Although it’s common to refer to menopause symptoms, it’s actually the transition phase called perimenopause that causes the majority of symptoms.
Perimenopausal symptoms can start months or years before your periods stop and last for up to 4 years after. If you can believe it, there are over 34 different symptoms women experience, but you may not experience them all:
Irregular Periods
As the responsiveness of the ovaries starts to decrease, the hormones that are produced declines. Furthermore, oestrogen and progesterone can become unbalanced. For example, intermittent anovulatory cycles (missed periods) results in lower levels of progesterone over a cycle. So, in the early stages of the transition to the menopause, periods may become irregular and change in nature. You may find your periods:
- Last longer or may only last a couple of days
- May be heavier or lighter than normal
- Are more frequent – every 2 weeks – or less frequent
Some months you may not notice any changes, and other months you may notice that your periods are different. It is worth keeping a diary of your periods to see if they are changing as this is a clear indication that you may be entering the perimenopause.
Vaginal Dryness
It is estimated that up to 60 percent of women experience moderate to severe vaginal dryness because of menopause.
Vaginal dryness is caused by a reduction in oestradiol, a type of oestrogen, during the perimenopause and menopause. Vaginal dryness can cause an itchy or sore vagina, pain or discomfort during sex, a need to pee more often and can make you more susceptible to urinary tract infections.
Increased Need to Urinate and UTIs
Women may experience the need to go to the toilet more often, or in some cases lose control of their bladder during the perimenopause. This is because the vagina and urethra lose their elasticity and the pelvic muscles become weaker. In addition, women may experience more urinary tract infections (UTIs) due to lower levels of oestrogen.
Breast Soreness
The unpredictable spikes and falls in both oestrogen and progesterone during the perimenopause can cause breast soreness.
Breast pain as a symptom of the perimenopause feels different from the type of pain experienced just before your period. Breast pain during the perimenopause feels like a burning sensation or soreness, it can also feel like a sharp, stabbing or throbbing pain. It may be felt in both breasts or just one breast.
Once women have reached the menopause and their periods have stopped, breast pain should ease off and no longer cause any discomfort.
Reduced Sex Drive
Reduced sex drive or a loss of libido is common during and after the menopause affecting 20-40 percent of women.
Vaginal dryness along with other symptoms such as sore breasts, fatigue, hot flushes can all impact a woman’s desire to have sex.
Digestive Problems and Bloating
Low oestrogen levels can result in less fluctuating cortisol levels which increases blood sugars and slows down digestion. As oestrogen plays a role in the function of the gastrointestinal system, low levels can cause bloating, indigestion, acid reflux, stomach cramps along with nausea, flatulence, constipation, and diarrhea.
Weight Gain
Hormonal changes during the perimenopause often mean women gain weight, particularly around their abdomen. On average women gain 4-7lbs in weight during the menopause.
Due to the declining levels of oestrogen, the body tries to produce more of this hormone from elsewhere in the body. It does this via the fat cells (adipose cells), as such, the female body may need to be fatter for this to happen.
Hot Flashes, Night Sweats, Body Odor
Hot flushes and night sweats are the same, the only difference is that night sweats are hot flushes that happen at night.
Hot flushes and night sweats are caused by declining oestrogen levels, this impacts your brains’ ability to regulate body temperature. Your body thinks it is overheating when it isn’t and your brain triggers the body to cool down by sweating and increasing blood flow through the skin’s blood vessels which causes the flush.
Hot flushes and night sweats are common menopausal symptoms and can vary in severity and duration. For about 20 percent of women, they can be quite severe and cause a lot of distress impacting work, sleep, and overall quality of life. However, for most women going through the menopause, they only occur occasionally.
Experiencing hot flushes and night sweats can also increase body odor. In addition, symptoms such as anxiety create sweat produced in the apocrine glands. Anxiety sweat is fatty and breeds and feeds on bacteria which creates a more pungent smell.
Insomnia, Trouble Sleeping
During the perimenopause, levels of the hormones oestrogen and progesterone fluctuate and gradually decline as a woman nears the menopause. These hormone changes can have a drastic impact on sleep.
Oestrogen is important for managing the level of magnesium in the body. Magnesium is used by the body to help muscles relax and low levels can make it more difficult to fall asleep. In addition, falling oestrogen levels cause hot flushes and night sweats which can also impact the natural sleep cycle.
Progesterone also plays a key role in as it helps you fall asleep and stay asleep. Fluctuating and declining levels of this hormone will make it more difficult to slip into a deep sleep. It can also impact the quality of sleep, making you feel tired in the morning.
