The Complete List of Menopause Symptoms At Every Stage and Age

If we told you that there are over 100 possible symptoms of menopause, would you be tempted to hide under your pillow until it was all over? We wouldn’t blame you. The dozens and dozens of potential symptoms listed here do not sound like they make life pleasant—and many times they definitely do not.

That said, there’s no reason you have to suffer or white-knuckle your way through these years. Symptoms can be effectively managed—especially with a treatment plan that looks at you as a whole person and pulls in a variety of solutions and lifestyle tweaks that help you feel good. 

Keep in mind that menopause is an individual experience that differs widely among women. You will absolutely not experience all of these symptoms. (Whew!) But knowing what you may expect, from the all-too-common to the more sneaky, under-the-radar symptoms, can help you prepare and find help when you need it. 

Understanding Menopause

The menopausal transition lasts many years. It’s the time when your ovaries begin to wind down their function to close out your reproductive years. As you age, you’ll go through its various stages:

• Perimenopause: This is the phase leading up to menopause where hormones estrogen and progesterone fluctuate, triggering a cascade of menopausal symptoms. Perimenopause usually starts in your mid-40s, though it can begin as early as your 30s or as late as your 50s. Most women find that they’re in perimenopause for about four years, though for some, it can persist for as long as a decade. Unfortunately, it’s impossible to predict how long you’ll be in the perimenopause phase.
• Menopause: Once you’ve gone 12 consecutive months without a period, you have officially hit menopause. The average age of menopause is 51. Your ovaries have stopped releasing eggs, and this marks the end of your fertility. 
• Postmenopause: The period of time that starts right after menopause. You’ll be in this postmenopausal phase for the rest of your life. During this time, your estrogen levels remain low. And while symptoms don’t magically stop as soon as you are postmenopausal, many women see that they improve in severity over time or disappear altogether.

Common Physical Symptoms of Perimenopause and Menopause

Once perimenopause arrives in your life, you’ll likely see and feel its symptoms. As hormone receptors all over our body are impacted by falling estrogen, symptoms can truly pop up anywhere, from a sore knee to a foggy brain. Below, you’ll find a run down of various symptoms of menopause and when they are most likely to occur. Some are incredibly common while others may be a bit more surprising. 

Vasomotor Symptoms

These are, by far, the most common symptoms of menopause, affecting 75% of women. More than half of women live with vasomotor symptoms for almost 12 years, according to research in JAMA Internal Medicine. 

When it happens: Vasomotor symptoms are most likely to start in perimenopause (or even premenopause for some women) and persist for a number of years postmenopause.

Possible symptoms include:

• Hot flashes: A sudden sensation of warmth that can be mild to intense.
• Night sweats: These are basically hot flashes at night that are known to disrupt sleep, waking you up drenched in sweat.

Genitourinary Symptoms

As estrogen declines, vaginal tissue becomes thinner and drier. What was once plump tissue that supported healthy sexual and urinary function now makes you more prone to symptoms that affect vaginal and urinary health:

When it happens: These symptoms—also called GSM (genitourinary syndrome of menopause) —can begin in perimenopause and last throughout postmenopause. Many women continue treatment for these symptoms long-term.
Possible symptoms include:

• Increased urinary tract infections (UTIs)
• Overactive bladder
• Urinary incontinence
• Urinary urgency
• Vaginal dryness

Fatigue

Fatigue affects three out of four women during the menopausal transition. Yes, this often has to do with sleep disturbances, but hormonal changes and life stress are just as big energy zappers. When it comes to hormonal changes, estrogen, progesterone, and melatonin decrease in midlife, while higher cortisol levels at bedtime can keep you wired. (And that’s not even mentioning the racing thoughts that hit at bedtime thanks to dropping estrogen levels and increased anxiety). 

When it happens: Fatigue can affect women at any time during the menopausal transition.

Possible symptoms include:

• A level of bone-deep exhaustion that’s more than just feeling a little tired
• Trouble falling or staying asleep

Breast Changes

Oh, they ache! Hormonal changes before your period trigger breast tissue changes in perimenopause. 

When it happens: As you move closer to menopause, the hormonal fluctuations may trigger these changes at seemingly random times of the month.

Possible symptoms include: 

• Breast aching and soreness
• Breast stinging
• Breast swelling
• Breast tenderness
• Breast tightness

*Though breast changes and discomfort can be a normal part of perimenopause and menopause hormone fluctuations, women should inform their clinician of any new changes to ensure proper breast cancer screening is done.

Musculoskeletal Symptoms

Nearly half of Midi patients complain of musculoskeletal symptoms like joint pain. These symptoms are caused by a combination of hormonal fluctuations (estrogen is key for muscle elasticity and joint health), age-related wear and tear, and lifestyle and environmental factors like diet, exercise, and stress. 

