What Are the 34 Symptoms of Menopause?
For many women, the onset of menopausal symptoms can feel like navigating uncharted waters without a map. The sudden waves of change, physically, mentally and emotionally, often catch us by surprise. Surprisingly, despite menopause being a natural phase that every woman will eventually face, many find themselves unprepared, often mistaking one of these 34 symptoms of menopause for isolated health issues or simply attributing them to age.
In fact, a recent survey revealed that 49% of participants did not feel informed about menopause, and 90% of postmenopausal women were never taught about menopause in school.
Fortunately, more women are beginning to embrace this stage of life with curiosity rather than dread. With the right knowledge, menopause can become a powerful and empowering transition instead of something to fear.
When does menopause start?
While the average age of menopause is 51, women can start experiencing symptoms of menopause much earlier. In fact, perimenopause, the actual transition period into menopause, can begin as early as your mid-30s and last for years. When symptoms strike, especially when you are on the younger side, they can catch you off guard.
What are the 34 symptoms of menopause?
Understanding the 34 symptoms of menopause is like arming yourself with a well-stocked toolkit for this major life transition. 80% of women will experience at least one symptom during perimenopause, and being aware of what lies ahead prepares us mentally and emotionally. It can also help us to distinguish between normal changes and potential health concerns.
Early recognition of menopausal symptoms allows us to seek timely medical advice and interventions if needed. Moreover, knowing that countless women share similar experiences can be immensely reassuring and comforting during moments of frustration.
It’s important to know that every woman’s journey through menopause is different. Some will be lucky enough to experience little to no symptoms, while others will feel their life is turned upside down. And while hot flashes and irregular periods are often expected, there can be some unusual menopause symptoms that you may not even be aware of.
If you are experiencing any of these 34 symptoms of menopause, talk to your healthcare provider about ways to manage them.
1. Hot flashes
The most common menopausal symptom is hot flashes. You may hear them referred to by their medical term: vasomotor symptoms, or VMS for short.
The exact cause of hot flashes is still not fully understood, but changes in hormone levels and an alteration in our body’s internal thermostat, the hypothalamus, play a role.
The intensity of hot flashes is different for everyone, but most women report they feel like a sudden warm sensation, usually on the upper body, face, neck, and chest. It may be associated with drenching sweat, reddening of the face, and a rapid heart rate. They tend to last anywhere from 30 seconds to a few minutes.
2. Night sweats
Meet hot flash’s ugly step-sister, night sweats. Night sweats are basically hot flashes that happen at night, waking you up from your peaceful slumber. In general, hot flashes tend to be more intense but short, while night sweats may be more gradual and produce more sweating.
3. Irregular periods
As ovulation becomes more unpredictable, so does your period. In the early part of perimenopause, there tends to be a shortening of cycle length, followed by progressively longer time periods between cycles. You never know what you are going to get from your flow. One month can be light, and the next month it can seem like a crime scene.
4. Vaginal dryness
Loss of estrogen during the menopause transition can cause the tissue of the vagina to become thin and dry. You may notice pain during sex and may even be sensitive to certain clothes or wiping after you go to the bathroom. It’s not uncommon to experience itching, burning, or irritation.
5. Mood swings
4 out of 10 women experience severe mood swings during this time of life. One moment, you feel upbeat and cheerful, and the next, overwhelmed with irritability or sadness.
Fluctuating hormone levels, particularly estrogen and progesterone, play a significant role in these emotional changes. Changes in sleep quality can make matters worse, not to mention dealing with the other menopausal symptoms and stressors that come with being a mid-life woman.
Mood swings can also signify something more severe. Risk for anxiety and depression is increased during this time, so it’s important to talk to your healthcare provider about changes to your mood.
6. Weight gain and belly fat
One of the most dreaded and distressing of the 34 menopause symptoms is the unwanted change in body composition. The changes in hormone levels can contribute to changes in metabolism and body composition. As estrogen plays a role in regulating body weight and fat distribution, its decline can gradually redistribute fat from the hips and thighs to the abdomen. This shift in fat storage and changes in metabolism often result in weight gain for many women.
7. Sleep disturbances and insomnia
Sleep disturbances are a common symptom of menopause. In fact, almost 50% of women experience sleep problems during this time.
Hot flashes and night sweats can contribute to restless nights. Changes in sex hormones also play a role as they impact melatonin and serotonin levels, both of which play a critical role in sleep.
