What are the symptoms of menopause?

Symptoms of Menopause

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

Vasomotor Symptoms

• Hot flashes and night sweats are the most common menopausal symptoms, affecting approximately 50-75% of women during the menopausal transition 2
• These symptoms typically last more than 7 years and can significantly impact quality of life 2
• Hot flashes are defined as transient sensations of heat, sweating, flushing, anxiety, and chills lasting for 1-5 minutes 3
• The underlying mechanism involves abnormal hypothalamic thermoregulatory control resulting in vasodilatory responses to minor elevations in core body temperature 3

Genitourinary Symptoms

• Symptoms of atrophic vaginitis include vaginal dryness, dyspareunia (painful intercourse), urinary urgency, and pruritus (itching) 1
• More than 50% of menopausal women experience genitourinary symptoms, collectively known as genitourinary syndrome of menopause (GSM) 2
• These symptoms are often chronic and can significantly affect sexual function and quality of life 2
• Urinary complaints may include urgency, frequency, and incontinence 1

Sexual Function Changes

• Reduced libido (decreased sexual desire) is a common associated symptom 1
• Sexual dysfunction may be exacerbated by vaginal dryness and psychological factors 1
• Dyspareunia (painful intercourse) is consistently linked to the menopausal transition 1

Sleep and Mood Disturbances

• Sleep disturbances are consistently linked to the menopausal transition 1
• Night sweats can disrupt sleep patterns and contribute to fatigue 1
• Mood disturbances including depression are commonly reported during menopause 1
• Anxiety may accompany hot flashes and other menopausal symptoms 3

Musculoskeletal and Other Physical Symptoms

• Arthralgias (joint pain) and myalgias (muscle pain) are reported by many women during menopause 1
• Fatigue is a common complaint that may be related to sleep disturbances 1
• Weight changes and redistribution of body fat may occur 1

Cognitive Changes

• Some women report cognitive dysfunction or "brain fog" during the menopausal transition 1
• However, the direct link between cognitive changes and menopause is less consistently established than other symptoms 1

Important Considerations

• Not all symptoms attributed to menopause are directly caused by hormonal changes; some may be related to aging or other psychological disorders 1
• The severity and impact of symptoms vary widely among women 4
• Symptoms like poor libido, lethargy, and cognitive changes may be related to anxiety, depression, or other factors independent of ovarian function 1
• Menopause is officially diagnosed after 12 months of amenorrhea resulting from permanent cessation of ovarian function 5
• The perimenopause (transition period) precedes the final menses by several years, and some symptoms like hot flashes often begin during this time 5

Assessment of Symptoms

• Standardized scales like the Greene Scale can help establish symptom range and severity 1
• Menopause-specific quality of life tools such as MENQOL can help evaluate the impact of symptoms on daily functioning 1, 4
• The frequency and severity of symptoms should be assessed to determine appropriate management strategies 4