Common symptoms during menopause

Most women experience symptoms during menopause, but many are unsure what is normal and what might be caused by something else. Here we review the most common complaints and explain what lies behind them.

Why do we get symptoms?

Symptoms are mainly caused by falling and fluctuating oestrogen levels. Oestrogen affects nearly every organ in the body, from the brain to the heart, the skeleton, the skin, and the genital area. When levels change, the body reacts in many different ways.

It is important to know that symptoms vary enormously from woman to woman. Some have hardly any complaints, while others find that daily life changes significantly. Both are perfectly normal.

Hot flushes and night sweats

Hot flushes are the best-known symptom. About 8 out of 10 women experience them. A hot flush is a sudden feeling of intense heat that spreads across the face, neck, and chest. It usually lasts from 30 seconds to a few minutes and may be followed by sweating and chills. It is a peculiar sensation, and it can strike at any time, in the middle of a meeting, on the bus, or while you are sleeping.

Night sweats are the same phenomenon, just at night. Many women say they wake up drenched and have to change the bedding. It is not just unpleasant in itself, it also ruins sleep.

The cause is that oestrogen deficiency affects the body's thermostat in the hypothalamus. Even small changes in body temperature trigger an exaggerated cooling response. The body thinks it is overheating, even when it is not.

It can help to keep the bedroom cool, dress in layers, and be mindful of known triggers such as alcohol, spicy food, and hot drinks.

Sleep problems

Over half of women in menopause report sleep difficulties. Some struggle to fall asleep at all, others wake repeatedly through the night or far too early in the morning without being able to fall back asleep. The result is the same: you never feel truly rested.

Sleep problems are often connected to night sweats, but oestrogen also affects sleep quality directly. Lower oestrogen can lead to lighter sleep and more awakenings even without night sweats. So resolving the hot-flush issues is not always enough to restore good sleep.

Consistent sleep routines, limited screen time before bed, and a cool bedroom are good places to start. And talk to your doctor if the problems persist over time.

Mood swings and emotional changes

Many women experience irritability, sadness, anxiety, or sudden mood shifts during menopause. Over half report irritability, and about 43 per cent report depressive symptoms. It can feel as though your emotions have suddenly taken on a life of their own.

Oestrogen has a direct effect on the production of serotonin and noradrenaline, two brain chemicals that regulate mood. When oestrogen fluctuates, these systems are affected. Sleep deprivation often amplifies emotional complaints. A negative spiral can develop where poor sleep leads to worse mood, which in turn makes it harder to sleep.

Physical activity has documented effects on mood. Even a daily 30-minute walk can make a noticeable difference. It is not a magic solution, but it is one of the interventions that consistently proves helpful.

Brain fog and concentration difficulties

Around half of women experience what is commonly called brain fog. You search for words you normally use without thinking. You forget what you were about to say mid-sentence. You read the same page three times without anything sinking in. For women who are used to performing at a high level at work, this can be especially frustrating and frightening.

But it is important to know that this is a common and usually temporary effect of the hormonal changes. Oestrogen plays a role in memory and cognitive function, and most women see improvement once hormone levels stabilise. So it is not the beginning of something permanent, even though it can feel that way in the moment.

Feel free to use written notes and reminders, and be patient with yourself. Talk to your employer if it affects your work.

Joint and muscle pain

This is actually the single most common symptom, even though it is rarely discussed. According to international studies, 65 per cent of women experience joint and muscle pain during menopause. Many notice it first in the shoulders and knees, others in the hands and fingers.

Oestrogen has an anti-inflammatory effect, and when levels drop, joints and muscles can become stiffer and more tender. Many women assume it is simply due to ageing, but hormones play a significant role.

Regular movement keeps joints flexible, and strength training is especially beneficial for protecting both joints and bones.

Vaginal dryness and urinary complaints

Lower oestrogen affects the mucous membranes in the vaginal area and urinary tract. About 37 per cent of women experience vaginal dryness, which can cause everyday discomfort and pain during intercourse. It is a topic many are reluctant to raise, even with their doctor.

Some women also experience an increased need to urinate, urinary leakage, or recurrent urinary tract infections. All of this is linked to the mucous membranes becoming thinner and more vulnerable without oestrogen.

Local oestrogen preparations such as creams or pessaries are highly effective and have few side effects. It is one of the simplest treatments to start, and it makes a big difference for many.

When should you see a doctor?

It is a good idea to talk to your doctor when symptoms affect your quality of life. Good treatment options exist, from lifestyle changes to hormone therapy. You do not need to simply tough it out.

Contact your doctor especially if you experience severe mood swings, persistent sleep problems, or symptoms that make it hard to function in daily life. It is not making something out of nothing. It is taking your body seriously.