When it happens: For some women, joint pain is one of the first symptoms of perimenopause, whereas others don’t experience it until postmenopause.

Possible symptoms include: 

• Frozen shoulder
• Joint pain
• Joint stiffness
• Loss of grip strength
• Muscle aches
• Muscle loss

Dermatological Symptoms

As estrogen levels decline, skin can lose moisture and connective tissue that helps it retain its elasticity. Many women also have hair and nail changes as the loss of estrogen also decreases keratin, a protein in your hair, nails, and skin.

When it happens: While you may start to notice many of these changes in perimenopause, the American Academy of Dermatology points out that our skin loses 30 percent of its collagen in the five years after menopause, at which point collagen loss continues but at a much slower rate.

Possible symptoms include:

• Acne
• Changes in body odor
• Dry skin
• Fine lines and wrinkles
• Hair that becomes more wiry, curly, or dry
• Hair thinning or loss
• Increased facial or body hair
• Itchy ears
• Itchy skin
• Nail changes, including dryness, ridges, cracks, chips and splits, or curling
• Pigmentation problems like melasma
• Sagging skin

Cardiovascular Symptoms

Estrogen plays a key role in protecting the heart, and when the hormone starts to go down, your cardiovascular health can be at increased risk. 

When it happens: Although it’s important to care for your heart health throughout your life, this risk is highest after menopause.
Possible symptoms include: 

• Increased risk of heart disease: An increase in abdominal fat, higher lipid levels, and changes in blood vessels during the menopausal transition can make you vulnerable to cardiovascular disease, according to research in Circulation.
• Changes in blood pressure (which also increase heart disease risk).
• Palpitations: That feeling that your heart is beating quickly, pounding, or skipping a beat are palpitations, which affect 47% of menopausal women, though they are not typically associated with underlying heart disease. 

Gastrointestinal Symptoms

Was your digestion running smoothly and now it’s…not? You may start to experience GI symptoms that weren’t a problem before when estrogen begins to decline.

When it happens: Digestive health can change starting in perimenopause and continue throughout the entire transition.

Possible symptoms include:

• Abdominal pain
• Acid reflux or GERD
• Bloating
• Constipation
• Gas
• Loose stools
• Nausea

Weight and Metabolic Changes

Weight gain and body changes during perimenopause are incredibly common, affecting 87% of patients at Midi. The frustrating part about weight gain during this stage is that it can happen even if you haven’t changed your diet at all. This can happen, in part, because women transitioning through menopause burn roughly 250-350 less calories a day than when they were younger. Hormonal changes can affect where your body stores fat and can affect your metabolism. Changes in lifestyle—like lack of exercise and sleep, increased stress—can also contribute to weight gain.

When it happens: Most women start to notice weight changes during perimenopause especially as they near menopause.
Possible symptoms include:

• Body composition changes, primarily an increase in abdominal fat (aka meno belly)
• Slowed metabolism
• Weight gain

Changes in Menstrual Patterns

Even if you could predict your period with some accuracy before perimenopause, your flow now may be full of surprises. Periods can start to get wild and unpredictable due to hormonal fluctuations. They can be  lighter, heavier, shorter, longer, or feature spotting, and your cycle length can differ from one month to the next. In one study, 78% of midlife women reported that they had bleeding that lasted for 10 or more days, 67% said they endured six or more days of spotting, and 35% said they had three or more days of heavy bleeding. 

When it happens: Irregular periods are often one of the first–if not the first–symptom of perimenopause for many women.

Possible symptoms include:

• Lighter or heavier periods
• Longer or shorter periods
• Spotting (prior to menopause)

Common Psychological and Cognitive Changes

Mood & Memory Symptoms

If everything your partner does right now drives you up a wall, you are far from alone. If you’re having so many brain blips that you recently found your keys in your freezer, welcome to the midlife brain. These mood changes and brain fog can show up in a variety of ways that may be surprising, and they can have a major ripple effect on your relationships.  

When it happens: Hormonal fluctuations and midlife stuff (work stress, relationship stress, caregiving stress…you get the picture) contribute to these emotional and cognitive issues, and they often start in perimenopause. Once your hormones settle down postmenopause, the hormonal trigger for these symptoms will be gone, and many women find that their mood evens out again. However, because the causes are so multifactorial, you may still experience these symptoms depending on what’s going on in your life.

