a woman with menopause symptoms
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Hot Flash

The Most Common Menopause Symptoms Are Wild—But Also Manageable 

From hot flashes to hair loss, here's what to expect. 

Despite the fact that 1.3 million women enter menopause every year, it’s only recently that the world has started paying attention to menopause symptoms. It’s long overdue, considering the symptoms of menopause go well beyond the oft-parodied hot flash. 

“It has been well established that menopause can affect a woman from head to toe,” says Somi Javaid, MD, a fellow of the American Congress of Obstetricians and Gynecologists and founder and chief medical officer of HerMD. Menopause impacts your sex life, your mental health, even your wardrobe. It’s time to make menopause symptoms as top of mind and well-acknowledged as those experienced during puberty. 

As significant as these lifestyle changes are to women, talking about menopause is important from more than just a cultural perspective. “It’s important to talk about the impact that a decline of estrogen has on the body, in general,” says ob-gyn Leah Millheiser, MD, a North American Menopause Society–certified menopause practitioner and the chief medical officer of Evernow menopause treatment center. “This includes a loss of bone mass, which can lead to osteoporosis and potentially life-threatening bone fractures down the road; cardiovascular disease; type 2 diabetes; weight, skin, and hair changes; cognitive changes; and sexual function changes (think a decreased sex drive, vaginal dryness, and pain during sex).” Says Dr. Millheiser, “Knowledge is key here.” As is a good relationship with your doctor, so that together you can decide on the best menopause treatment for you. 

So what can you expect? Here's everything you need to know about menopause symptoms. 

But first, what is menopause?

Menopause is defined as the cessation of ovarian function and is officially diagnosed when you’ve gone a full year without a menstrual period. However, you can be experiencing pre-menopause symptoms, also known as perimenopause, for years before that. “From puberty to menopause, your period is the result of a follicle, or egg, being released at ovulation and failing to be fertilized,” says Lizellen La Folette, MD, a board-certified ob-gyn and medical advisor for Stripes. “The cycle is controlled by estrogen and progesterone, our reproductive hormones. During menopause, the ovaries become more and more resistant to ovulating because there are fewer and fewer follicles to release.”

This drop-off isn’t linear, which is why you may experience years of irregular periods and early menopause symptoms before officially entering menopause. (For most women, the menopausal transition starts around age 45—the average age of menopause diagnosis is 51.) The result is that “the brain-ovary connection goes from being a well-oiled machine that produces regular cycles to a state of stress and dysfunction,” Dr. La Folette says. 

What are common menopause symptoms?

Big changes are to be expected during this time, and while they may be totally natural, menopause symptoms can feel pretty disorienting. Much like the symptoms you might experience during your period or pregnancy, the symptoms of menopause are systemic, meaning they’ll cause changes in expected places (like your vagina) and in some not so expected places (like your skin). 

Common menopause symptoms include: 

Hot flashes and night sweats

At the mention of menopause, the first thing you probably think of are vasomotor symptoms—a.k.a. hot flashes. Hot flashes can feel different for every woman. They might include excessive perspiration, heart palpitations, anxiety, and even chills. 

Sleep problems 

Aside from the sheet-soaking night sweats that can have you up in the middle of the night in a panic, hormonal changes can also cause other sleep disturbances. Menopausal women are more likely to develop sleep disorders like sleep apnea, according to Johns Hopkins Medicine

Sexual dysfunction 

Your sex life during menopause and perimenopause will likely include some uncomfortable changes: low libido, vaginal dryness, pain during sex, and problems with orgasm are all common. Impacts to sexual functioning and libido are also commonly reported during perimenopause. (Don’t worry; there are plenty of hormonal and nonhormonal menopause treatments that can help, as well as more lubricants than ever that you can buy.) 

Hair loss

Hair thinning isn’t an “official” menopause symptom since it’s not related to estrogen loss, says gynecologist Mary Jane Minkin, MD, a menopause specialist and clinical professor of obstetrics and gynecology at Yale, but it’s still commonly reported at the onset of menopause. If you’re experiencing it, you’re not alone. 

Skin changes

The drop in your estrogen levels during menopause can wreak havoc on your skin. “Estrogen plays a role in collagen production, skin’s elasticity, thickness, and moisture levels, as well as healthy blood vessel formation,” says Sarvenaz Zand, MD, a board-certified dermatologist in San Francisco and founder of Zand Dermatology. “When we produce less estrogen, we begin to see the opposite: fine lines and wrinkles, dryness, sensitivity, dullness, sagging, and less of a rosy glow.” 

Menopause can also trigger the onset of rosacea. “We also lose fat and bone volume in our cheeks, so jowls become more prominent,” Dr. Zand says. 

Breast changes

Menopause may also come with breast tenderness and loss of volume. As estrogen decreases, mammary glands shrink and breasts tend to lose firmness, according to Penn Medicine

Mood changes

Menopause can also trigger a lot of mental changes, those so-called mood swings. “Mood and memory disturbances, such as depression and anxiety, are common during menopause,” says Dr. Javaid. Anywhere from 18% to 40% of women experience depression during menopause and perimenopause, and up to a quarter experience newfound anxiety, according to research published in 2021.

“It’s really important to put pen to paper in a journal and keep track of changes in mood and irritability to see if there’s a pattern,” says Dr. La Folette. “Many issues go neglected over the years amidst the balancing act between child rearing, busy work schedules, and life stress.”

Brain fog

“The brain-hormone connection is integral to how well you feel your brain is functioning,” says Dr. La Folette. The combination of fluctuating hormones and age during the menopausal years results in a loss of synaptic connections in the brain. “Women report problems with memory concerns during menopause, such as difficulty with word finding, the presence of brain fog, and forgetfulness,” Dr. Javaid adds. 

Bladder issues

Urinary symptoms, such as UTIs and incontinence,  are also very common during menopause, says Dr. Minkin: “I teach people how to do Kegel exercises several times a day.”

When should I see a doctor about my menopause symptoms?

While menopause may be a totally natural process, it doesn’t mean you have to live with its symptoms. When you start noticing irregularities in your menstrual cycle, talk to your doctor. “Because women may experience a wide range of symptoms during menopause, any new symptoms, such as those which are considered unusual for your body, should be discussed with your healthcare provider,” says Dr. Javaid. 

When you do enter menopause, don’t panic, she adds. There are many menopause treatment options—hormonal and nonhormonal—available to give you a better quality of life. 

Macaela MacKenzie is a writer and editor specializing in wellness. She writes about self-care, mental health, fertility, and women’s equality with a focus on breaking down stigmas in women’s health.