Fatigue and Tiredness
Other perimenopause symptoms such as night sweats, joint aches, and the need to urinate more frequently all impact a good night’s sleep, resulting in fatigue and tiredness during the day.
Tiredness and fatigue have an impact on being able to carry out and cope with day to day tasks and life events. This can result in stress which in turn increases levels of the stress hormone cortisol in the body – raised cortisol levels, particularly at night will impact your ability to fall asleep and stay asleep.
In addition, low levels of oestrogen can also result in a feeling of fatigue.
Anxiety, Depression and Mood Swings
Research indicated that 61 percent of perimenopausal women experienced low mood.
Sleep problems caused by perimenopause symptoms such as night sweats, lead to sleep deprivation which in turn can cause anxiety and/or depression.
In addition to poor sleep quality, anxiety, and depression, along with low mood are associated with low levels of serotonin. Oestrogen influences the production and breakdown of serotonin, so lower levels of oestrogen will impact serotonin levels in women going through the menopause.
Poor sleep can also have an impact on your levels of the stress hormone cortisol. Your cortisol levels rise and fall throughout the day, with levels being higher first thing in the morning. But a lack of sleep can cause your cortisol levels to rise and stay high which can impact mood, including feelings of anxiety and depression.
Memory Issues
Memory loss or lapses, trouble concentrating and the feeling of ‘brain fog’ can be worrying but are natural symptoms of the perimenopause and menopause. Up to 47 percent of the women we surveyed experienced ‘brain fog’, reduced memory and concentration during the menopause.
It’s a symptom many women do not often associate with the early stages of the menopause – instead of putting it down to being too busy or stressed with work or life in general.
Across all cultures, 34-62 percent of women experience menopause-related memory changes which often mimic the symptoms associated with early signs of dementia.
A drop in oestrogen levels can result in a lack of focus and concentration, but other symptoms associated with the menopause can also cause memory and concentration issues.
Sleep deprivation as a result of poor sleep caused by night sweats and other symptoms; anxiety and increased stress levels due to a lack of sleep can all impact cognitive function and could be the cause of memory issues, trouble concentrating and ‘brain fog’.
Headaches, Dizzy Spells
Declining oestrogen levels can impact blood circulation, the nervous system and blood pressure by reducing the reactivity of the artery walls. This, in turn, affects the brain resulting in dizzy spells.
Falling oestrogen and progesterone levels are also the cause of headaches in menopausal women and some women may even experience migraines for the first time during perimenopause. Women who suffer from headaches around their period due to low oestrogen levels may find headaches increase as they transition to the menopause. But after menopause, some women find that headaches, in particular, migraines lessen.
Joint Pain, Muscle Tension
Oestrogen and progesterone level fluctuations can be responsible for the aches and pains women feel as they transition through the menopause. There are oestrogen and progesterone receptors all over our bodies including joints, and as oestrogen and progesterone levels fall, this can cause joint inflammation.
Hair Loss
Women may notice their hair becoming thinner or even hair loss during the perimenopause, as well as brittle nails and dry, itchy skin or acne breakouts.
This is due to the declining levels of oestrogen and progesterone which can affect hair growth, causing it to grow more slowly, become thinner and even fall out.
In addition, as oestrogen and progesterone levels fall, this triggers a group of hormones called androgens to increase. Androgens are known as male hormones and include testosterone and androstenedione and are present in both men and women. In women, an increase in these hormones can shrink hair follicles causing hair loss, but excess levels can also result in hair growth in unwanted places such as on the face.
Brittle nails are caused by weakening keratin layers. Keratin is a protein that nails are made up of but drops in oestrogen weaken the keratin layer of the nail causing it to break more easily. Dehydration can also cause nails to become dry and break more easily.
Dry, Itchy Skin and Acne
Oestrogen is associated with the production of collagen, as well as the production of natural oils that keep our skin supple and prevents it from drying out. As oestrogen levels drop, this impacts the creation of collagen and natural oils in our skin causing it to become dry and itchy.
Some women even experience acne during the menopause caused by a decrease in oestrogen and an increase in testosterone.
So, what can you do to ease or deal with the symptoms?
Hormones play a vital role in every woman’s health and wellbeing. When they are in harmony and working together, you’ll feel it – and will benefit from renewed energy, restful sleep, clear skin, good moods, healthy weight levels and more. However, an imbalance in one hormone leads to an imbalance in others and the impact can trigger symptoms that can be life altering.
With hormone replacement therapy, you can find relief from these symptoms. Schedule a time to speak with one of our board-certified physicians about ReVital’s Bioidentical Hormone Replacement Therapy.