On this page, we will cover menopause signs and symptoms, explaining what causes some of the more common symptoms. Some women may have no symptoms around menopause, but research suggests over 80% of women do experience one symptom or another.
'Vasomotor symptoms' is the fancy term for hot flushes, cold flashes, day sweats, night sweats, or any symptom to do with your body's temperature regulation. These are commonly described as temporary periods of intense heat in the upper body, arms or face, which may be followed by skin flushing and sweating. Sometimes hot episodes are followed by chills and can be accompanied by a feeling of anxiousness, or you may just start shivering even if in a warm room.
Why does this happen? Recent research suggests that these symptoms are caused by changing levels of oestrogen. The hypothalamus is the part of the brain responsible for your controlling your body’s temperature. With falling levels of oestrogen, the hypothalamus becomes more sensitive to external temperature changes, and this can lead to your body over compensating for temperature variations.
You may notice your period has become lighter, or less frequent, and sometimes it can become heavier or more frequent. All of these changes are normal during perimenopause, but if any concern you, such as they become very heavy and difficult to manage, please see your doctor who can offer a variety of treatments to help. The medical term for heavy periods is 'menorrhagia.’ Here is a link to the NHS assessment and resource on heavy periods. Heavy bleeding during perimenopause is very common, with approximately one in four women reporting this symptom.
Why do your periods change? Oestrogen and progesterone work together to regulate your menstrual cycles. A typical cycle has two peaks of oestrogen and a rise in progesterone during the 2nd half of the cycle. As the levels of progesterone fall, this is when your period occurs.
This cycle of hormones typically lasts between 21 to 35 days and varies between each woman.
During perimenopause, your ovaries’ ability to produce hormones such as oestrogen, progesterone and testosterone becomes more variable. This variability in hormone production leads to irregular periods and changes in the heaviness or timing of bleeds.
Vaginal symptoms, difficulty with bladder and bowel control, and sexual problems are common issues that we don't feel are talked about enough. Research estimates one in two women experience sexual problems, and most don’t seek help for these symptoms.
We're saying it right now: please don't think of these symptoms as a natural part of ageing. There is no need to be embarrassed as it's more than likely half of your friends are also experiencing the same thing. The good news is that these symptoms are easily treated with vaginal oestrogens, the correct exercise regime, or lubricants and moisturisers.
What causes these symptoms? The vagina, urethra, bladder and pelvic floor muscles are very sensitive to oestrogen and progesterone. They rely on these hormones to stay healthy and nourished. Loss of oestrogen around menopause causes the vaginal skin to become thin, losing collagen support and elasticity. There is also a reduction in secretions leading to less lubrication and changes to your vagina’s normal environment. All of these changes can result in Genitourinary Symptoms of Menopause (GSUM), which include dryness of the vagina, pain during sex, itchiness, burning or incontinence.
Libido is just another name for sex drive, which depends on a whole range of factors, one of which is (you guessed it!) hormones. Data from the largest US study of women's health (SWAN) showed that 65% of postmenopausal women infrequently or never felt sexual desire, and yet 3 out of 4 women rated their sex lives as moderately to extremely important.
What can you do? The first thing is to remember that mood and stress have significant effects on your sex drive. Taking care of mental health and taking time for yourself will help. There are also products, such as lubricants, which are specifically made to help vaginal dryness and pain. Local hormone replacement therapy has also been shown to help with vaginal dryness and pain.