out response signals for a five-alarm fire, telling the circulatory system you’re about to overheat. Your body then floods with chemicals from your nervous system. This causes your heart to pump faster, the skin blood vessels to dilate to increase blood circulation, more blood (radiating off the heat) — and your sweat glands to release sweat to cool.
What you can do: Maintain a healthy weight, improve your lifestyle, layer your clothes, and get plenty of daily movement. It’s also important to talk with your healthcare provider about potential hormonal support such as HRT.
Night sweats. Night sweats are the close cousin of hot flashes, but they haunt you in your sleep. These intense flashes of heat are the number one cause of sleep disturbances. In addition, lack of sleep leads to a host of other symptoms, such as impaired judgment, lack of focus, moodiness, and being more prone to accidents.
Why it happens: Night sweats are caused by the same hormonal shifts and circulatory changes as hot flashes. In addition, these symptoms may worsen at night due to your sleeping environment and homeostatic changes that occur while your body recovers from the day.
You can do: The same lifestyle factors that help manage hot flashes that can support your body when managing night sweats. In addition, wear cooling fabrics that wick away moisture, lower the room temperature, and use bedding that cools the body (including sheets, mattress toppers, and pillows).
Mood changes. You may experience a spectrum of emotions during the menopausal stages. Women sometimes report feeling irritable, sad, unmotivated, anxious, irritable, aggressive, exhausted, panicky, and tense. Menopausal women are also more at risk for depression during these stages of life.
Why it happens: As your estrogen levels decline, your body goes through an array of changes linked to mood. Loss in estrogen may affect how your body manages serotonin and norepinephrine, which directly relate to mood disorders. Researchers have also found higher brain protein levels known as monoamine oxidase A (MAO-A) in perimenopausal women. This brain protein is linked to depression and mood disorders. Another factor is night sweats that may impair regular sleeping patterns. Lack of sleep is directly related to mood and depression.
What you can do: Self-care and self-nurturing are significant factors when it comes to supporting your mood. It’s essential to find a balance between caring for yourself and life obligations. Lifestyle adjusts also come into play. Eating a healthful diet, getting daily exercise, and reducing your intake of harmful substances (smoking, drinking, and poor-quality foods) can support your mood. It’s also crucial to find support through friends, family, groups, and mental healthcare providers. You don’t have to suffer in silence.
Changes in sexual desire. Libido is known as your sexual appetite. It’s driven by brain function, hormones, learned behavior, and motivation. Some women have an increased interest in sex during menopause, while others experience a loss of libido.
Why it happens: As with other menopausal symptoms, libido changes can relate directly to hormonal shifts. As your hormone levels decrease, vaginal dryness and tightness can make sex painful. Additionally, other hormone-related menopause symptoms can dampen the mood, such as mood changes, weight gain, hot flashes, or night sweats. You may also experience a drop in testosterone, which is a hormone linked to sex drive.
What you can do: One of the best ways to support your sexual desire during menopause is to address the issues directly. For example, if sex is painful, you can try a lubricant that supports pH balance and supporting healthy vaginal tissue with our intimate wellness device. This can help in making sex more comfortable after menopause. In addition, talk with your healthcare provider for hormone support and also emotional care support. It’s also important to address other issues that may arise as you move into this new stage of life, such as closeness with your partner, desire to have new sexual experiences, and sexual issues your partner may be experiencing.
Stress incontinence. Stress incontinence is the involuntary leakage of urine at the most inopportune times. It’s most common when you sneeze, cough, laugh, jump, or run. But it can creep up at any time. For example, some women begin to experience stress incontinence after childbirth and notice an increase with age.
Why it happens: As estrogen levels decrease, the lining of the urethra thins. You may also experience pelvic relaxation or weakening of the surrounding pelvic muscles — both changes lead to urine leakage.
What you can do: You may think upping your Kegels is the answer but many women do not do proper Kegels or don’t do them at all and muscle strength is only part of the problem. We recommend seeking a consultation with a pelvic floor physical therapist for a thorough evaluation. This expert will examine and assess your pelvic floor function and put you on a plan that best supports your pelvic floor health. In addition to guidance from your pelvic floor expert, you may also use our vFit intimate wellness device to help support healthy tissue and strength.
