5 signs and symptoms of starting menopause

Signs of Starting Menopause
Learn the five signs that may indicate a woman is starting menopause.

As women age, the reproductive cycle begins to slow down and prepares to stop. Hormone levels (estrogen and progesterone) that influence various systems in women’s bodies drop. The decrease in the levels of hormones gives rise to the symptoms of menopause.

Five signs of starting menopause include the following:

  1. Irregular menstrual periods. In the starting months of menopause, women face problems in their menstrual cycle. The next period may come sooner or later than the actual date, and the bleeding may become scanter or heavier. The periods may last for more than a week. However, bleeding after menopause can be a sign of serious issues, such as uterine cancer.
  2. Hot flashes and night sweats. Hot flashes are a sudden feeling of feverish heat, followed by sweating and chills. There could be flushing of the face and neck. The symptoms commonly occur during the night and usually, last between 30 seconds and 10 minutes. Their frequency may range from several times an hour to just one or two times a week. Some women may experience anxiety alongside. Hot flashes last for three to five years after they start but can even persist after menopause.
  3. Insomnia. Insomnia is the inability to stay or fall asleep. Women may find they cannot sleep for as long as they used to sleep earlier and have to get up often during the night. Difficulty sleeping may be caused by hot flashes that are common during the night or may be caused by the changing estrogen levels ahead of menopause.
  4. Vaginal drynessThe decreasing estrogen levels can cause the vagina to become dry. The dryness may cause itchiness and irritation of the vagina. Affected women may experience pain during sex.
  5. Mood changes. There is no clear cause of why mood changes happen during menopause. It may be due to insomnia and hormonal changes that can make women irritable and experience sudden mood shifts. Some women experience an inability to manage their daily stress, whereas some develop mental health issues, such as depression and anxiety.

5 other problems that can come with menopause

  1. Heart problems: Although men have higher chances of developing cardiovascular disorders, such as coronary artery disease, than young women, the scenario changes after women attain menopause. After the age of 60 years old, women are more likely to die from heart issues compared to men of the same age. Women who experience menopause as early as before the age of 35 years old have their chances of developing heart disease go up steadily as they age.
  2. Decrease in bone density: Osteoporosis is the thinning of bones that makes them prone to fracture, particularly of the hip and spine. This happens when the bones lose calcium and bone density reduces. At the age of 65 years old, about three out of 10 women have osteoporosis. After the age of 80 years old, the number of women with osteoporosis goes up with as many as eight out of 10 women experiencing the condition. The decreased bone density makes women more likely to experience tooth decay.
  3. Problems of the urinary tract: The drop in estrogen levels brought on by menopause can thin the linings of the urethra and bladder and result in problems, including
    • Stress incontinence. The involuntary passing of a small amount of urine while sneezing or lifting heavy weights due to post-menopausal loss of bladder control.
    • Urge incontinence. A sudden and frequent urge to urinate due to an overactive bladder.
    • Nocturia. Women with post-menopausal bladder control problems may have to get up in the middle of the night due to the urge to urinate.
    • Painful urination. Some women feel pain in the urethra while urinating. Because of low estrogen levels that cause thinning of the vagina (vaginal atrophy), the odds of developing recurrent urinary tract infections in women after menopause increase.
  4. Weight gain: The hormonal changes during and after menopause contribute to the body changes, such as weight gain, particularly between the ages of 50 and 59 years. Women who gain weight around the abdomen increase their chances of developing heart disorders and diabetes.
  5. Skin and hair issues: Due to decreased estrogen levels, women develop skin dryness and wrinkles. They may experience dry hair and temporary hair loss.


If menopause occurs in a woman younger than ___ years, it is considered to be premature. See Answer

How do doctors diagnose menopause?

The doctor usually diagnoses menopause after taking the menstrual history of the patient that includes the gaps between two periods, the amount of blood flow during periods, and the time passed since the last period. Generally, the absence of periods for at least 12 months counts as menopause.

A blood test that measures the levels of the follicular stimulating hormone can help the doctor ascertain their diagnosis of menopause. However, for many women, a blood test is not necessary. Most of the time, their menstrual history is enough to diagnose menopause.

What is the best treatment for menopause-related health problems?

Many women can usually deal with their menopause by following a healthy eating pattern and by being physically active. If the symptoms of menopause start to become bothering, women can talk to their doctor.

There are many treatment options that the doctor can suggest to make women feel at ease during and after menopause. These include hormonal treatments and nonhormonal treatments. Women need to discuss with their doctors about the right treatment for them.

Hormonal therapy (also called hormone replacement therapy or HRT)

  • Estrogen therapy. Estrogen therapy involves taking estrogen in the form of pills, skin patches, and vaginal creams. The therapy is often prescribed for women who have had a hysterectomy.
  • Estrogen and progesterone or progestin hormone therapy. Often called combination therapy, estrogen and progesterone or progestin hormone therapy are meant for women who still have their uterus. Taking estrogen with progesterone lowers women’s risk of uterine cancer after menopause.

Nonhormonal therapy

  • Treatment of specific symptoms of menopause (if required). For example, estrogen alternatives, also called synthetic estrogens, such as ospemifene, can help improve symptoms of vaginal atrophy, such as dryness, itching of the vagina, and painful sex.
  • Healthy diet. Women should follow a diet that contains all types of food groups, such as whole grains, beans, nuts and seeds, fish, and plenty of fruits and vegetables. They should avoid foods and beverages that may cause hot flashes, such as spicy foods, alcohol, coffee, and tea.
  • Regular exercises. Regular exercises not only keep the weight under check but can also act as a stress buster and help women deal with mood changes.

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Medically Reviewed on 10/10/2022
Image Source: iStock Images

Coney, P. "Menopause." Medscape. Sept. 11, 2021. <https://emedicine.medscape.com/article/264088-overview>.

"Menopause." Mount Sinai. <https://www.mountsinai.org/health-library/report/menopause>.