Within our private group often members will ask “Is this normal?”. So many symptoms that are part of the menopause are surprising until you’re in it and learning about it. I thought I’d take this chance to run through some of the main symptoms and what to expect.
Common symptoms usually include:
These are often considered the most common symptom of the menopause and occur in around 3 out of 4 women. They usually come on very suddenly and spread throughout your body, chest, neck and face. Hot flushes vary in length from a few minutes to much longer. Hot flushes can be associated with symptoms such as sweating, dizziness, light-headedness and even palpitations of your heart. They can occur many times throughout the day and can continue for many years – some women even experience hot flushes in their 80s. Hot flushes usually occur spontaneously but can come on after eating certain types of food or drinking alcohol, especially wine. However, some women don’t suffer with hot flushes but can have many other symptoms.
These can also be very common and troublesome. Many women find they wake up several times each night and are “drenched” with sweat and need to change their bed clothes and bed linen.
Not all women experience mood swings but for other women they can be very disruptive to home and family life. They can be more common if you have had premenstrual syndrome in the past.
Tiredness and poor sleep
This can be related to disrupted nights’ sleep from the night sweats but many women find that they have more unsettled and less fulfilled nights’ sleep when they are menopausal. Even if your sleep is not affected, you may find that you are more tired than normal during the day.
Lack of libido
Reduced or absent libido (sex drive) occurs when your hormone levels fall. This can also be related to low testosterone levels in your body.
It is common to find that you do not concentrate as well as you used to. Many women find that it is harder to multi-task and this can be very frustrating.
Although you may notice that your periods become scantier and lighter, some women find that their periods become closer together and even heavier as you approach the menopause.
Oestrogen is very important at providing lubrication in your joints and can also reduce any inflammation in your joints. Low levels of oestrogen can lead to many of your joints feeling stiff and aching.
Hair and skin changes
Although your skin can change as you become older, the changes in your hormone levels can lead to additional changes to your skin. Oestrogen is important at building collagen, the protein that supports the structure of your skin. Lower levels of oestrogen can lead to skin changes such as reduced elasticity of your skin, dry skin, fine wrinkling of the skin and your skin becoming thinner. Some women find their skin becomes itchier too. Acne and increased facial hair growth can also occur during the menopause. Oestrogen is very important for your hair growth so you may notice that your hair becomes thinner and less glossy.
Depression, anxiety, panic attacks and irritability
Emotional symptoms during the perimenopause and menopause can really vary between women. Some women find that symptoms of depression, anxiety, panic attacks, anger and irritation worsen so much that they really interfere with the quality of their life. These symptoms can affect your emotional well-being and really add to the stress of life in general.
It can be common to forget words, appointments, birthdays and even doing silly things (for example putting your car keys in the fridge!). Many women find that their brain does not feel as engaged as much as it used to and this can really affect their ability to work and function.
Worsening premenstrual syndrome (PMS)
Some women find that their PMS symptoms such as bloating, irritability, food cravings, mood swings and lethargy worsen. These symptoms are usually due to the fluctuating levels of progesterone that occur in your body.
If you have had migraines in the past, then you may find that your migraines become more severe or closer together. This can be a sign that your hormone levels are changing.
Vaginal dryness, itching or soreness
Vaginal dryness or atrophy, also called atrophic vaginitis, is a change in your vagina which develops when there is a significant decrease in oestrogen levels. Oestrogen is important at acting as a natural lubricant in your vagina and helps to keep this area moist. The lack of oestrogen tends to cause the tissues around your vagina to become thinner, dryer and inflamed. These changes can take months or even years to develop and vary between women. Your vagina may shrink a little and expand less easily during sex making sexual intercourse more painful or uncomfortable. Your vulva may become thin, dry and itchy. You may also find you have episodes of thrush more frequently.
The low levels of oestrogen in your body can also cause your bladder to become thinner and less elastic. This can lead to symptoms of recurrent urinary infections such as cystitis or result in you needing to pass urine more frequently. All these symptoms can be present long after your menopause, even when you do not have any other symptoms. These common symptoms affect the vast majority of women at some time after the menopause and can be treated easily. As the problem is usually due to lack of oestrogen, the usual treatment is replacing the oestrogen in your vagina and the surrounding tissues. A cream, vaginal tablet or ring containing oestrogen is often prescribed and works very well. Using topical oestrogen in this way is not the same as taking HRT and does not have the same risks associated with it. It can be safely used by most women and can also be used on a regular basis over a long period of time (usually indefinitely) as your symptoms will often return if you stop this treatment.
Vaginal lubricants and moisturisers can be used either with hormones or on their own and are usually also very effective. These are available either to buy from chemists or over the Internet. Moisturisers are used regularly whereas lubricants are usually used during sexual intercourse. Some lubricants may cause irritation, so if you have very sensitive skin, an alternative product may be preferable. Many products are tested for allergies. Your symptoms should improve after about three weeks of treatment. You should see your doctor if your symptoms do not improve, as sometimes these symptoms can be due to other conditions.
This Sounds Scary …
This isn’t written to scare you as it’s unlikely any woman will suffer from all of these symptoms. I want you to feel reassured that this is normal. Every woman’s journey through the menopause is unique but you are not on your own.