The signs of menopause include a variety of complaints affecting many body systems. The way in which a single event – the cessation of ovarian production of sex hormones – so radically influences our bodies is a validation of the important role played by hormones.
The following symptoms are all associated with the transition from the childbearing years to the post-reproductive years. Their order has no particular significance, with the exception of hot flashes and night sweats, which are the most common complaints of women regarding menopause. In fact, women in other parts of the world do not experience as many adverse effects during the transition to menopause. This is due to many variables, but mostly to diet and lifestyle. For example, only 10-15% of Japanese women report hot flashes and sweating.
The symptoms listed below are all signs that hormone production by the ovaries is declining. They may or may not be part of a woman’s transition. Here are some of the symptoms experienced during the transition, in addition to hot flashes and sweats.
Hot flashes and night sweats
One of the first signs that you are entering perimenopause (the two to five years before your period ends) is the onset of hot flashes and sweating. Hot flashes and sweating affect 75-80% of western women who go from motherhood to menopause.
Irregular menstrual periods
One of the first clues to the onset of perimenopause is irregular menstruation. Even though your periods have always been regular, as your ovaries begin to stop producing estrogen and progesterone, your periods will probably become irregular. You may have irregular bleeding and even heavy bleeding for a few days between your periods. Other women have very light and short periods. Menstrual periods may get longer every three months or more.
Heavy bleeding during your period is another problem encountered during perimenopause. Bleeding can sometimes last for several days. Irregular secretion of estrogen and progesterone is the cause. Often, progesterone levels drop before estrogen. This results in what is called « unopposed estrogen », which means that the effects of estrogen are no longer balanced by the rhythmic cycle of progesterone. During the menstrual cycle, estrogen stimulates the build-up of the lining of the uterus. This endometrial lining is then removed during menstruation. When estrogen is not in opposition, the lining of the uterus accumulates more than usual, resulting in more material to be evacuated and therefore in heavier and longer periods.
Depression, irritability and anxiety
The symptoms of perimenopause can be stressful and confusing. Hot flashes and sweats are unpredictable and can be embarrassing. They also lead to loss of sleep. Over 40% of women also report physical and mental exhaustion during perimenopause and menopause. These complaints can be part of a vicious cycle in which hot flashes disrupt sleep and sleep loss contributes to problems with energy levels, fatigue, and even memory and concentration. A natural consequence is often a feeling of depression. Feeling depressed, sad, on the verge of tears, having no energy and frequent mood swings can all be due to depression. Irritability and anxiety are also common complaints in perimenopause. Feelings of nervousness, aggression and inner tension are common. Feelings of anxiety are often associated with hot flashes.
Between 40 and 60% of perimenopausal and postmenopausal women report sleep problems. In many cases, sleep difficulties are due to hot flashes and night sweats that disrupt sleep. Sometimes insomnia is due to anxiety, which is another common complaint in perimenopause. During the transition to menopause, sleep patterns often change, and the insomnia associated with this period may be due to a change in sleep habits.
Check out the next blog post for more on menopause and what are the signs.