women's health
∙6 minute read
Menopause is a milestone that every woman reaches, but how it shows up and feels can vary widely. Some women breeze through it with barely a bump in the road. Others experience years of discomfort, confusion, and frustration. And it often starts earlier than expected, with symptoms creeping in around the age of 47, or even younger for those going through early menopause.1
But what exactly are menopause symptoms? And more importantly, what can you do about them?
You may have heard the phrase “34 symptoms of menopause” thrown around online.2 While it’s not a medically recognised list, it’s based on the real-life experiences of countless women. The symptoms range from the ones we all know about like hot flushes and night sweats, to the ones people talk about less, such as brain fog or joint stiffness.3
What’s important to understand is that menopause doesn’t just affect your periods or your temperature. It’s a whole-body transition, influenced by fluctuating and declining hormones (mainly oestrogen and progesterone) and it touches nearly every system, from your brain to your bones.3
| Vasomotor | Genitourinary | Psychological and cognitive | Bone and skin |
|---|---|---|---|
| Hot flushes | Vaginal dryness | Mood swings | Dry skin |
| Night sweats | Pain during sex | Anxiety | Thinning skin |
| Chills | Itching and irritation | Low mood | Hair thinning |
| Heart palpatations | Recurrent urinary tract infections | Poor concentration or brain fog | Brittle nails |
| Urgent need to pee | Memory lapses | Joint pain | |
| Peeing more frequently | Low self-esteem | Muscle aches | |
| Incontinence | Difficulty coping | Loss of breast fullness | |
| Pain while peeing | Insomnia | Reduced bone density (osteoporosis) | |
| Reduced vaginal elasticity | Fatigue | Loss of skin elasticity | |
| Reduced libido | Lack of motivation | ||
| Decreased genital sensitivity | Feeling overwhelmed |
Vasomotor symptoms are the most well-known signs of menopause, and often the ones that drive women to seek help.
Hot flushes and night sweats are hallmark features here. They’re caused by the body’s temperature regulation system going haywire due to the drop in oestrogen.4 One minute you’re fine, the next you’re drenched in sweat, tossing off the covers at 3am.
These symptoms can affect your sleep, confidence, and day-to-day comfort. And they can last longer than you might expect. For some women, vasomotor symptoms linger for four to five years. For others, they can persist for a decade or more.4
They also tend to hit harder for some groups. Research shows that Black women often experience more frequent and severe hot flushes, while Asian women tend to report fewer.5
Menopause can impact your mind, mood, and mental clarity. This can be particularly unsettling for women who have never struggled with their mental health before.
Feelings of anxiety, low mood, irritability, and even panic can appear seemingly out of nowhere. Some women describe it as feeling like they’ve lost control of their emotions, or like they’re suddenly “not themselves” anymore.6
Cognitive changes can be just as frustrating. Brain fog, forgetfulness, and difficulty concentrating are common during perimenopause (the transitional stage before menopause). You might struggle to find the right words, forget why you walked into a room, or feel like you’ve lost your edge at work.3,6
Often overlooked and under-discussed, genitourinary symptoms can have a huge impact on quality of life and intimate relationships.
As oestrogen levels decline, tissues in the vaginal and urinary areas can become thinner, drier, and less elastic. This can lead to discomfort during sex, itching, increased risk of urinary tract infections, and even urinary incontinence.7
Unlike hot flushes, which tend to improve over time, genitourinary symptoms often get worse if left untreated. And because many women feel embarrassed to talk about them (even with a doctor), they can go unmanaged for years.7
Changes to your joints, muscles, skin, and hair can also be linked to the menopausal transition.
You might notice more aches and pains, especially in the morning. Your joints may feel stiffer, your muscles more tired, and recovery from exercise slower. These changes are often tied to inflammation and collagen loss, both of which are affected by declining oestrogen.3
Your skin may become drier or more sensitive, and hair may start to thin. Nails might become brittle. These are all normal symptoms of the hormonal shifts happening beneath the surface.3
For some women, these changes are subtle. For others, they can be a major source of discomfort or self-consciousness. In either case, recognising them as part of menopause can help you make more informed choices about lifestyle, nutrition, and possible treatments.
Of course, menopause is defined by the end of menstrual periods, but the road there is rarely straightforward.
The first signs often show up during perimenopause, which can start several years before your final period. You might notice changes in cycle length, heavier or lighter bleeding, or skipped periods. The unpredictability can be frustrating, but it’s a key signal that your ovaries are producing less oestrogen.1,3
During this time, it’s still possible to get pregnant, though fertility is declining. Until you’ve gone 12 consecutive months without a period, you’re not officially considered postmenopausal.3
If any of this sounds familiar, you’re not alone. The menopause transition affects every woman differently, but for many, symptoms can seriously impact day-to-day life.
However, you don’t need to guess what’s going on. A simple blood test can help give a clearer insight as to whether your hormones are responsible for your symptoms or not, guiding you towards the right treatment path for you.
There’s no one-size-fits-all answer. For most women, symptoms begin in the perimenopausal years and continue for a few years after their final period. The median duration is around four years, but some women experience symptoms for over a decade.1,3
Early onset of symptoms (especially before age 45) may signal early menopause, which can come with additional health risks such as osteoporosis and heart disease. If you suspect you’re entering menopause early, speak to a healthcare professional.1,3
Menopause is more than the end of periods. It’s a complex, whole-body transition that can affect your physical health, mental wellbeing, relationships, and quality of life. If you’re around 47 and noticing changes (or even younger and suspect early menopause), it’s worth paying attention. Hormone testing is a powerful first step, and support is available.
Gold EB. The timing of the age at which natural menopause occurs. Obstetrics and gynecology clinics of North America. 2011;38(3): 425–440.
Belcaro G, Cesarone MR, Cornelli U, Dugall M. MF Afragil® in the treatment of 34 menopause symptoms: a pilot study. Panminerva medica. 2010;52(2 Suppl 1): 49–54
Santoro N, Roeca C, Peters BA, Neal-Perry G. The menopause transition: Signs, symptoms, and management options. The journal of clinical endocrinology and metabolism. 2021;106(1): 1–15.
Khan SJ, Kapoor E, Faubion SS, Kling JM. Vasomotor symptoms during menopause: A practical guide on current treatments and future perspectives. International journal of women’s health. 2023;15: 273–287.
Avis NE, Crawford SL, Green R. Vasomotor symptoms across the menopause transition: Differences among women. Obstetrics and gynecology clinics of North America. 2018;45(4): 629–640.
Hunter MS. Psychological and somatic experience of the menopause: a prospective study [corrected]. Psychosomatic medicine. 1990;52(3): 357–367.
Carlson K, Nguyen H. Genitourinary syndrome of menopause. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025.
Written by Hassan Thwaini
Clinical Pharmacist and Copywriter, Master of Pharmacy (MPharm)
