19 Symptoms You’re Approaching Menopause

Menopause Symptoms to Be Aware Of

Symptoms of MenopauseWith contributions from Krystina O.

Sometimes menopause begins with changes in periods, hot flashes, or loss of libido. You begin to wonder, “What is going on with my body?” All the signs point towards you entering menopause.

What Is Menopause and What Are the Stages of Menopause?

We hear “menopause” and we assume that we simply end menstruation and are menopausal. However, there are several stages of menopause before we are actually “menopausal.”

Perimenopause is the initial stage of menopause. According to the North American Menopause Society (NAMS), perimenopause occurs when the body begins to provide signals that that menopause is beginning. The crazy thing about perimenopause? Although it has begun, it can still be years until your final menstrual period.

The average age of perimenopause is 47, but there is some variability.

Menopause is defined by NAMS as “the spontaneous, permanent ending of menstruation that is not caused by any medical treatment.”  A woman is typically felt to be menopausal when she has not had a menstrual period for 12 months.

Menopause naturally occurs between the ages of 40 and 58, with the average age being 51.  A woman can look to her mother as a guide as to when she is most likely to reach menopause.  However, there are several variables that can affect when she will reach menopause.  For example, smokers often reach menopause two years earlier than nonsmokers.

Postmenopause occurs once you’ve been one year without a menstrual period.  Once you have hit this mark, you will then be considered postmenopausal for the rest of your life. Any vaginal bleeding after this point is considered abnormal and should be investigated by a physician immediately.

You may think that you will be symptom-free during this stage.  However, certain symptoms are known to remain for a while.  Vaginal dryness and hot flashes can continue for a while due to decreased estrogen levels. Also, once you’ve become postmenopausal, you’re risk of developing hormone-related diseases such as osteoporosis decreases.

Menopause Symptoms You Should Be Aware Of

Now that you understand what perimenopause, menopause, and postmenopause are – you may start to notice symptoms months or years before you are in menopause. You won’t know exactly when this will start, but if you pay attention to how you are feeling, you will start to notice changes.

Symptoms will vary from woman to woman, and some women may not have any symptoms that their periods may end soon.

Here are 19 telltale symptoms you are entering the menopause:

Hot Flashes

You will know a hot flash as soon as you have one.

A hot flash is a sudden overwhelming blast of heat starting at your forehead going down into your feet and accompanied by sweating. You may also experience flushing or redness in your face and upper body.

The experience of a hot flash can range from minor sweating to a feeling as if you are covered in too many blankets in a 90-degree room.

Hot flashes are your body’s response to the decreased supply of estrogen. Not all women experience hot flashes, but most do.

How quickly estrogen diminishes determines how frequent and strong your hot flashes will be. If your estrogen production stops suddenly, you are in for some pretty harsh hot flashes.

Night Sweats

Night sweats are severe hot flashes occurring after you have fallen asleep.

They wake you up the middle of the night leaving you cold and clammy. Your heart might be pounding, and your sheets soaked in sweat.

For many women, night sweats can be so severe that they disrupt sleep and make it difficult to function during the day.

Increased Sweating

Menopause causes increases in sweat production separate from hot flashes and night sweats. This rise leads to increased body odor even if you maintain a good hygiene routine.

And while body odor changes are common, they are bothersome.

Ask your doctor about treatments for managing hormonal imbalances or make simple changes to your way of life, such as wearing clothing that is lighter and breathable.

Next page: More menopause symptoms and signs, including changes in period, vaginal dryness, mood swings, mental health, and more. 

Changes in Periods

If your menstrual periods start to come more often or less often, are heavier or lighter, or have changed in duration, you’re probably on your way to menopause.

It is also possible your periods will become unpredictable, and you may not know when the next one will come, how long it will last, and how heavy or light it will be.

You can still get pregnant as long as you are getting periods, so it is a good idea to maintain your contraception method.

Any bleeding – even spotting – after your periods have completely stopped isn’t normal and should be brought to your doctor’s attention.

Vaginal Dryness

One of the earliest signs of menopause is vaginal dryness. As estrogen decreases, so does the body’s lubrication of skin, hair, and more intimate areas, such as the vagina.

Vaginal dryness can make sex painful and uncomfortable.

Talk to your doctor about over the counter (OTC) lubricants, prescription lubricants and gels, oral and cream medications, and/or hormone replacement therapy (HRT) to help ease vaginal dryness. (HRT helps your body to produce natural lubrication.)

