Perimenopause, menopause, and postmenopause can be very challenging times, with declining hormones playing a large part. Hot flashes are the most common symptom, with 75% of North American women experiencing them. But there is a wide range of other uncomfortable, lesser-known symptoms that may surprise you.
Every woman's experience of the menopausal transition is unique. Some sail through it barely noticing a thing, while others can experience debilitating symptoms.
Becoming familiar with some of these lesser-known menopause symptoms can help you better advocate for your well-being and improve the quality of your life.
It’s very important you consult your healthcare provider to discuss concerns before embarking on any treatments.
1. Skin Changes
Skin changes during the menopausal transition are very common, and many women report a sudden onset of skin aging several months after menopause symptoms begin. Estrogen is an essential component of skin function, and as it and other hormones plummet, you may notice that your skin starts to become dryer, thinner, and itchy.
Collagen drops 30% in the first five years of menopause. Reduced collagen causes the skin to lose its elasticity and firmness, become more prone to damage, and develop more fine lines and wrinkles.
Our body during menopause retains much less water than it once did, dropping from approximately 60-70% to around 55%. This makes it very important to stay hydrated.
Additionally, at around 50 years of age, the pH level of our skin changes, and our skin becomes more sensitive.
Menopause skin symptoms:
- Dry and itchy skin
- Loss of elasticity and firmness
- Easily irritated skin
- Wounds heal more slowly
Tips for managing skin changes:
Use a high-quality broad-spectrum SPF sunscreen, avoid hot baths and showers, stay hydrated and eat a healthy diet, use a mild cleanser, and consider using skincare products specifically developed for menopausal skin, such as Finlay+Green’s clean moisturizer.
2. Hair Loss
Hair loss during menopause is not uncommon. During perimenopause, both estrogen and progesterone decline, causing hair to grow more slowly and become thinner. At first, it may not be obvious, but during perimenopause, hair shedding starts to ramp up.
The first signs can be subtle:
- More hair collecting around your shower drain
- More hair on your pillow or clothing
- You need to clean your hairbrush more often
- Hair breakage becomes more common
Then you may notice:
- Your parting getting wider
- Your ponytail getting thinner
- Your hair taking on a lackluster appearance
Once the excessive shedding has gone on for a while, you may start to see visibly thinning and bald patches, which can be really distressing.
Tips for managing hair loss:
- Follow a healthy, balanced diet
- Reduce stress
- Avoid using heated styling tools
- Don’t tease your hair
- Schedule a visit with your doctor if hair loss persists
3. Changes in Sex Drive
As you go through the menopausal transition, you might notice your sex drive is changing. Some women can experience increased sex drive, while others experience a decrease.
More than a third of women who are in perimenopause and postmenopause report having sexual difficulties, from a lack of interest in sex to trouble having an orgasm.
Steep decreases in estrogen levels can lead to vaginal dryness and tightness, resulting in discomfort during sex. Thinning of the vaginal wall, also known as vaginal atrophy, is also possible.
Tips for managing decreased libido and uncomfortable sex:
- Vaginal lubricants
- Hormone Replacement Therapy (HRT) if it's the right fit
- Kegel exercises
- Communicating with your partner
- Finding alternate ways to maintain intimacy besides intercourse
Other physical and mental changes, including stress and depression, can also affect your libido. Weight gain is common, and feeling uncomfortable in your new body may decrease your desire. Hot flashes and night sweats can also leave you feeling too tired for intimacy.
4. Anxiety and Depression
During perimenopause, women experience sudden hormonal shifts, making them particularly vulnerable to major depression—especially those who have gone through major depression previously.
Serotonin, the brain chemical that promotes feelings of happiness and well-being, can decrease during menopause, contributing to increased anxiety, sadness, and irritability.
Poor sleep and insomnia partly caused by night sweats make you 10 times more likely to be depressed. Other external stressors can also contribute to increased mood swings and depression.
