What Are The 34 Symptoms of Menopause? The Signs & Symptoms You Need To Know

Donald Grant
Dr Donald GrantMB ChB DRCOG MRCGP Dip.orth.medGP & Clinical Advisor

The menopause journey is a little different for every woman and often has no clear beginning or end. For some, it’s over relatively quickly. For others, it can be years before you have your last period. Among all the hot flushes, sleep disturbances, and mood swings — how can you know when you are going through the menopause?

Although menopause affects everyone in different ways, there are said to be around 34 symptoms and signs of menopause that women typically experience at this stage of life. So what are the 34 symptoms of menopause?

We’ve created this page so that you can read all about menopause and the signs to look out for. Some of these are more common than others, and the level at which they are experienced can range from mild to severe, but these are the main physical and mental changes that occur during menopause.

Read on to find out more.

Visit our menopause guides page to find out more about the menopause — we’ve created helpful pages on everything from HRT reviews and medication guides to information on the menopause.

In this article:

  • What are the 34 symptoms of menopause?
  • Is there a test to see if you are menopausal?
  • What is the right age for menopause?
  • How many stages are there in menopause?
  • Can menopause be treated?

What are the 34 symptoms of menopause?

Early signs of the menopause (perimenopause) can be hard to interpret if they’re happening occasionally. Feeling irritable one day and tired another can easily be put down to other things.

Here are the early signs of menopause women may experience:

1. Irregular periods

The menopause is when a woman stops having periods and can no longer get pregnant naturally.

An irregular menstrual cycle is one of the first signs of menopause that you may experience. You will start to notice your periods change, and they become more irregular before stopping completely. This can take years, so you may experience irregular periods for a long time.

2. Hot flushes

Hot flushes (known as hot flashes in the US) are one of the most common symptoms of menopause.

When you experience a hot flush, your body suddenly feels like it is overheating. You feel hot and flustered, and redness can appear on the face, neck and chest, which some women can feel embarrassed about. Sometimes this may feel like it happens for no apparent reason, and sometimes it is linked to specific triggers such as hot drinks or spicy foods.

It’s not known exactly why hot flushes occur, but it’s thought to be connected to the changes in oestrogen levels that happen during menopause. These may affect the hypothalamus, which helps regulate body temperature.

3. Night sweats

Hot flushes that occur at night are called ‘night sweats’. These can happen when you are asleep, and can wake you up suddenly, drenched in sweat. Many women find night sweats very disruptive to their sleeping routine.

As with hot flushes, night sweats are caused by hormonal imbalances affecting the body's temperature control.

4. Insomnia and poor sleep

    Difficulty sleeping and insomnia are clear signs of menopause. Often sleeping problems are caused by hot flushes and night sweats, but women going through the menopause also report problems with getting to sleep in the first place, as well as non-restorative sleep and early morning waking.

    5. Fatigue

      Fatigue and extreme tiredness is another typical symptom of menopause. If you are struggling to sleep due to night sweats, you are likely to find yourself feeling fatigued during the day.

      Fluctuating hormone levels such as oestrogen and progesterone can affect your energy levels too, leaving you feeling flat and exhausted.

      6. Irritability

        Irritability is a very common menopausal symptom. We can all feel irritable sometimes, but if you’re experiencing these feelings much more often than you used to, it may be a sign of menopause. This is due to hormonal fluctuations affecting your mood, stress levels, and blood sugar levels.

        7. Bloating

          Bloating — whether water retention or gas bloating — is a common sign of menopause. You may notice this as swollen or puffy feet and ankles.

          To tackle bloating, try to drink lots of water and reduce your salt intake.

          8. Digestive problems

            If you’ve noticed gas bloating as a menopause symptom, you may also experience digestive problems such as stomach aches and pains, cramping, nausea, constipation and diarrhoea.

            Fluctuating hormones can impact our natural digestive rhythms, as well as causing us to feel stressed. The increased levels of the stress hormone, cortisol, can also affect our digestion too.