Loss of Libido

Some women report they are less interested in sex or have problems getting aroused when they are going through menopause.

The sudden drop in sexual desire is caused by hormonal imbalances and other symptoms of menopause, such as vaginal dryness and depression.

Mood Swings

Menopausal mood swings are common but can be hard to cope with. They also bring about a rollercoaster of emotions – one minute you are happy as can be, the next you are either angry or crying hysterically.

Your mood swings can be abrupt and/or extreme. And sometimes your ability to control your moods can be frustrating and confusing.

Anxiety and Depression

Menopause and depression are commonly experienced together, and there are different reasons why some women experience depression and anxiety during menopause.

Some culprits are:

  • Genetics
  • Hormones
  • Trauma
  • Stress
  • Medications
  • Chronic health conditions
  • Loneliness

It is not always possible to completely avoid feelings of anxiety and depression, but with healthy eating, staying active and keeping social helps.

Concentration and Memory Problems

Changes in your hormone levels during menopause can impair your ability to concentrate and can result in memory problems.

It is very common to experience lapses in your memory and have problems concentrating during the early and middle stages of menopause.

Sore Breasts

If your breasts feel sore and tender, this is probably due to menopausal hormonal changes. You may benefit from wearing comfortable bras and cutting out caffeine which exacerbates swelling.

And even if you still get periods, sore breasts aren’t just going to be limited to your cycle. The severity of pain and tenderness can range from uncomfortable to extremely painful even with the simplest touch.

Talk to your doctor if breast soreness and tenderness cause you a lot of discomforts. Your doctor can recommend an OTC treatment or prescribe one to other you some relief.

Next page: continue to the next page to learn about other common symptoms of menopause including fatigue, incontinence, and weight gain.


Fatigue is a very common symptom of menopause and involves feelings of weakness, tiredness, and low energy. You may also experience irritability and inability to focus.

Menopausal fatigue is caused by hormone changes, especially estrogen. When estrogen drops, so does your energy.

Chronic fatigue can severely impact your life. If fatigue is affecting you at work or in your relationships, talk to your doctor about treating hormonal imbalances to restore energy levels.

Sleep Problems

Many menopausal women report unrefreshing sleep and problems falling asleep.

Research shows women start to experience sleep issues years before the onset of menopause according to the UCLA Sleep Disorders Center.

Waking up several times during the night, struggling with insomnia, or tossing and turning, could also be menopause related.

If these issues affect your focus during the day, talk to your doctor about ways to resolve and manage sleep problems.

Chronic Headaches

Women who experience headaches around or during their monthly cycles will likely experience them during menopause. Headaches can also be a side effect of HRT therapy.

As your body begins to slow down its production of estrogen, your headaches will be more frequent and severe.

The good news is that once you officially reach menopause, you will stop experiencing these headaches due to lowered hormone levels.

Hair, Skin, and Nail Changes

When your estrogen levels decrease, your hair can become dry, thin, and weak and prone to split ends and breakage.

Your skin may also become dry and thin, and you might find you have sensations your skin is itchy or tingly, or you may experience a crawling feeling.

Hormonal fluctuations can also lead to brittle fingernails. Symptoms of brittle nails include:

  • Changes in normal nail color
  • Ridges on nails
  • Peeling, cracking, curling, chipping or splitting
  • White spots
  • A feeling of dryness
  • Dry cuticles and hangnails


Reduced levels of estrogen cause the thinning of the lining of the urethra – the short tube that allows passage of urine from the bladder to the outside of your body. The surrounding pelvic muscles will also start to weaken as you get older – a process called pelvic relaxation.

Both factors will result in urinary incontinence – involuntary urine leakage.

Small changes such as drinking less coffee, tea, sodas, and alcohol, limiting other liquids, and keeping a healthy weight can help minimize your symptoms.

Kegel exercises can help to tighten your pelvic floor. These exercises involve repeatedly tightening and releasing your pelvic floor muscles for a few seconds at a time.

Weight Gain

Weight gain is the most frustrating part of menopause for most women especially since the weight starts to accumulate at your midsection.

Therefore, as you get older, it is important to maintain a healthier lifestyle because having more weight in your midsection puts you at risk for many serious health conditions, including heart disease.


Bloating is a very common symptom of menopause and related to the increase of intestinal gas and fluid retention caused by hormonal fluctuations. It is similar to the bloating you experience before and during your period.

