What are the symptoms of menopause?

Symptoms of Menopause

The primary symptoms of menopause include hot flashes/night sweats, vaginal dryness, urinary complaints, sexual dysfunction, sleep disturbance, mood disturbance, depression, cognitive dysfunction, arthralgias/myalgias, and fatigue, which can significantly impact quality of life. 1

Common Menopausal Symptoms

Vasomotor Symptoms

• Hot flashes and night sweats: Experienced by approximately 50-75% of women during menopausal transition 2, 3
  • Typically last 4-7 years but can persist for more than a decade 2
  • Occur in 46-73% of female breast cancer survivors 1
  • Can significantly disrupt sleep and daily activities

Genitourinary Symptoms

• Vaginal dryness: Affects more than 50% of menopausal women 3
• Dyspareunia (painful intercourse): Common and often progressive 2
• Urinary complaints: Including urgency and recurrent infections 1
• Vaginal irritation and pruritis 1

Sexual Function Changes

• Decreased libido 1
• Sexual dysfunction: Affects at least 50% of women after breast cancer 1
• Difficulty with orgasm 1

Psychological and Cognitive Symptoms

• Mood disturbances: Including irritability and anxiety 1
• Depression: Consistently linked to the menopausal transition 1
• Cognitive changes: Including difficulty concentrating and memory issues 2, 4
• Sleep disturbances: Often exacerbated by night sweats 1

Physical Symptoms

• Arthralgias/myalgias: Joint and muscle pain 1
• Fatigue: Common and can be debilitating 1
• Bone loss: Accelerated during the menopausal transition 2
• Metabolic changes: Including increased abdominal fat and changes that predispose to cardiovascular disease and diabetes 2, 4

Symptom Patterns and Duration

• Vasomotor symptoms are most pronounced during the first 4-7 years but can persist for more than a decade 2
• Genitourinary symptoms tend to be progressive rather than improving over time 2
• Symptoms can occur in any combination or sequence, and the link to menopause may sometimes be elusive 2
• In spontaneous menopause, vasomotor symptoms tend to decrease in frequency and severity following 12 months of amenorrhea 1

Impact on Quality of Life

• Menopausal symptoms can have a profound impact on quality of life 1
• Hot flashes negatively influence quality of life in breast cancer patients 1
• Sexual dysfunction and vaginal symptoms can significantly affect intimate relationships 1
• Sleep disruption from night sweats can lead to chronic fatigue and mood disturbances 1

Special Considerations

Male Menopausal-Like Symptoms

Men receiving androgen deprivation therapy (ADT) for prostate cancer may experience similar symptoms:

• Hot flashes (50-80% of men on ADT) 1
• Gynecomastia (up to 80% depending on treatment) 1
• Decreased testicle size 1
• Thinning of body hair 1

Cancer Survivors

• Chemotherapy may cause transient or permanent menopause in premenopausal women 1
• 33-73% of premenopausal women treated for breast cancer become perimenopausal or postmenopausal after treatment 1

Assessment Considerations

When evaluating menopausal symptoms, it's important to:

• Assess the frequency and severity of symptoms 1
• Evaluate impact on daily activities and quality of life 1
• Rule out other medical causes for symptoms (e.g., thyroid disease) 1
• Consider using standardized assessment tools like the Greene Scale or MENQOL 1

Understanding these symptoms is crucial for proper diagnosis and management, as menopausal symptoms remain substantially undertreated despite effective treatment options being available 2.