Possible symptoms include: 

• Anger
• Anxiety
• Decreased motivation
• Depression
• Difficulty concentrating
• Difficulty with word retrieval
• Feelings of dread
• Increased clumsiness
• Increased sensitivity to stress
• Irritability
• Isolation
• Memory lapses/forgetfulness
• Mood swings
• Panic attacks
• Reduced self-confidence
• Social anxiety
• Social withdrawal
• Sudden onset of phobias (e.g., fear of driving)
• Sudden tears

Sleep Symptoms

Are you awake at 3 a.m. reading this right now? We wouldn’t be so surprised: Sleep disruption impacts up to 47% of perimenopausal women and up to 60% of postmenopausal women. Estrogen and progesterone both support good quality sleep. Plus midlife stress, menopause symptoms like night sweats, and underlying sleep disorders may also be keeping you up.

When it happens: Unfortunately, sleep problems crop up both in perimenopause and menopause.

Possible symptoms include:

• Insomnia
• Restless legs syndrome
• Sleep apnea (brief pauses in breathing that occur during sleep)
• Waking up in the middle of the night

Sensory and Neurological Symptoms

This is where some of the more surprising and shocking (pun intended) menopausal symptoms come in—which range in severity and unpleasantness—and can affect you from your head to your toes.

When it happens: The issues below can be caused by problems outside of the menopausal transition (so it’s a wise move to get checked out by a healthcare professional), but they may also be a feature of your menopause experience.

 Possible symptoms include:

• Blurred vision
• Burning mouth
• Changes in taste perception
• Coordination Issues
• Dry mouth
• Electric shock sensations
• Fidgeting/restlessness
• Formication (sensation of insects crawling on the skin)
• Headaches
• Hot feet: A sensation of burning or warmth in the feet, often at night
• Increased sensitivity to noise
• Migraine
• Numbness in extremities
• Phantom smells
• Scalp sensitivity
• Sensitivity to light
• Temperature intolerance
• Tingling extremities
• Tinnitus (ringing in the ears)
• Tremors
• Vertigo or balance issues, such as sudden dizziness or loss of balance

Immune and Allergic Symptoms

You’ve always found springtime to be enjoyable–until recently when your nose doesn’t stop running and your eyes constantly itch. Or maybe you’re noticing your chest erupt in rashes…for no discernable reason. The hormonal shifts of menopause can affect your immune system, increasing your sensitivity to allergens and making you more vulnerable to symptoms of preexisting immune-related conditions. 

When it happens: Although these can start at any time, some evidence analyzing new asthma symptoms suggests that the odds of experiencing them may increase throughout the menopausal transition as you age.

Possible symptoms include:

• New allergies or increased reactions to existing allergies
• Autoimmune flare-ups: Hormonal changes potentially exacerbating autoimmune conditions
• Dry or itchy eyes
• Frequent cold-like symptoms
• Skin rashes
• Sudden onset of hives or eczema

Oral and Dental Changes

You may not be aware that menopause plays a role in oral and dental health. (Jaw drop?) Even your oral tissues have estrogen receptors, so an estrogen deficit, as well as lifestyle habits (such as an unhealthy diet or tobacco or alcohol use) boosts the risk of oral problems.

When it happens: The timing of these issues can vary widely, but over half of women over 40 report changes in their teeth and gums, and more than one in three say their oral health has declined with age, according to a survey.

Possible symptoms include:

• Burning mouth syndrome (painful sensation of burning or tingling in the mouth)
• Gingivitis (gum inflammation)
• Oral pain and discomfort
• Periodontitis (gum disease that can lead to tooth loss)
• Tooth sensitivity

Sexual Health Changes

Hormonal dips, mood changes, relationship issues and more all factor into the sexual health symptoms that may become an unwelcome part of your life. In fact, these issues cause significant distress for one in seven women during midlife:

When it happens: These symptoms are extremely common in perimenopause and postmenopause, but are some of the easiest to treat.
Possible symptoms include: 

• Decreased libido
• Vaginal dryness
• Pain or discomfort during intercourse

Get your questions about sexual health during midlife answered—from issues of desire to painful sex and beyond. Watch Midi's webinar "Navigating Sexual Health During Menopause" for lots of useful info.

Additional Symptoms

By now it should be clear that menopause doesn’t stop at hot flashes, fatigue, breast tenderness, and sexual dysfunction. It can also factor into more under-the-radar changes, like the ones below.

Respiratory Symptoms

Did you know that lung function goes on a rapid decline during the menopause transition and postmenopause, affecting your respiratory health? That’s according to  research in the American Journal of Respiratory and Critical Care Medicine. 

When it happens: It’s possible you’ll notice these symptoms both during perimenopause and beyond.

Possible symptoms include: 

• Breathlessness (called dyspnea)
• Shortness of breath
• Tightness in chest 
• Wheezing

Appetite and Digestive Changes

Menopause can turn down the switch on your body’s appetite control center, while an increase in abdominal fat also affects hormones that control hunger and fullness.

