Symptoms of menopause

Physical symptoms

Physical symptoms may include:

• irregular periods
• hot flushes
• night sweats
• sleep problems
• sore breasts
• itchy, crawly or dry skin
• exhaustion and fatigue
• dry vagina
• loss of sex drive (libido)
• headaches or migraines
• more pronounced premenstrual syndrome (PMS)
• aches and pains
• bloating
• urinary problems
• weight gain due to a slower metabolism.

Psychological and emotional symptoms

Psychological and emotional symptoms may include:

• feeling irritable or frustrated
• feeling anxious
• difficulty concentrating
• brain fog
• forgetfulness
• lowered mood
• mood swings
• feeling you can’t cope as well as you used to.

Watch this video of a Jean Hailes endocrinologist talking about menopause and what to expect.

Hot flushes and night sweats

More than 57% of women experience hot flushes and night sweats during menopause. They generally start in your chest area and spread to your upper chest, neck and face. They can also spread over your whole body. The flushes may feel like a burning, overheating sensation. You may also have reddening of the skin and different degrees of sweating. When a flush happens at night, it’s called a night sweat.

Everyone experiences hot flushes differently. For example, you might have mild, quick hot flushes every now and then, or you might have more than 20 a day.

We don’t know exactly what causes hot flushes. Lower oestrogen levels may affect parts of the brain that regulate your body temperature. Many studies suggest that stress and anxiety can influence the frequency and intensity of hot flushes. Some foods or alcohol can also have an impact.

Sleep disturbance

It’s common for your sleep patterns to change during perimenopause and menopause. Around 25% of women aged 50–64 years experience sleep problems. Sleep difficulties are more common after menopause.

Women who have experienced surgical menopause are more likely to report severe symptoms.

Poor sleep can cause other health issues. It has been linked to cardiovascular disease, obesity, mood disorders and diabetes. It is also associated with increased mortality.

Sleep disturbance can be caused by:

• changes to your hormone levels (e.g. growth hormone, prolactin, cortisol and melatonin)
• hot flushes and night sweats
• mood disorders
• abnormal circadian rhythms (24-hour cycles that regulate sleep and wakefulness)
• having other chronic conditions (e.g. sleep apnoea)
• having other sleep problems (e.g. restless leg syndrome).
  

Visit the Sleep Health Foundation website for more information about menopause and sleep.

Mood and emotional health

You may notice that menopause causes your mood to change. This is due to changing hormone levels. You might experience:

• irritability
• increased anger
• low mood
• depression and anxiety.

Research suggests that women are more likely to feel depressed during the menopause transition.

Women who have a history of depression or premenstrual syndrome (PMS) may be more likely to develop depression during this time.

Bladder, vaginal and vulval problems

As you move into perimenopause and menopause, low oestrogen levels can change your vulval, vaginal and bladder tissues. These changes may affect up to half of postmenopausal women.

Vaginal atrophy (or vulvovaginal atrophy)

Declining oestrogen levels causes bladder and vaginal tissue to become thin. This can affect areas such as your:

• vaginal lining
• vulval skin
• bladder
• urethra (tube that leads from the bladder to the outside of the body)
• pelvic floor muscles.

These changes are commonly known as vaginal atrophy.

Dry vagina and pain during sex

Around the time of menopause, you might experience vaginal dryness and reduced vaginal elasticity. This can lead to pain during sex and a loss of sex drive (libido).

Learn more about painful sex and treatment options.

Vaginal irritation

You might experience vaginal and vulval irritation during the menopause transition. Typical symptoms include:

• burning
• itching
• redness
• swelling
• vaginal discharge
• pain during sex.

Urinary symptoms

Ageing and menopause can cause your pelvic floor muscles to become weaker. Your pelvic floor muscles help you hold your wee in. Menopause also causes your bladder to become less elastic, which means it can’t hold as much wee as it used to. These changes can lead to urinary symptoms such as:

• the need to wee often and with a sense of urgency
• pain or burning when weeing
• weeing more often than usual, including at night
• blood in your wee
• urinary incontinence, especially when coughing, sneezing or laughing
• recurrent urinary tract infections (UTIs) due to a lack of oestrogen on the bladder and urethra, and changes to the urethra.

While symptoms such as hot flushes usually disappear over time, bladder, vaginal and vulval problems can persist and may even get worse. But many effective treatments are available.

Aches and pains

Changing hormones, particularly a drop in oestrogen levels, can cause aching, painful joints and other musculoskeletal symptoms.

Oestrogen is important for your joint health, as it protects against inflammation. It also helps regulate fluid around your joints.

During menopause, joint pain is commonly experienced in your knees and hips. It may also occur in your shoulders, neck, elbows and hands. Your aches and pains might be stronger in the morning and fade later in the day.

Related resources

Learn more about menopause management options and managing menopausal symptoms.

Download our fact sheets or visit resources for more information.

This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at August 2022.