Common Signs and Symptoms of Menopause
Patients keep telling me that nobody is talking about menopause with them.
Many have been experiencing issues for years without recognizing that there is a connection to their hormones. Some have been reporting symptoms to their PCPs or GYNs and the only response they get is a shrug.
This is unfortunate. Education about this transitional time is important. Knowing what symptoms may be related to hormonal changes can give people a sense of relief. Helping them to manage symptoms can be a great boost to their quality of life.
Menopause is defined as when menstrual cycles cease for a year. This can occur between ages 40-58 years old, with the average age being 51. Often, people don’t realize that hormonal changes begin many years prior to menopause.
Cycle Changes
Some people will pass many months without a period thinking they are in menopause only to have Aunt Flow show up unannounced. This is common in the time leading up to menopause. Initially, in the early perimenopause (meaning “around menopause”) stage, there will be slight changes in the length and amount of bleeding. Perimenopausal usually begins about 8-10 years prior to menopause, often in one’s 40s but can be earlier for some.
Over time, there will be greater variation in cycle length.
One woman lamented that she used to be able to schedule her vacations around her cycles as they used to be so predictable.
The late perimenopausal stage will result in spans of time between periods that are 60 or more days.
It’s during this late stage of perimenopause that people are likely to begin to notice the classic hot flashes and/or night sweats that are associated with menopause. It’s the other symptoms of menopause that many don’t realize may be a result of the hormonal changes that are happening.
Mood Changes
Depression, anxiety, and irritability are commonly reported during the perimenopausal and menopausal stages. For those who have struggled with this prior to perimenopause, it may be intensified for them. Perhaps it was brief, only right before the onset of their periods and now it seems to be more present than not. For others, this may be a new symptom altogether.
Sleep and Fatigue
These often go hand in hand. It’s hard to have good energy levels when sleep is impaired. Poor sleep is one of the most common symptoms people experience related to perimenopause and menopause. It’s also possible for some to have good sleep but experience daytime fatigue.
Body Changes
Many notice that their metabolism has changed and that their body composition is different from prior to the onset of perimenopause. Other common body changes include the thinning or loss of hair, reduced elasticity of the skin, and decreased vaginal moisture. Obviously, these changes can be very upsetting.
The Good News
Fortunately, there are many interventions that are available to help support people as they move through these years. It’s important to individualize a plan and make changes as needed. People have different needs and these can change as the months go by! Treatments can vary from diet and lifestyle interventions, and herbal and nutritional supplements to bioidentical hormone therapy. It’s really up to the person to decide what they would like to do. I think an important consideration for people is to think about not only the challenges that are impacting their quality of life today but to visualize what they want their lives to look like for the next decades to.