            9. Vaginal dryness

              Vaginal dryness is a very common menopausal symptom. This is caused by reduced levels of oestrogen in the body, which is responsible for the natural lubrication of the vagina.

              Without it, vaginal tissues become thinner over time and more prone to irritation, which can make sex uncomfortable and painful.

              10. Changes in libido (sex drive)

                Changes in sex drive are common during menopause (again as a result of changing hormone levels). More commonly reported is a lowered sex drive and or decreased libido, but some women do experience an increase in their sex drive.

                11. Mood changes

                  Lots of women experience mood changes or mood swings as part of menopause. These can be much more severe than those experienced during your period, and can negatively affect your mood, leaving you feeling low, anxious, irritable, sad, or angry.

                  12. Anxiety

                    As well as severe mood swings, some women — between roughly a quarter and a third of all women who go through menopause — experience anxiety.

                    13. Depression

                      Women going through menopause are at a higher risk of developing depression due to fluctuating hormone levels. If you are worried at all, or you notice that your low mood is persistent, severe, or stopping you from enjoying things that you normally would, or going about your day-to-day life, speak to your doctor.

                      14. Headaches

                        Headaches can be caused as a result of fluctuations in hormones. These headaches can be very severe and distressing.

                        If you experience ‘hormone headaches’ during your period, you are more likely to get headaches when you are going through menopause too.

                        15. Breast tenderness

                          Like period or pregnancy symptoms, breast tenderness or soreness can happen around the menopause. This is a result of hormonal stress and fluctuation.

                          You may experience this as soreness, a dull ache, or sharper pains.

                          16. Weight gain

                            Decreasing oestrogen levels during menopause are responsible for a change in metabolism, which causes women to lose muscle mass and gain fat, especially around the middle. This can cause weight gain (though some women do sometimes experience weight loss).

                            17. A hot or burning mouth

                              It may sound unusual but a hot mouth is one of the 34 signs of menopause to look out for. This can affect the roof of your mouth, tongue and lips, causing a burning sensation, hot mouth, or metallic taste.

                              This symptom is thought to be a result of the reduced production of saliva during menopause, and is sometimes called ‘burning mouth syndrome’.

                              18. Joint pain & joint issues

                                Stiffness, aches and pains in the joints is a common menopause symptom, caused by the decreasing oestrogen levels (resulting in joint inflammation, which leads to these problems).

                                19. Dizziness

                                  Dizzy spells are a frequent symptom of menopause. This particular effect may be compounded by hot flushes, fatigue, dehydration and blood sugar levels, making feelings of dizziness worse.

                                  20. Thinning hair or hair loss

                                    Decreasing levels of oestrogen and progesterone (both of which play a role in hair growth and maintenance) cause hair follicles to shrink during menopause. This results in thinning of hair and hair loss.

                                    21. Electric shocks

                                      One of the more unusual-sounding of the 34 signs of menopause is electric shocks. Scientists don’t know exactly why some women going through menopause experience electric shocks, but it is thought to be down to oestrogen affecting the nervous system and causing neurons to misfire.

                                      You may experience electric shocks as a precursor to hot flushes.

                                      22. Pins and needles/tingling extremities

                                        Pins and needles, or tingling in your extremities (hands and feet) can also be caused by hormones affecting the nervous system. You may experience this as a numbness or tingling.

                                        23. Gum problems

                                          If you’re having gum issues, it may be a sign of menopause. Gum problems such as gum recession, gingivitis, and bleeding gums can occur during menopause. These gum problems may cause a metallic taste in your mouth.

                                          24. Difficulty concentrating

                                            It’s not unusual for women going through menopause to experience difficulty concentrating and a lack of focus. If you’re having problems concentrating on tasks at work or daily activities, then this may be a result of decreasing oestrogen affecting your brain’s energy levels and ability to concentrate.