Next page: More information on menopause symptoms including irregular heartbeat and osteoporosis, and how to determine a menopause diagnosis. 

Irregular Heartbeat

An irregular heartbeat is a relatively common problem in women going through menopause. The problem is related to fluctuating estrogen levels.

An irregular heartbeat is known medically as heart palpitations. It occurs when the heart beats faster than normal or more forcefully. This might give an unpleasant awareness of your heartbeat and may feel as if your heart is pounding or has skipped a beat.

While irregular heartbeat is normal during menopause, these events may alarm you. And while it is likely nothing to worry about, you should still talk to your doctor if these episodes are frequent or scary enough to cause you concern.


Osteoporosis is a bone disease that weakens your bones and increases your risk of fractures.

The actual cause of it is unknown, but researchers do know there is a connection between osteoporosis and menopause.

The lack of estrogen is directly linked to a decrease in bone density, and the longer a woman is experiencing lower estrogen, the more likely her bone density will be compromised.

Talk to your doctor about your risk factors for osteoporosis and potential ways to preserve bone health.

Treatment for Menopause Symptoms

There are a variety of ways to feel better while you’re experiencing menopausal symptoms.

Certain medications may help in relieving menopause symptoms:

  • Hormone replacement therapy helps reduce hot flashes and night sweats. It can also prevent osteoporosis.  This therapy is not recommended for people with certain cancers, blood clots, strokes, or liver disease.
  • For women who are unable to take hormones to treat hot flashes, blood pressure medications, antiseizure medications, and even antidepressants can help (and they even help with mood swings).
  • Topical estrogen can be applied for vaginal dryness.
  • Non-prescription medication options include lubricants for vaginal dryness and over-the-counter sleep medications.

Some women do not want to take medications – or want to include a non-medication treatment along with their prescribed medication. Here are some options to try:

  • Black cohosh. Black cohosh is a phytoestrogen, meaning that it contains a substance that has a weak estrogen-like effect.  Because of this, it may reduce symptoms associated with menopause.  Research is mixed, but the side effects are minimal, making it a generally safe supplement.
  • Evening primrose oil. This is specifically thought to treat hot flashes, but there is no scientific evidence to support this claim.  It has a higher side effect profile and interacts with more medications so check with your physician prior to ingestion of this supplement.
  • Other treatments, including acupuncture, chiropractic care, and massage, are not thought to be beneficial – but are also not thought to be harmful, either. If you find benefit or find them pleasant, it is generally thought to be safe to continue.

Do I Have Menopause?

You may want to know, “Am I really menopausal?” Likely your physician will guide you to track your menstrual cycles. As discussed, once you’re menstrual cycle-free for 12 months, you’ll be diagnosed as menopausal.

This can be agonizing. As your periods begin to slow down, you’ll probably note that they become irregular, erratic and that you miss one or two. Then it shows back up again.

It’s a frustrating experience.

There are laboratory tests that your physician can run that can help. Drawing the level of the follicle stimulating hormone (FSH) can help to determine your ovarian function. If the FSH level is elevated, your physician will know that the ovaries are beginning to shut down. Once this begins to happen, menopause symptoms are likely to begin to develop.

Seeing Your Doctor

You should be seeing your doctor regularly for preventative healthcare and any medical concerns. Continue going to your appointments before, during, and after menopause. Preventative healthcare should include mammograms and breast and pelvic exams.

You should talk to your doctor about heavy or irregular menstrual bleeding that is abnormal for you, new bleeding between periods, bleeding while you are taking hormone replacement therapy, and any bleeding from your vagina after you have not had a period for at least six months.

Your doctor can also prescribe medications to help you manage some of the symptoms of menopause, including insomnia, hot flashes, mood changes, and vaginal dryness.

It’s important to know that you shouldn’t be embarrassed about your menopausal experiences and menopause symptoms, and learn to be open to talking with your doctor about any concerns related to menopause or other health worries.

The Bottom Line…

While this is a confusing and intimidating time for you, menopause doesn’t define who you are.

During your menopause journey, remember to take your time, don’t blame yourself or feel guilty for things that may be out of your control, and let your family know what you’re going through and provide simple ways they can support you.


Mayo Clinic (Menopause)

National Institute on Aging (Menopause)

Mayo Clinic (Perimenopause)

UCLA Sleep Disorders Center (Sleep and Women)

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