Weight gain. Reluctantly called the middle-age spread, many women experience weight gain during perimenopause, especially around the midsection.
Why it happens: The hormonal shifts you experience during perimenopause and menopause may slow your metabolism. As your metabolism slows, it becomes harder to lose weight and keep weight off. A significant factor is women often don’t adjust their lifestyle. So when your metabolism slows, it’s important to realize the same calories in does not equal the same calories out. In addition, other symptoms of menopause such as lack of sleep, fatigue, and depression may increase your risk of weight gain. Genetic factors also come into play — so if you have family members with excess weight around the abdomen, it may be a telling sign for you.
What you can do: Adjustments in your diet and exercise regimen are an important place to start. You may need to decrease your caloric intake to support a lower metabolism. It helps to add high fiber foods, increase your vegetable intake, and drink plenty of water. These nutritional resources help you stay full longer. A change in your exercise plan may also help. Perform exercise that keeps you in the fat-burning zone, and try to get daily movement. Also, speak with your healthcare provider about support for your hormone levels and any mood changes you’ve experienced.
Breast changes. Just like puberty and periods, as your hormones change, your breast will undoubtedly feel it. You may notice your breasts feel tender and achy, change in size and/or shape, or even feel lumpy as you enter perimenopause.
Why it happens: Fluid retention in your breasts is common before your period. This can cause swelling, tenderness, and aching. The hormonal changes you experience during menopause can cause cycle irregularities. In addition, glandular tissue in your breasts shrinks as your body turns off your milk-production system. This can cause denser, fattier breast tissue, which may cause your breast to become heavy and drop — and result in loss of fullness. If your breasts feel lumpy, they may be from fibrocystic changes.
What you can do: Finding the right support for your breast is key. Talk with a bra expert to make sure you have the right size bra and one that supports your breast all day. In addition, regular upper body strength training exercises can support breast tissue, along with stretching and massage. Also, talk with your gynecologist about hormone support if symptoms become severe and impairing. Lumpy breasts don’t immediately mean cancer, so don’t panic. But it’s important to keep up with regular monthly self-breast exams and your recommended mammogram schedule to track any changes in the breast tissue.
Digestive health issues. Hormones play a significant role in digestion, so it’s common to have a disruption in normal GI health during menopause. This may include gas, bloating, nausea, constipation, diarrhea, abdominal discomfort, and belching.
Why it happens: Estrogen helps keep cortisol (our primary stress hormone) levels low. When estrogen levels decline in menopause, cortisol levels rise. This can have several effects on the GI tract, including reduced production of stomach acid (or HCL) and slowed GI motility — meaning your food digests slower, which can lead to uncomfortable symptoms.
What you can do: Take plenty of time to eat, chewing each bite several times before swallowing. Avoid foods known to cause gas and bloating. Take digestive enzymes and probiotics, and eat plenty of prebiotic foods. Staying hydrated can also help relieve digestive issues.
Fatigue. Feeling bone tired? Many women report severe exhaustion as one of the first symptoms they noticed during menopause.
Why it happens: Your energy-supporting hormones (testosterone, estrogen, progesterone, thyroid, and adrenal) are all in flux during menopause. As your body tries to adapt and maintain homeostasis, you feel downright worn out. Poor sleep quality due to night sweats, the need to pee at night, sleep apnea, and restless leg syndrome are also major contributing factors to menopause exhaustion.
What you can do about it: Maintaining a healthy lifestyle is one of the best things you can do. Exercise daily on a level that works for you. If you’re too exhausted, a brisk walk will help. Eat plenty of fresh foods, drink ample water, and prioritize sleep. Take naps when you need to, and create a sleep environment that is cool, quiet, and completely dark and consider magnesium and other supplements and teas to help with restful sleep.
- Headaches and migraines. Headaches are a tricky business. Menopause may make hormone-induced headaches and migraines less severe when linked to the hormonal fluctuations of your menstrual cycle. Conversely, you may experience them for the first time around perimenopause because of new hormonal fluctuations.