                                            25. Memory lapses & forgetfulness

                                              Another symptom of menopause caused by decreasing oestrogen levels affecting the brain is temporary memory lapse. This can also be exacerbated by fatigue, making you more forgetful than usual.

                                              26. Itchy skin

                                                Oestrogen levels in the body impact our skin's health — oestrogen is associated with collagen production, the production of natural oils, and skin hydration, helping to keep our skin fresh and healthy.

                                                As oestrogen levels decrease, skin can become dry, itchy, sensitive, and more irritable.

                                                27. Brittle nails

                                                  If you’ve noticed your nails starting to chip or damage more easily than normal, it may be another sign of menopause.

                                                  Fluctuating oestrogen levels cause the keratin layer of our nails to weaken. Keratin is responsible for keeping our nails strong, healthy and hydrated, so this can lead to brittle, weak nails.

                                                  28. Urine leakage

                                                    Some women going through menopause may notice that they are less able to control their bladder, causing urine leakage (also known as urinary incontinence or stress incontinence). This can happen when you cough, sneeze, or lift something heavy.

                                                    29. Changes to body odour

                                                      Body odour can change when you reach menopause age, as hormone changes affect natural scent and the production of sweat.

                                                      30. Increase in allergies

                                                        This may sound unusual, but allergies and hay fever can become heightened during menopause. This is because of the connection between hormones and the immune system (which is responsible for allergic reactions).

                                                        If you suffer from allergies, you may be more likely to experience an increased reaction at menopause age.

                                                        31. Heart palpitations

                                                          During menopause, an irregular heartbeat or increased heart rate can be experienced. This is due to low oestrogen levels causing an overstimulation of the nervous system.

                                                          This is generally nothing to worry about, but if you’re worried about your heart, speak to your doctor.

                                                          32. Panic attacks

                                                            Some women report suffering from panic attacks during menopause. This is not thought to be a common symptom, but can affect those going through menopause, especially alongside anxiety and heart palpitations.

                                                            33. Osteoporosis

                                                              Osteoporosis is a condition which weakens the bones, making them more fragile, brittle, and prone to fractures.

                                                              The drop in oestrogen during menopause is a big contributor to osteoporosis — oestrogen helps to build and maintain healthy, strong bones. When oestrogen levels decrease, bone density drops and bones become weaker and more fragile. This means menopause leads to an increased risk of osteoporosis.

                                                              34. Muscle tension & tightness

                                                                Muscle tension may also occur as a result of menopause. This is thought to be due to increased stress levels during menopause — a lot of this tension and anxiety can be carried in the muscles, causing you to tense up and feel tight or sore.

                                                                These are the 34 symptoms of the menopause, physical, psychological and emotional effects of the changes hormone levels in the body.

                                                                If you have noticed a lot of these signs, and you are finding menopause symptoms hard to manage, it is worth speaking to your doctor or pharmacist. There are plenty of treatment options and lifestyle changes that can alleviate distressing menopausal symptoms, support your body, and make them easier to manage.

                                                                Is there a test to see if you are menopausal?

                                                                If you think you’re experiencing the first signs of menopause, your doctor will likely carry out a blood test to check your hormone levels, specifically that of FSH (follicle-stimulating hormone) and oestrogen.

                                                                They will also want to rule out any other conditions that could be behind the symptoms. This blood test can help to determine whether it really is the menopause — if it is, then your oestrogen levels will be reduced.

                                                                There are home test kits that supposedly test the urine for FSH. However, testing for FSH levels alone is not usually a reliable marker of what’s going on. If you think you might be menopausal and the symptoms are becoming a problem, it’s best to get tested professionally by your doctor.

                                                                What is the right age for menopause?

                                                                There is no ‘right age’ for the menopause. The onset of menopause can happen as early as a woman’s thirties (though this is unusual), or as late as her sixties.

                                                                Unfortunately, there’s no way of knowing what age you will be when it happens to you — and it is unrelated to how soon you had your first period (which is a common misconception about menopause).