8. Fatigue and tiredness
With the significant impact menopause has on sleep, it’s no surprise that women feel more daytime fatigue. Just getting through the day can feel like a challenge, especially when you’re juggling hot flashes, night sweats, and restless sleep. Hormonal changes can also directly affect energy levels and contribute to a persistent sense of exhaustion. If fatigue is worsening or interfering with daily life, it’s worth discussing with your healthcare provider. It may be related to menopause—or something else entirely, like thyroid issues, iron deficiency, or sleep apnea.
9. Decreased libido
Decreased sex drive is a common but highly sensitive topic that many women face during the menopause transition. This decline in sexual desire can be attributed to the significant hormonal changes occurring in a woman’s body. Some of these changes may be a consequence of menopause, while other changes are due to the aging process.
Other factors can decrease sex drive during this time in a woman’s life. As estrogen and progesterone levels drop, the natural lubrication and blood flow to the genital area may diminish, leading to discomfort and reduced sensitivity. Changes in body weight, fatigue, mood and poor sleep can also affect one’s desire for intimacy.
10. Anxiety and/or depression
Many people may think that anxiety and depression are unusual menopause symptoms; however, they are pretty common. Studies have shown that up to 23% of women may experience mood disturbances, as the fluctuations in estrogen impact neurotransmitters, including GABA and serotonin.
Progesterone, commonly called the “relaxation hormone,” declines during this time, making us more short-tempered and less able to cope with stress.
Life changes and sleep disturbances can further contribute to the risk of developing depression and anxiety, and according to Johns Hopkins Medicine, if you’ve had depression before, you are more likely to experience it again during menopause.
If you don’t feel yourself and notice it impacting your everyday activities, getting help is critical. There are many treatments that can help, from lifestyle behaviors to therapy and even medication.
11. Thinning hair
The role of estrogen in the body is far-reaching, so symptoms of menopause can impact several different parts of the body, including your skin and hair. The decrease in estrogen can lead to changes in hair texture and density that leave it brittle, fine, and prone to breakage. Additionally, the reduction in estrogen can affect the hair’s growth cycle, potentially leading to increased shedding.
12. Facial hair
While the hair on your head may be starting to thin, unwanted new hair growth on your face may be sprouting. Androgens like testosterone are hormones typically associated with male traits, such as facial hair growth. Women have testosterone too, but when the ratio of estrogen to androgens changes, some women may notice thick hair on the chin, upper lip, and face.
13. Dry skin
Dry, itchy skin is a common complaint during the menopause transition. Estrogen plays a vital role in maintaining skin’s moisture and elasticity and helps to regulate the production of collagen and oils that keep the skin supple and hydrated. As estrogen declines, the skin’s ability to retain moisture diminishes, leading to dryness, itchiness, and an overall dull appearance.
Furthermore, lower estrogen levels can affect the skin’s natural barrier function, making it more susceptible to environmental factors and moisture loss. The drop in estrogen also influences sebum production, which can result in changes in skin texture and oiliness.
14. Skin wrinkles
Collagen production is heavily influenced by estrogen production, so it’s no surprise that as estrogen levels decline, the skin can become thinner and more prone to wrinkles. Studies estimate that women lose approximately 30% of their skin collagen in the first five years after menopause. It impacts more than just the skin on our face. This significant loss contributes to decreased skin elasticity and integrity, leading to increased wrinkling, bruising, and slower wound healing all over our bodies.
15. Memory problems and brain fog
Brain fog, often described as a sense of mental fuzziness or difficulty concentrating, is a dominant symptom experienced by many women during menopause. Estrogen plays a multifaceted role in the brain, aiding in the regulation of neurotransmitters and maintaining cognitive function. As estrogen levels decline, neurotransmitter activity can become less efficient, leading to challenges in memory, focus, and mental clarity. The hormonal fluctuations can also affect sleep patterns, contributing to fatigue and difficulty concentrating during the day.
This decline in estrogen may also contribute to an increased risk of neurodegenerative diseases, such as Alzheimer’s, particularly in women as they age.
16. Headaches and migraines
Once again, declining estrogen levels can produce unusual menopause symptoms. This time, it’s due to estrogen’s impact on neurotransmitters and blood vessels in the brain. Fluctuations in estrogen can trigger migraines by affecting the dilation and constriction of blood vessels in the brain, potentially leading to changes in blood flow to the brain. Tension headaches can also be impacted by hormonal changes.