Why it happens: Researchers have indicated the sudden drop in estrogen before your period is linked to migraines and hormonal headaches. This is why some women who take birth control are more prone to these types of headaches since they go from three weeks of dosing with estrogen to no estrogen dosing. Additionally, some women taking HRT may also have the same experience.
What you can do: Talk with your healthcare provider about additional medications or supplements you can take. You may also discuss your current birth control or HRT for any recommended adjustments.
Oral health issues. When we say everything dries out during menopause, we mean everything — including your saliva. A decrease in natural saliva production can put you at risk for oral health issues.
Why it happens: As your hormones drop, you begin producing less saliva. Saliva is responsible for rinsing bacteria and food particles from your teeth. It also keeps your gums hydrated, so they don’t recede. A dry mouth can lead to bad breath, gum disease, and tooth decay. It may also increase your risk of “burning mouth syndrome,” a condition that gives you a burning feeling in all your oral tissues.
What you can do: Talk with your dentist about an oral rinse that can prevent dry mouth. Also, talk with your doctor to see if HRT can support your oral health and get recommendations on dietary changes that may help alleviate symptoms.
New or increased allergies. Coughing, itchy eyes, and hives may increase during menopause. You may also notice new or worsening food sensitivities and allergies, leaving some of your favorite foods off the table.
Why it happens: Your body has estrogen receptors all over, including on your immunoregulatory cells (the cells responsible for keeping your immune responses in check). Estrogen may play a role in how your body responds to allergies and inflammation. Progesterone usually keeps this system balanced, but you may notice allergies, asthma, and sensitivities worsening as it drops.
What you can do: Learn your triggers. Notice if they come and go with your cycle or of certain environmental elements can worsen symptoms. Also, keep your diet in check, keep your vitamin D levels healthy, and talk with your healthcare provider about medications or other supportive therapies.
Difficulty concentrating and memory lapses. If you lose your train of thought mid sentence or put the milk in the pantry, you’re not alone. Brain fog, forgetfulness, and lack of focus are common issues during menopause.
Why it happens: Estrogen can impact memory before or during menopause. So it’s possible the hormone fluctuations you experience play a part in memory problems. Additionally, other menopausal symptoms like night sweats, headaches, and insomnia can leave you feeling mentally drained. While memory lapses in older adults are often attributed to early onset dementia or Alzheimer’s disease, studies have shown that most menopausal women experience improved cognition once they move into post-menopause.
What you can do about it: Exercise and a healthy diet can support brain function. Taking care of your body will also improve your quality of sleep, which boosts brain power. In addition, keeping your brain active is a great way to improve cognition. Also, take time for self-care, including meditation, relaxation, massage, and regular deep breathing. Finally, talk with your healthcare provider if you feel you need extra support or possible medication.
Tight muscles and joint pain. Stiffness, aches and pains come with age. The normal wear we place on our joints becomes more apparent as joint fluid dries out and soft tissue damage increases. But many women begin to experience joint and muscle pain as they transition into perimenopause.
Why it happens: Though hormone changes affect your joints and muscles, it’s not easy to pinpoint exactly why these changes happen. Many people in general become less active as they get older. Weight gain and general wear and tear over the years may also contribute. Other issues such as arthritis and osteoporosis can also increase risk of pain, stiffness, and inflammation.
What you can do: Keep active with daily exercise and flexibility practices. Drink plenty of water and rest. Stress management is also essential since tension can show up in our muscles. Some dietary issues may arise that can lead to joint inflammation, so talk with your doctor if you think you may have developed food sensitivities. Also talk with your doctor about pain management and other therapies that can support joint health like food supplements and massage.
Irregular heartbeat. On average your heart beats 60-100 times per minute. However, you may experience times when your heart skips a beat, beats faster, or is out of rhythm. A single episode may last for a few seconds up to a few minutes. These symptoms may worry you, but often they are not dangerous and simply normal symptoms of menopause.
