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Signs and symptoms of menopause


During perimenopause and menopause, it can be surprisingly difficult to see that all the symptoms you’re experiencing are related, especially when they arise separately over months — or even years. The average woman has eight different menopause-related symptoms. But she may never connect the dots to realize that the underlying cause behind all of these confusing symptoms is hormonal imbalance.

A woman thinking about menopause

Hormonal imbalance causes perimenopause and menopause symptoms

As women, our hormone levels change throughout our lives, and for the most part, our bodies have the ability to adjust. But the shifts in your sex hormones may become too extreme or happen too quickly for your body to manage them, especially when you’re in perimenopause and beyond.

You can then experience wide-ranging symptoms, from fatigue and moodiness to vaginal dryness and joint discomfort, to low libido and fuzzy thinking. You may just think these are signs of worsening PMS but in fact it’s the start of your menopause transition.

Imbalances and fluctuations occur in many types of hormones

To address their patients’ menopause symptoms, many conventional practitioners look only at the changes to the hormones progesterone and estrogen. But finding real relief is not that simple. Your hormones behave more like a big orchestra than separate instruments. We know that specific fluctuations in estrogen, progesterone and testosterone can determine whether or not you develop symptoms. But it’s more a question of balance than of specific hormone levels.

Finally, it’s not just your sex hormones that can affect how you feel: insulin levels, thyroid function and adrenal health are all intertwined with your sex hormones too. That’s because all your body’s hormones affect one another. This explains why the conventional approach to menopause and symptom relief is often too simplistic to be safe and effective.

The best way to know if you’re in menopause is to check in with how you’re feeling and do it often, especially because there’s no single test to confirm you’re in perimenopause or menopause.

Menopause symptoms can be confusing

Women call us every day for help with their difficult symptoms. Many begin by saying, “I know I’m not in menopause because I don’t have hot flashes or night sweats.”

But when we ask for specifics about their symptoms — “Are you fatigued and irritable? Is your thinking fuzzy?” — it can be a clarifying moment. Often we hear back, “Well, yes, I am tired and snappy. Yes, my thinking is muddled,” and one that’s so common, “Yes, I’ve definitely gained weight.”

While these women (and you) may not realize it at first, these are all menopause-related symptoms.

The 16 most common symptoms of perimenopause & menopause

At Women’s Health Network, we have one of the largest databases on symptoms of hormonal balance available – literally millions of women have taken our profile. Here are the 16 most common symptoms they experience:

  • Irregular periods: The most important question to answer about your period is, “is it irregular for you?” in terms of the length of your cycle or heaviness of your period. Changes in your period are often the first signal that your sex hormones are beginning to shift in perimenopause.
  • Hot flashes and night sweats: Hot flashes can strike once a day, or up to 20 times or more, causing intense flashes of heat along with increased heart rate, dizziness, headache and even claustrophobia or the feeling of being trapped. They can be debilitating, especially when they occur and night and cause sleeplessness.
  • Sleep difficulties: You may toss and turn restlessly as you try to sleep, or wake up regularly in the middle of the night. Insomnia is often caused by a progesterone deficiency in perimenopause or menopause.
  • Weight gain: Changes to your weight or the shape of your body are another noticeable symptom. Shifting hormones tell your body to store fat in the abdominal area, even if you’ve never had a weight problem before. This menopause and perimenopause weight gain is difficult to lose even with diet and exercise.
  • Fatigue/loss of energy: Not getting enough sleep may make you feel tired, but exhaustion or crashing fatigue can occur even when you get a lot of rest, leaving you feeling physically and emotionally drained.
  • Forgetfulness or fuzzy thinking: One of the most alarming symptoms for many women is memory changes or fuzzy thinking — and it’s extremely common.
  • Thinning hair or hair loss: Imbalances between estrogen and testosterone can cause thinning hair. Many women start to notice clumps of hair in their shower drains during menopause or perimenopause.
  • Vaginal dryness: It can be a difficult symptom to discuss, but 50% of women in perimenopause and menopause experience vaginal changes, with dryness, itching and pain that affect their sex lives, activities and even the clothes they wear.
  • Low libido: While vaginal dryness can contribute to low libido, a drop in progesterone or a testosterone deficiency by itself can also leave you without a sex drive.
  • Joint discomfort /stiffness: Joint pain or stiffness in the back, knees or hips is an unexpected symptom that may be caused by fluctuating estrogen levels. Hard to believe but true!
  • Food cravings: If you had cravings with PMS, you may notice they are getting worse. This can be due to your body’s increased needs for valuable micronutrients, or to the “crash cycle” pattern of fatigue/carbohydrates/fatigue with hormonal imbalance that so many of us fall into.
  • Digestive discomfort: Embarrassing and uncomfortable gas, diarrhea, and constipation can all increase in perimenopause and menopause.
  • Anxiety and/or sadness: Perimenopause can raise your stress level, and can create hormonal imbalances that affect mood and emotional health. Stress hormones directly affect the production and balance of other hormones.
  • Irritability and/or moodiness: Feeling angry all the time and snapping at your friends and family doesn’t feel good — for you or them. Outbursts and mood swings are some of the first signs many women notice in perimenopause.
  • PMS-like symptoms: You may think stronger cramps, bloating, breast tenderness, headaches or mood swings are due to worsening PMS, but as symptoms get more frequent or severe, it’s often a sign of perimenopause.
  • Feeling overwhelmed: Perimenopause and menopause can compound existing stress levels, causing your body to be overcome with too many demands. Under these conditions, it’s likely you’ll feel overwhelmed mentally and feel unable to deal effectively with anything.

Reduce your perimenopause symptoms naturally

Your symptoms are your body’s way of asking — or yelling — for help. By listening to what they’re telling you about your individual hormonal imbalance, you’ll be able to provide the targeted support your body needs to naturally rebalance its hormones. Effective natural options include include phytotherapy, vitamins and minerals, and simple dietary and lifestyle adjustments that can provide relief by resolving the single root cause of all your symptoms.

Last Updated: November 27, 2022
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