When it happens: Changes in appetite and cravings that can pop up in perimenopause and persist or change during the years after menopause.

Possible symptoms include: 

• Loss of appetite
• Decreased desire for food without gastrointestinal illness
• Increased cravings, often for sweet or salty foods
• Unusual metallic taste in the mouth

Other Psychological and Behavioral Changes

Conditions like obsessive-compulsive disorder (OCD) or attention-deficit/hyperactivity disorder (ADHD) have been shown to appear or worsen at menopause. Hormonal fluctuations change how your brain functions, and some women may experience:

When it happens: Changes in mood and behavior can start in perimenopause.

Possible symptoms include: 

• Impulsivity or risk-taking behavior
• Heightened sense of caution or anxiety bordering on paranoia
• Compulsive or repetitive behaviors (e.g., checking or cleaning)

Symptoms by Stage

The menopause experience is so unique for each woman that we can’t reliably tell someone if they’ll have a certain symptom, how severe it will be, when it’ll rear its ugly head, and how long it will last. In fact, some women have no symptoms at all in perimenopause or postmenopause. And oftentimes, the symptoms overlap across the menopausal transition. Hot flashes and night sweats are one example of a symptom that may stick around far longer than you’d like. That said, there are some trends in what women report experiencing. Here’s a basic rundown of what you might expect:

Perimenopause

As your body goes through estrogen withdrawal, you might expect:

• Irregular and unpredictable menstrual cycles
• Brain fog and memory problems
• Dental issues
• Heart palpitations
• Hot flashes
• Mood swings
• Night sweats
• Sleep difficulties

Menopause

Remember, menopause isn’t a stage but a moment in time when you’ve gone 12 straight months without a period. This is the day you officially enter menopause. Symptoms you experienced in perimenopause are likely to continue during your period-free year.  

Postmenopause

Although your ovaries have closed up shop, that doesn’t mean your symptoms have. Though many of them will start to improve, you might still expect:

• Dry skin
• Hot flashes
• Low libido
• Mood problems
• Night sweats
• Sleep difficulties
• Urinary incontinence
• Vaginal dryness
• Weight changes 

In addition, due to the fact that estrogen levels remain very low during postmenopause, you’re also at a higher risk for some of the health effects of estrogen deficiency, such as osteoporosis and heart disease.

Factors Influencing Symptom Severity and Duration

As we mentioned earlier, not every woman will have every symptom on this list. Even among the most common symptoms—hot flashes/night sweats, fatigue—there are some women who are never affected. There are likely several factors that play into what menopause symptoms affect you and when, including genetics, lifestyle choices, overall health status, and cultural and environmental factors. Remember that there are multiple causes for many of the symptoms on this list. Sometimes it’s menopause hormones, other times it’s a lifestyle habit, and sometimes your genes set you up for it—and it may be all of those things too. 

When to Seek Medical Advice

Some of these symptoms, such as insomnia, gingivitis, breast discomfort, or shortness of breath, can have numerous causes. In some cases, they are considered red flag symptoms. Regardless if they’re caused by menopause or not, you should seek help for any symptom that is worrying you, encroaching on your quality of life, affecting your physical or mental function, or is uncomfortable. 

If your health problems are caused by or related to menopause, there are good treatments available, from hormone replacement therapy (HRT) and other medications to supplements, lifestyle changes, and psychosocial support that can relieve symptoms and help prevent many of the chronic diseases that also affect your wellbeing in midlife.

Working with a menopause specialist at Midi to develop a plan to fit your symptoms, lifestyle, and preferences for treatment will help you manage your symptoms effectively so you can feel good throughout this monumental shift in your life.

The Takeaway

• There are more than a 100 potential menopause symptoms—and these affect nearly every aspect of your physical and mental well-being. The most common symptoms of menopause include hot flashes and night sweats, fatigue, mood changes, sleep difficulties, decreased libido, vaginal dryness, joint pain, and weight gain. More surprising symptoms like oral health issues, new or worsening allergies, and dizziness may also be related to menopause and falling estrogen levels.
• Every woman has a unique menopause experience, since multiple factors, including genetics, lifestyle, and health status, factor into what symptoms she has and when.
• Women are encouraged to seek medical advice whenever they experience a concerning symptom (such as shortness of breath, bleeding gums, breast changes, heart palpitations, etc) that may be related to menopause, but may also be indicative of another health problem. It’s also good to seek care when symptoms are affecting quality-of-life by causing discomfort or disruption in the day. 
• Bottom line: There are a lot of evidence-backed treatment options available for menopause symptoms that can improve midlife.