17. Joint pain and stiffness
Around the time of menopause, almost half of women will experience joint pain. Estrogen plays a role in maintaining joint health by helping to regulate inflammation and supporting collagen production, a protein that provides structure to joints and other connective tissues.
Estrogen also has anti-inflammatory properties, so as it decreases inflammation in the joints can occur.
Moreover, as women age, natural wear and tear on joints can also contribute to joint pain, and menopause can coincide with the onset or exacerbation of conditions like osteoarthritis.
18. Digestive issues and bloating
Surprisingly, perimenopause can impact our digestive system in several ways. Changes in estrogen levels can affect the motility of the intestines, leading to irregular bowel movements, bloating, and constipation. Moreover, the drop in estrogen can influence the balance of gut bacteria, also called the estrobalome, which plays a crucial role in maintaining healthy digestion. Stress, which can become more pronounced during menopause, might also exacerbate digestive issues, as it can influence gut function and contribute to symptoms such as irritable bowel syndrome (IBS).
19. Incontinence or frequent urination
Incontinence and urinary issues are prevalent concerns that some women face during the menopausal transition, and their emergence can be attributed to a combination of hormonal changes, aging-related factors, and the effects of childbirth.
Declining estrogen levels can weaken the muscles that support the bladder and urethra, leading to stress urinary incontinence, a condition where activities like sneezing, laughing, or lifting can trigger leakage. Additionally, the loss of estrogen can affect the elasticity of the urethral tissues, potentially contributing to urinary urgency and frequency.
Childbirth, especially if it involves vaginal delivery, can also contribute to weakened pelvic floor muscles and urinary issues. Furthermore, as women age, the muscles and connective tissues that support the bladder and urethra naturally weaken, increasing the likelihood of urinary problems.
20. Breast tenderness
Breast tenderness is a common symptom of premenstrual syndrome due to fluctuating hormone levels, so it’s no surprise that it is on of the 34 symptoms of menopause as well. Estrogen and progesterone play a role in breast health, and as hormone levels rise and fall, the tissue can become more sensitive and responsive, resulting in sensations of soreness, swelling, or discomfort.
21. Changes in body order
Some women report a shift in their body odor as they go through menopause. Hormonal changes can alter the way sweat is produced, leading to a more pronounced or different odor than before. Additionally, the extra sweat from hot flashes and night sweats can encourage the growth of bacteria under your arms, leaving you with unpleasant changes in smell.
According to Harvard Health Publishing, our sense of smell can change during this time, so we may think we smell poorly, even if we don’t.
22. Gum problems and oral health changes
A lesser-known and unusual symptom of menopause pertains to oral health. As estrogen levels drop during this transition, many women may experience changes in their gums, including increased sensitivity, bleeding, and a higher susceptibility to gum disease. This hormonal shift can also lead to a decrease in saliva production, resulting in dry mouth, which not only causes discomfort but can also increase the risk of cavities and tooth decay. Furthermore, changes in the oral mucosa can lead to feelings of burning or pain, often termed “burning mouth syndrome.”
Declining estrogen levels can also contribute to bone loss in the jaw, which may increase the risk of tooth loss and compromise the overall structure that supports dental health.
23. Palpitations and irregular heartbeats
Some women report feeling like their heart is fluttering, racing, or skipping beats during perimenopause and menopause, and heart palpitations are indeed one of the 34 symptoms of menopause. These palpitations are often due to hormonal fluctuations, particularly estrogen’s influence on the cardiovascular system. While occasional irregular heartbeats can be harmless, it’s important to rule out any underlying cardiac conditions with your doctor.
24. Allergies and food sensitivities
An unusual menopause symptom that often goes under the radar is an increase in allergic reactions or sensitivities to foods, chemicals, or environmental factors. Estrogen affects immune system regulation, and when levels drop, some women may find themselves suddenly sensitive to things that never bothered them before.
25. Changes in cholesterol
It’s not uncommon for women who’ve had healthy cholesterol levels their entire lives to see unfavorable changes during menopause. Estrogen has a protective effect on lipid metabolism, and as levels decline, LDL (“bad” cholesterol) often rises while HDL (“good” cholesterol) may drop. These shifts can increase the risk of cardiovascular disease, the leading cause of death in women. In fact, the risk of heart disease significantly increases after menopause, making it a critical time to monitor cardiovascular health.