                                                                Typically, menopause tends to occur between the ages of 45 and 55. Today, the average age for women to experience menopause is 51 years old. Approximately 5% of women will start late (after 55) and a further 5% will start early (before 45).

                                                                How many stages are there in menopause?

                                                                Menopause has three stages: perimenopause, menopause, and postmenopause.

                                                                What most women think of as ‘the menopause’ is actually the symptoms associated with perimenopause, which last for an average of four years before gradually easing into the menopause and postmenopause.

                                                                Postmenopause is the point at which a woman has gone an entire year without having a period. By this point, her hormone levels have usually stabilised. While symptoms can linger, they will likely be far diminished compared to what they were during perimenopause.

                                                                Can menopause be treated?

                                                                As a natural process of life, menopause cannot be halted or cured, but there are treatment options available that can help alleviate the distressing physical symptoms and psychological effects of the menopause.

                                                                Taking some form of hormone replacement therapy (HRT) can relieve menopausal symptoms such as insomnia, mood swings, hot flushes and vaginal dryness.

                                                                Most menopause symptoms are caused by lowering oestrogen levels within the body, so using HRT medications to replace these hormones that are missing helps alleviate these problems.

                                                                HRT should be initiated by your doctor after tests have been completed to confirm your diagnosis. This ensures that you are on the right HRT for you, as there are many different types and treatment regimes.

                                                                In the section below, you can find a number of HRT options that can help to treat symptoms.

                                                                HRT treatments for menopausal symptoms

                                                                Hormone replacement therapy (HRT) is very effective at treating menopausal symptoms.

                                                                There are a few different types of HRTs that can help treat your symptoms. The right one for you will depend on a few things, such as whether or not you’ve had a period in the last year and still experience some type of menstrual cycle, or whether you’ve had a hysterectomy.

                                                                The HRT treatments available at The Independent Pharmacy are:

                                                                If you’re not sure which is the right treatment for you, you can speak to one of our qualified pharmacists for guidance.

                                                                You can also visit our menopause HRT treatments page for further information or if you’d like to learn more about each type of HRT.

                                                                Natural remedies for menopausal symptoms

                                                                Some people like to use natural remedies to treat their symptoms.

                                                                While HRT is the most successful and effective treatment option for reducing symptoms like hot flushes, there are some natural remedies that are thought to provide some relief.

                                                                Here are some natural remedies for menopause:

                                                                • Black cohosh
                                                                • Hawthorn berries
                                                                • Red clover
                                                                • Ginseng
                                                                • Ginkgo biloba
                                                                • Soy
                                                                • Clary sage
                                                                • Evening primrose oil
                                                                • St John’s Wort

                                                                As with all natural remedies and herbal therapies, the above are not regulated or medically proven to help with menopause, so there may be risks involved. Should you choose to use herbal remedies, use them with caution.

                                                                There are also some lifestyle changes you can make that may alleviate some of your symptoms. Eliminating caffeine from your diet and eating a healthy, high-fibre, plant-rich diet can be beneficial. Regular exercise such as yoga or swimming can also help ease symptoms.

                                                                There is no way to ‘get over’ the menopause, but you can find ways to alleviate your symptoms and make yourself more comfortable.

                                                                Summary

                                                                The stops and starts of menopause can be challenging and upsetting, and it doesn’t look the same for everyone. The 34 symptoms of menopause that we’ve listed above can vary from person to person, as can the severity of these signs and symptoms. You may experience many of them, or just a few.

                                                                Fortunately, there are HRT (hormone replacement therapy) treatments that can effectively treat severe and distressing symptoms. For many users, they notice a significant improvement, and taking HRTs can dramatically improve their quality of life.

                                                                Browse our menopause (HRT) treatments page to read more and start your online consultation today, or speak to one of our professional advisors at The Independent Pharmacy for expert advice around prescription HRT tablets, gels or patches.

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