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7 Menopause Symptoms Caused by Your Changing Hormones

By Romy Weinberg
Reviewed by Alyssa Quimby, M.D.
April 15, 2024
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Getting your first period may have been a surprise. But menopause—when your estrogen levels drop and your period stops permanently—is very different. Its onset is usually gradual, marked by a series of hormonal changes in your body that often cause noticeable symptoms. This can last anywhere from a year to almost 10 years.

Perimenopause, when the ovaries begin to slow estrogen production, tends to start in your 40s. And the average age of reaching menopause is 51, according to The American College of Obstetricians and Gynecologists.

While some symptoms are common, the menopausal experience is unique for everyone.

“Menopausal symptoms are as varied as women are different,” says Carla Williams, M.D., a board-certified gynecologist and menopause practitioner in Greenwich, Connecticut. Some of the most common are irregular periods, hot flashes, vaginal dryness, mood swings, weight gain, hair and skin changes, and brain fog.

While many symptoms don’t require treatment, any that affect your quality of life should be discussed with your doctor—and you should be given choices on how to address them, says Williams. Rare but more serious symptoms, such as heart palpitations, should always be assessed by a medical professional.

Here are seven of the most common symptoms of menopause, and what you can do about them.

Periods You Can’t Predict

As you approach menopause, the ovaries begin to make less estrogen; some months they may release an egg and other months they won’t. As a result, your periods may come more or less often, they might be shorter or longer, heavier or lighter, and you may even skip periods. This phase can be brief or it can last several years. Although it’s normal for periods to change leading up to menopause, you should tell your doctor about any bleeding changes. Abnormal bleeding, especially after menopause, can be a sign of more serious health problems.

Bringing the Heat

The sudden feeling that you’ve been lit like a furnace from your feet to your head is a hot flash, and it’s a menopause hallmark. The exact cause isn’t known, but hot flashes are believed to be related to changes in the hypothalamus, the part of the brain that regulates body temperature. They tend to last only a few minutes and come and go throughout perimenopause and menopause.

Hot flashes don’t cause serious medical harm, but they can be debilitating for some people. And the length of time you will have hot flashes is unpredictable—for some people, it’s a year or two; but, for the majority of women, it’s five years or more.

Dressing in layers, carrying a fan, and drinking cool beverages are good ways to deal with hot flashes, but if this symptom is interfering with your life, you may want to ask your doctor about hormone therapy.

Hormone therapy typically includes estrogen alone or combined with progesterone. Progesterone is important for women who have a uterus because it balances the estrogen and prevents the lining of the uterus from overgrowing which may lead to uterine cancer.

The benefits of hormone therapy—besides treating bothersome symptoms of menopause—is that it protects against bone loss and may reduce colon-cancer risk.

The risks of hormone therapy include increased risk of breast cancer, blood clots, and gallbladder disease. Risks vary depending on the therapy, as well as age and medical history, so talk to your doctor to see if it’s right for you.

If you’re hesitant about hormone therapy, consider instead some lifestyle changes that may help. Avoid alcohol, spicy foods, caffeine, and foods with added sugar, which can trigger hot flashes and disrupt sleep.

Sleep Woes

Trouble falling asleep or waking up long before your usual time are common during menopause, since levels of the hormone progesterone tend to drop. According to the Journal of Menopausal Medicine, progesterone can have sedative and calming effects. It aids your brain in making the calming neurotransmitter GABA, which helps you fall and stay asleep. With less of it, you might feel more anxious and have a harder time falling asleep, says Esther Blum, an integrative dietitian and certified nutrition specialist in Fairfield County, Connecticut. Night sweats can also interrupt your quality of shut-eye.

The key to sleeping better is managing stress, according to Blum. Moderate exercise—like yoga, walking, and meditation—during the day also can help.

Unexpected Weight Gain

An unfortunate side effect of aging is slower metabolism. The onset of perimenopause and menopause can commonly cause changes in body composition: Muscle mass decreases and fat tends to deposit in the lower abdomen and thighs.

Good nutrition is key to minimizing weight gain. Nutrient-rich foods, lean proteins (Blum recommends four to six ounces per day), green leafy vegetables, and whole grains should be the focuses of your diet. Blum suggests eliminating “white carbs” such as pasta, rice, and potatoes. Calcium-rich foods may reduce bone loss and help prevent osteoporosis.

What they say about increased muscle mass helping to burn fat is true. So strength-training is crucial for building the muscle needed to improve metabolism. Cardio workouts are also important to decrease the risk of heart disease, to strengthen bones, and to improve circulation. Plus, they can potentially lower the risk of dementia.

Dryness Down There

As estrogen falls, vaginal atrophy can set in. The thinning and loss of elasticity of the vaginal tissue can cause discomfort as well as painful intercourse and can lead to a loss of interest in sex. Over-the-counter moisturizers and lubricants may provide relief; but, if the irritation is accompanied by hot flashes or other symptoms, your gynecologist may also consider low-dose estrogen treatment.

Dry Eyes, Too

One surprising symptom of changing hormone levels is dry eye, or lack of sufficient tear production. While this can happen to both men and women, according to the American Academy of Ophthalmology, it’s more common in women who have gone through menopause.

Dry eyes may feel like they’re stinging, burning, scratchy, or irritated; or your vision may be blurred, at times. Some tips for coping with dry eye include avoiding using a hair dryer; running a humidifier in dry rooms; wearing wraparound glasses outside to block drying wind; and adding omega-3 fatty acids to your diet, either with foods, such as oily fish and flaxseeds, or with a dietary supplement. If your dry eyes are interfering with your life or comfort, see your doctor.

Swinging Mood

Just as the buildup of sex hormones can be blamed for adolescent moodiness, their dip during menopause may cause the blues, anger, and irritability. Especially for people with a history of depression, menopausal changes can provoke anxiety and feelings of sadness.

If you’re diagnosed with clinical depression, antidepressant medication and cognitive behavior therapy is often recommended. Because alcohol is a depressant, avoiding it or drinking only in moderation can help ward off the blues, too.

For milder mood swings, estrogen may be helpful, but so can eating a balanced diet. Blum tends to recommend a low glycemic-index diet, high in phytonutrients—a “rainbow plate” featuring a diverse range of fruit, vegetables, and fiber—which encourages microbial diversity in the gut and can improve overall health and mood.

Having a support network is important during this time—you can find a local support group and talk to others going through menopause right here in the Women & Midlife community. If you’re struggling or feeling overwhelmed, reach out for additional help. A qualified mental health professional can offer expert relief recommendations.

The symptoms of menopause may be uncomfortable but know that you’re not alone—and that you’ll get through it. Knowing what’s happening in your body and having support as you’re going through it are key to thriving during this transition in your life.

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