What Are the Symptoms of Menopause?

If you're in your late 30s or early 40s, it's natural to wonder: What are the symptoms of menopause? The earliest signs typically show up before your period stops for good, throwing your cycle out of whack. The other changes are ones you've likely heard about: hot flashes, insomnia, incontinence, memory issues, night sweats, and mood shifts. 

It sounds overwhelming, but the signs of menopause don't arrive as a neat checklist, so you won't necessarily feel every single one. Read on for what's typical, what might need extra attention, and when to talk with a clinician.

Early Signs of Menopause Often Start With Period Changes

You might understandably be searching for answers to questions like, “What are the symptoms of menopause?” But technically, you should be wondering about the symptoms of perimenopause. That’s because menopause is technically one moment in time—you’ve officially hit menopause when you’ve gone 12 consecutive months without a period. But you’ll likely start noticing some physical or mental changes before that. 

Those months or years before menopause begins, when you might first start noticing that something seems to be up, are considered perimenopause—a transition period of fluctuating hormones and unpredictable symptoms. 

Perimenopause can be so innocuous that you don’t even realize it’s happening (you can still get pregnant, right up until you reach menopause), or it can feel a lot more obvious. This is when you’ll likely start noticing those early signs of menopause, which can include:

• irregular periods or skipped periods
• heavier or lighter bleeding 
• change in cycle length (longer or shorter periods)
• difficulty sleeping 
• increased vaginal dryness
• brain fog 

Common Symptoms of Menopause From Head to Toe

The signs and symptoms of menopause can vary for everyone. Some are more common than others, but you’re not guaranteed to feel all of them.

Vasomotor symptoms 

Studies have found that 60% to 80% of women experience hot flashes and night sweats, making them the most common sign of menopause. 

A hot flash feels like a sudden flare-up of heat in your chest or face, sometimes paired with sweating, red blotchy skin, and even anxiety. Night sweats are simply hot flashes at night, with unexplained sweating while you sleep. 

Mood changes

Fluctuating moods come with the territory sometimes. A 2023 review of 22 different studies and surveys concluded that menopause can make women more vulnerable to depression and anxiety; for others, it feels more like mood shifts. 

About 40% of women experience mood changes that feel similar to PMS, according to the American College of Obstetricians and Gynecologists (ACOG). This can include:

• crying more than you usually do
• not feeling like yourself
• feeling overwhelmed or irritable more often
• having trouble focusing or struggling with low energy 

Sleep disruptions

More than 40% of women deal with sleep disturbances during perimenopause and menopause, according to the National Council of Aging. This can look like: 

• insomnia or difficulty falling asleep 
• lighter sleep, where you wake up more often and feel tired when you wake up
• sleep disorders like sleep apnea
• fatigue and daytime irritability from not getting enough rest 

Cognitive symptoms

A decline in cognitive functioning is one of the most common concerns, according to the World Journal of Psychiatry. Many women report brain fog, forgetfulness, trouble concentrating, and difficulty finding words. 

Genitourinary symptoms 

A decline in estrogen can result in a slew of genitourinary symptoms that can affect your sex life and bathroom habits. These include:

• vaginal dryness
• feelings of discomfort or pain during sex
• burning, itching, or irritation in your vaginal area 
• low libido 
• difficulty reaching orgasm 
• leaking urine
• recurrent urinary tract infections (UTIs)
• a frequent urge to urinate 

Weight symptoms

Weight gain or body composition changes are common symptoms women notice in midlife. In fact, 87% of Midi patients say they experience weight gain and body changes. You can largely blame fluctuating hormone levels, as estrogen drops can cause muscle loss and fat gain.

Symptoms of Menopause at 50 Can Look Different From Person to Person

Common doesn't mean universal. Some women find that symptoms worsen with age; for others, they stay mild throughout. Symptoms can vary from person to person, so if your experience looks nothing like a friend’s, that’s normal. 

Menopause Symptoms and What They Can Feel Like 

What Is Normal, What Is Common, and What Should Not Be Ignored

There's no standard test for menopause. A clinician identifies it based on your age, symptoms, and menstrual history, with a more formal diagnosis once you've gone 12 months without a period.

Red flags to watch out for include:

• abnormal or heavy bleeding
• bleeding after sex 
• fainting
• chest pain and new severe pain in general
• persistent or severe feelings of depression
• sudden neurological symptoms
• recurrent UTIs
• painful sex
• severe symptoms that are disrupting your everyday life 

If severe symptoms are disrupting your daily life, see a healthcare professional, such as a Midi clinician, even if your symptoms seem to line up with menopause.

Treatment Options for Menopause Symptoms

Menopause is normal, but that doesn't mean you have to live with every symptom. Here are some approaches based on your symptom type:

• Hot flashes and night sweats: Avoid spicy or hot foods, dress in layers, try gentle exercise like yoga or walking, and keep your sleep space cool.
• Mood changes: Prioritize sleep, try meditation, exercise daily, consider therapy, and lean on your support system. If symptoms feel severe, ask a clinician about antidepressants, anti-anxiety medication, or a referral to a mental health professional.
• Sleep disruptions: Keep a consistent schedule, build a screen-free bedtime routine, skip afternoon and evening caffeine and alcohol, and exercise regularly.
• Cognitive issues: A balanced diet, regular exercise, and enough sleep all help with brain fog and forgetfulness.
• Vaginal and urinary symptoms: Some issues like dryness, itchiness, UTIs, or feeling like you need to pee urgently need targeted treatment. Lubricants and creams can also help.

Hormone therapy is another option, but it's not one-size-fits-all and is a conversation to have with a healthcare professional, such as a Midi clinician.

Frequently Asked Questions (FAQs) 

What are the first signs of menopause?

Changes to your menstrual cycle, like irregular periods, shorter or longer cycles, and heavier or lighter flow, are usually first. These are often followed by night sweats, hot flashes, brain fog, mood shifts, and vaginal dryness or irritation.

Can you have menopause symptoms while still getting periods?

You can experience perimenopause and menopause symptoms while still getting your period for years. Perimenopause lasts, on average, for 4 years, but it can last up to 8 years. Menopause isn’t diagnosed until you haven’t had your period for 12 straight months. Remember, right up until you hit menopause, you can still get pregnant

Are mood changes and brain fog really signs of menopause?

Yes, they're among the most common. Many women describe mild memory loss, trouble concentrating, and feelings of depression and anxiety during this stretch.

What symptoms of menopause at 50 should prompt a visit to a clinician?

Contact a clinician if you have severe joint pain, heavy or abnormal bleeding, an abnormal heart rate, rapid hair loss, and severe depression or anxiety.

How do I know if it is menopause or something else?

Reach out to a clinician if you're concerned. There's no official menopause test, so they'll consider your medical history, symptoms, and age. Tracking your symptoms, moods, and family history helps them decide whether further testing is needed.