Menopause symptoms may include:
- Feelings of sadness or depression
- Anger and irritability
- Brain fog (also known as mental fatigue)
- Low self-esteem
- Loss of confidence
For many women, once they reach menopause, their hormones settle down, and most will stop having mood fluctuations. But for those with major depression, it is hard to predict if you’ll experience postmenopausal improvement.
It’s time to talk to your doctor if you are struggling with major depression. Don’t suffer in silence because mood changes are treatable. If you feel suicidal it’s really important to seek help immediately.
The Samaritans 24/7 Crisis Service:
Free and confidential
The fall in estrogen levels in women at menopause is one of the strongest risk factors for developing osteoporosis, which is a condition where bones become brittle and fragile.
Research indicates that up to 20% of bone loss can occur during the menopausal transition.
You can help reduce the risk of osteoporosis by following a few lifestyle recommendations:
- Exercise regularly to improve muscle strength and help reduce falls. Try weight-bearing exercises such as brisk walking, yoga, and Tai Chi. Also, consider strength training and flexibility exercises.
- Eat healthily and get enough calcium and vitamin D. Consider consuming foods such as green leafy vegetables, nuts, milk, prunes, figs, and oily fish.
- Avoid/reduce your use of stimulants. Quit smoking and only drink alcohol and caffeine in moderation.
It’s best to start these healthy habits early in life to gain the most benefits. Prevention is the key, but there are medical treatments available to help manage osteoporosis.
6. Changes in Vision
Vision and eye health can change during the menopausal transition. Declining estrogen can cause:
- Blurred vision: One of the most common vision changes
- Dry Eye Disease: Dry, burning, and itching eyes
- Cataracts: Sensitivity to glare, poor night vision, cloudy vision, double vision, and a loss of color intensity
- Glaucoma: Caused by a loss of estrogen and an increase in eye pressure damaging the optic nerve
Optometrists agree that the best ways of maintaining healthy eyes and maximizing your chances of spotting health problems are:
- Scheduling regular eye tests
- Following a healthy, balanced diet
- Avoiding smoking
- Treating health conditions such as diabetes and high blood pressure
7. Dry Mouth and Dental Problems
Teeth and gums are extremely susceptible to any hormonal changes. As your estrogen levels decline during perimenopause and menopause some people notice:
- Sensitive teeth
- Gum inflammation
- Burning mouth syndrome
- Things taste different
Saliva production is also impacted, causing dry mouth, which can lead to tooth decay. Just as menopause can affect bones, it can also affect the jaw and result in loosening teeth.
Tips for maintaining good oral health:
- Brushing at least twice a day with a soft-bristled brush
- Flossing once a day
- Replacing your toothbrush every 3 to 4 months
- Getting regular dental cleanings and check-ups twice a year
- Consider over-the-counter sprays/rinses targeted to alleviate dry mouth
Try to quit smoking and cut back on sugary food and drink.
8. Weight Gain
It’s common for women to experience weight gain during the menopausal transition.
The most pronounced weight gain is generally seen during perimenopause and in those first few years after your final period, and it is typically centered around your abdomen. Weight gain can continue at about a rate of 1.5 pounds each year as a woman goes through her 50s.
Age-related reductions in metabolism will slow down the rate at which we burn calories. Genetics also play a part, along with life pressures that make it harder to exercise. Lack of quality sleep and stress can also play a role.
Risks associated with extra weight can include:
- Type 2 Diabetes
- High blood pressure
- Heart disease
- Increased menopausal symptoms
The good news is that menopausal weight gain does tend to stabilize. You may have to alter your previous diet and exercise routines if they are no longer working. It’s important to do the following:
- Increase/intensify exercise routines
- Get adequate sleep
- Reduce your stress levels
- Consider a diet such as the Mediterranean Diet
It’s important to get regular medical check-ups. Be honest and open with your doctor and mention all your emotional and physical menopause symptoms even if you are not sure they are related to menopause. That way, your doctor can consider any other possible causes and suggest treatments or programs best suited for you.
NOTE: This blog is intended for informational purposes only and is not a substitute for medical advice. It should not be relied on as health or personal advice. Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or a medical condition.