Menopause is a biological process that marks the end of menstrual cycles. It typically occurs between the ages of 45 and 55. As oestrogen levels begin to decline, often starting in the early 40s, many women start to experience symptoms that can be distressing or disruptive to daily life.
Menopause is a deeply personal experience. For some, the end of fertility can stir unexpected emotions. For all women, it represents more than just a medical milestone. It is a hormonal shift that can influence the whole body, including mood, sleep, skin, bones, and heart health.
Although menopause is something every woman will go through, the symptoms and their severity can vary widely. Understanding these changes is important. It helps with managing symptoms effectively and recognising when they might indicate other health concerns.
Not all symptoms are exclusive to menopause
Many symptoms associated with menopause can also be signs of other medical conditions:
- Fatigue could be related to thyroid disorders or anaemia [1].
- Mood changes might stem from clinical depression or anxiety [2].
- Irregular periods could indicate uterine fibroids, endometrial hyperplasia, or rarely, cancer [3].
It's essential to consult with a healthcare provider to determine the exact cause of persistent or unusual symptoms.
How long do symptoms last?
Perimenopause can last several years, often beginning in the mid-to-late 40s. Symptoms may:
- Peak in the year before and after the final menstrual period [4].
- Persist for an average of 7 years, but some women experience symptoms for over a decade [5].
- Continue beyond menopause, especially urogenital symptoms like vaginal dryness [6].
Every woman’s journey is unique. Symptoms can fluctuate and vary widely in intensity and duration.
Symptoms by body part or system (all 34 commonly reported)
Neurological and psychological
- Brain fog – Difficulty concentrating or forgetfulness [7].
- Mood swings – Rapid emotional changes, irritability or sensitivity [8].
- Sleep disturbances – Trouble falling or staying asleep, often linked to night sweats [9].
- Difficulty concentrating – Mental fatigue or 'fuzzy head'.
- Memory lapses – Forgetting names, appointments, or tasks.
- Anxiety – Feelings of unease or panic without a clear cause.
- Depression – Persistent low mood, lack of interest or energy.
- Panic attacks – Sudden episodes of intense fear or discomfort.
Cardiovascular
- Palpitations – A fluttering or racing heartbeat [10].
- Hot flushes – Intense, sudden warmth with sweating or redness [11].
- Night sweats – Excessive sweating during sleep.
- Irregular heartbeat – Skipped beats or racing heart without exertion.
Musculoskeletal
- Joint pain – Aches and stiffness, especially in hands, hips or knees [12].
- Muscle tension – Persistent tightness or soreness.
- Muscle loss – Gradual decline in strength or muscle tone [13].
- Osteoporosis – Thinning bones, increasing fracture risk.
Skin, hair and nails
- Dry skin – Flaky, itchy or sensitive skin [14].
- Itchy skin – Generalised or localised itchiness without rash.
- Thinning hair – Hair feels less dense or sheds more [15].
- Hair shedding – Noticeable hair fall, especially in the shower or brush.
- Brittle nails – Nails that split, peel or break easily.
Urogenital system
- Vaginal dryness – Soreness, itching or pain during sex [16].
- Recurrent UTIs – Frequent infections or discomfort when urinating [17].
- Urinary urgency – Needing to urinate more often or urgently.
- Burning mouth syndrome – Tingling or burning sensation in tongue or mouth.
Reproductive system
- Irregular periods – Shorter, longer, heavier or lighter than usual [18].
- Breast tenderness – Achy, sore or swollen breasts.
- Breast changes – Loss of fullness or sagging over time.
- Decreased libido – Reduced interest in or enjoyment of sex [19].
Gastrointestinal and other
- Bloating – A sense of fullness or abdominal discomfort.
- Digestive changes – More gas, constipation or unpredictable bowel habits.
- Weight gain – Often around the middle, despite unchanged habits.
- Dizziness – Feeling light-headed or off balance.
- Allergies – New sensitivities or flare-ups of existing allergies.
- Electric shock sensations – Brief, nerve-like zaps under the skin.
- Tingling extremities or skin – Pins and needles in fingers, toes or skin.
- Body odour changes – Noticing a different or stronger personal scent.
- Gum problems – Bleeding, swelling, or increased sensitivity.
When to speak to a clinician
If symptoms are severe, prolonged, or interfere with your quality of life, speak to a menopause-informed clinician. Some symptoms may overlap with other medical conditions and should not be dismissed as “just menopause.”
With the right support, there are effective treatments and lifestyle changes that can help you feel more like yourself again. You don’t have to go through this alone.
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