Medically Reviewed by Samantha M. Dunham, MD on July 21, 2024 | Written by Progyny Editorial Team
During the menopause transition, hormones like estrogen and progesterone fluctuate and decline overall, which can cause a large variety of symptoms.
The appearance and severity of symptoms are unique to an individual, much in the same way that puberty and coming-of-age happen to everyone, but each person’s experience is different. While everyone’s experience is unique, you can be certain that you’re not alone in having symptoms. Up to 90% of individuals contact their healthcare provider on how to cope with menopausal symptoms.
Let’s dig into some that you may experience. Understanding what to expect and how common symptoms are may give you some peace of mind. Knowing that symptoms for 85-90% of people are time-limited and will go away as the body adjusts to the new normal with lower estrogen can help too.
Common symptoms
Hot flashes and night sweats
These are classified as vasomotor symptoms (VMS) caused by estrogen fluctuations and decreases.
They can impact quality of life and range from mild to severe – there are also some who have none. Up to 80% of people with ovaries notice some symptoms and, of those, about 1/3 have severe symptoms. VMS are also associated with increased bone turnover, which leads to bone loss, and cardiovascular risk.
- Here’s a quick breakdown: Hot flashes are a sudden, intense spread of warmth felt across your face, neck, and chest. Episodes can last from several seconds to five minutes.
- Night sweats leave you feeling hot and sweaty despite a comfortable room temperature. They may result in sleep disturbances if frequent.
- In both of the above, the hot flash/night sweat episode is often followed by moments of feeling chilled. Some people also report feeling heart palpitations and/or dizziness.
Irregular bleeding and menstrual cycles
One hundred percent of those in the menopause transition experience changes in bleeding patterns. You’ll notice changes in your cycle, with the cycle interval becoming shorter or longer. As ovulation becomes less frequent, you’ll then skip some cycles.
- You may have short cycles (less than 21 days) early in your transition and long cycles (more than 35 days) later in your transition.
- You may experience longer periods of bleeding. If it’s persistently heavier than normal, longer than normal, or occurring at less than 21-day intervals, it’s important to see your healthcare provider.
Joint pain and body aches
There are estrogen receptors all over the body. They are found in expected places such as reproductive and breast tissue, but also in places such as bone, brain and skin tissue.
Decreasing hormone levels during the menopause transition can add to aches. Joint pains can also be caused by inflammation, general wear and tear, and aging.
Vaginal dryness and discomfort
Declining estrogen levels can lead to Genitourinary Syndrome of Menopause (GSM) where people experience symptoms from the decrease in elasticity and lubrication in the delicate tissue of the vagina, vulva, bladder, and urethra. Up to 85% of people note symptoms such as:
- Vaginal dryness
- Pain with intercourse
- Increased urinary frequency and urgency
- Frequent urinary tract infections
- Vaginal burning or itching
Please note that GSM symptoms require treatment and will not go away on their own.
Sleep disturbances
Hormonal changes can lead to sleep fragmentations and changes in sleep patterns, such as interrupted sleep, early awakening, or trouble falling asleep. Sleep apnea and restless leg syndrome increase around menopause too.
Mood swings and emotional changes
Hormonal shifts can result in frequent changes in your mood. An estimated 20% of people have depression at some point and up to 12% will experience generalized anxiety disorder in their lifetime. Mood symptoms can increase during menopause. You may feel the following changes:
- Anger
- Irritability
- Anxiety
- Depression
- Loss of self-esteem and confidence
If you have a history of hormonally linked mood issues, you’re at a higher risk of anxiety and depression. Even without a history, it’s common for individuals to experience these symptoms.
Weight gain
Hormonal changes, aging, and changes in lifestyle can lead to weight gain during and after menopause. The average weight gain during the menopausal transition is five–10 pounds, with some gaining around one pound each year.
Thinning hair and dry skin
Fifty percent of people report changes in hair. Those changes, plus dry skin, are due to hormonal changes.
- You may notice thinning, loss of volume, and changes in your hair. Stress, underlying health conditions, and nutritional deficiencies may also impact hair loss.
- Your skin may become more dry and less elastic. This can lead to increased aging and wrinkling of the skin.
Memory problems and difficulty concentrating
Forty to sixty percent of people report cognitive symptoms such as forgetfulness. These symptoms manifest as brain fog, which includes:
- Difficulty remembering words, names, anecdotes, and numbers
- Inability to focus and concentrate
- Distractibility
Changes in libido
Hormonal changes can cause a decrease in your spontaneous sexual desire and reduce your body’s ability to achieve orgasm. Painful intercourse can exacerbate these issues and reduce your interest in sex further. Mood changes and sleep disturbances associated with menopause can further affect sexual well-being.
Less common symptoms
Here are a few symptoms that aren’t as common as the ones above: dry/burning mouth, dry eyes, vertigo/dizziness.
Coping with symptoms
Most individuals will experience menopause symptoms and studies have shown symptoms can last longer and be more severe for BIPOC individuals.
The type and severity of symptoms you experience also depend on factors like diet, activity level, medical history, and overall gynecologic health.
Talk to your healthcare provider to identify ways to cope with and manage your symptoms.