26. Insulin resistance
Estrogen and progesterone both play a role in how your body responds to insulin, and as their levels decline, insulin sensitivity may decrease. This means your body may become less efficient at moving glucose from your bloodstream into your cells, leading to higher blood sugar levels.
As a result, some women may notice new blood sugar fluctuations or even develop insulin resistance during or after the menopausal transition. This can contribute to weight gain, energy crashes, and increased cravings, especially for carbohydrates and sweets. Over time, these changes may raise the risk for type 2 diabetes and other metabolic concerns if left unaddressed.
27. Frozen Shoulder
One of the more surprising and lesser-known symptoms of menopause is frozen shoulder, also known as adhesive capsulitis. While not exclusive to menopausal women, it’s significantly more common in women between the ages of 40 and 60, right when hormone levels begin to shift.The connection isn’t entirely understood, but researchers believe that the decline in estrogen may contribute to increased inflammation and changes in connective tissue, making joints, particularly the shoulder, more vulnerable. Frozen shoulder typically develops gradually and is characterized by pain, stiffness, and limited range of motion that can last for months or even years.
28. Decline in muscle mass and strength
Another of the 34 symptoms of menopause are the changes that happen to muscle. Loss of estrogen contributes to sarcopenia—the age-related loss of muscle mass. As muscle declines, it can affect strength, metabolism, and even balance, increasing the risk of falls and fractures. Beyond mobility, low muscle mass has been linked to higher rates of chronic disease and even increased mortality in older adults, making it one of the more serious yet underrecognized consequences of menopause.
29. Dizziness and balance issues
Some women report occasional dizziness or feeling off balance during perimenopause. These symptoms may be linked to hormonal changes, blood pressure fluctuations, or even inner ear issues. If dizziness is persistent or severe, it’s important to get checked out.
30. Changes in taste and smell
On the list of 34 symptoms of menopuase are changes in taste and smell. Some women notice that their favorite foods taste different or that their sense of smell isn’t what it used to be. Additionally, women may notice “phantom smells” where they smell something, but there is no obvious cause of that scent. These sensory shifts may be due to hormone-related changes in the nervous system or oral health.
31. Ringing in the ear
Another unusual menopause symptom is ringing in the ears, also known as tinnitus. While it’s not fully understood, some researchers believe that hormonal fluctuations, particularly the decline in estrogen, may affect the auditory pathways or blood flow to the inner ear. This can result in a persistent ringing, buzzing, or whooshing sound in one or both ears. Tinnitus during menopause may also be worsened by stress, sleep disturbances, or other co-occurring symptoms, making it especially frustrating to manage.
32. Electric shock or tingling
Some women experience strange zapping sensations or tingling in their limbs, hands, or feet, often described as “electric shocks.” Though rare, these unusual menopause symptoms may be related to changing estrogen levels affecting the nervous system. Persistent symptoms should be evaluated to rule out other neurological causes.
33. Worsening (or new onset) ADHD
If you’ve been diagnosed with ADHD or suspect you might have it, menopause can bring on a whole new level of challenges. Estrogen plays a key role in regulating dopamine, a neurotransmitter involved in attention, motivation, and executive function. As estrogen declines, many women report worsening ADHD symptoms, including increased distractibility, forgetfulness, and difficulty staying organized.
For some, this stage of life is when ADHD is first recognized, as hormonal changes unmask symptoms that were previously manageable. Unfortunately, ADHD in midlife women is still underdiagnosed and misunderstood, making it important to speak with a knowledgeable provider if you notice significant changes in focus or mental clarity.
34. Dry and brittle nails
Long gone are the days of manicures that last forever. Like the skin, estrogen helps maintain nail health, and declining levels can lead to nails that are dry, ridged, or prone to breaking.
Final thoughts: Clarity on the 34 symptoms of menopause
While this list of 34 symptoms of menopause may seem overwhelming, remember: not every woman will experience all of them, and the intensity can vary widely from person to person. The good news is, you don’t have to tough it out alone. From nutrition and lifestyle changes to hormone therapy and non-hormonal medications, a menopause-informed healthcare provider can help you find relief and support.
Sometimes, simply understanding what’s happening in your body is the first step toward moving from fear to confidence—and taking back control of this transition.
If this was helpful, share it with another woman in your life who might be navigating perimenopause. No one should have to go through this feeling confused or alone.