Why it happens: Estrogen impacts the dilation of the coronary arteries. Lower estrogen levels can cause the arteries to contract. Higher estrogen levels will cause them to dilate. These changes can lead to changes in blood pressure and heart rhythm. So if you experience a sudden flux in estrogen, your cardiac system will respond. Estrogen also affects the autonomic nervous system. This system regulates heart rate and breathing. When estrogen levels change, the nervous system fluctuates between high and low stimulation, and it can cause irregularities in your heartbeat.
What you can do: Stress reduction is the best thing you can do for your heart. Deep breathing exercises, mediation, and learning to say “no” is a great way to soothe your nervous system. Exercise is also vital. A brisk evening walk will do wonders for your mind and heart. As always, talk with your healthcare provider if you need extra support or if you notice more sustained heart beat changes.
Tingling limbs and restless leg syndrome. All you want is a few hours of uninterrupted sleep, and suddenly your legs or other limbs are flooded with pins-and-needles. Tingling extremities, medically known as paresthesias, may happen when certain body postures pinch a nerve or press an artery. This can cause your limb to temporarily “fall asleep.” However, in many cases, tingling extremities usually return to normal after compression is relieved.
Why it happens: In most (but not all) cases, limb tingling during menopause results from natural hormone fluctuations. Estrogen has a complex relationship to the central nervous system. Estrogen may increase blood flow within brain tissue, promote anti-inflammatory effects, promote neuronal synapses, and affect neuroprotective and neurotrophic effects on tissues in the brain. As estrogen fluctuates during menopause, it can disrupt your central nervous system, producing symptoms like tingling extremities.
What you can do: Some women find relief when increasing their magnesium and iron intake. Talk with your healthcare provider before you begin any new supplement regimen. Daily exercise and stretching can also help calm the nervous system when it’s at rest. Also, improving regular sleep habits and avoiding caffeine and alcohol may reduce tingling and discomfort.
Osteoporosis. Osteoporosis translates to "porous bones." When bone density weakens, your bones become more prone to fractures from minor slips or simple movements. Osteoporosis can begin as minor bone loss, a condition known as osteopenia. If you’re diagnosed with osteopenia, you still have time to take action to prevent progression to osteoporosis — especially if osteopenia is discovered before menopause.
Why it happens: Loss of estrogen is directly related to a loss in bone density. Your bone density decreases over time as you experience lower estrogen levels. Women are at greater risk for osteoporosis if they experience menopause before age 45, go a long period without menstruating, or have irregular periods without ovulation.
What you can do: As with all menopause symptoms, a healthy lifestyle is a key to preventing osteoporosis. Get 30 minutes of exercise daily. Eat plenty of leafy greens, and keep your calcium and vitamin D intake optimal. Limit alcohol, quit smoking, and talk with your doctor about regular bone density screenings. Your doctor may also recommend medication that can help symptoms.
Dizziness. That sudden lightheadedness that hits you when you stand could be related to menopause. You may experience dizziness in a few ways: the room is spinning, you feel like you're going to faint, or you feel off balance.
Why it happens: Estrogen and progesterone changes are the reason behind many of your symptoms, and this is no exception. As your hormone levels dip, these changes affect your blood circulation which can cause fluctuations in your blood pressure. These shifts can result in dizziness.
What you can do: Hydration can help maintain a normal blood flow. It’s also important not to stand up too quickly or suddenly change directions if you’re prone to feeling off-balance. If you experience anemia, it’s important to talk with your doctor about iron supplements, which can help relieve dizziness.
Finding Support for Menopause Symptoms
It’s easy to brush off menopause symptoms as a part of the natural aging process. However, this time in your life should be a time to celebrate. So, don’t trick yourself into thinking you have to suffer. Talk with your healthcare providers — including your gynecologist, general practitioner, and mental wellness clinician — about your symptoms and concerns.
We recommend keeping a small journal or notes on your phone. Write down when you experience symptoms and any questions you may have for your providers. Also, seek support in your community. Talk with friends who may be facing the same challenges, and ask for support from your partner and family. Joylux also offers a menopause quiz you can use to find out more about the symptoms you’re experiencing.
Above all, practice self-care whenever possible. A healthy lifestyle is your best ally as you transition through menopause. Keep your body active, your mind engaged, and get plenty of downtime to unwind and be present with your body and mind.