Signs and Symptoms of Menopause: A Complete Guide

Menopause is often whispered about but rarely fully understood. It’s not just about missed periods — it’s a profound biological shift that rewrites the rulebook on how a woman’s body feels and functions. From sudden hot flashes to mood swings that catch you off guard, this phase invites women into a new chapter filled with both challenges and a sense of renewal. 

Recognising the signs and symptoms of menopause is the first step towards embracing this change with confidence. Here we'll help you unpack what to expect emotionally and physically, and explore practical ways to support hormonal balance during this transformative time.

What are the first signs of menopause?

Every woman's experience with menopause is unique, and the set of challenges they face also varies. While some women sail through menopause with minimal disruption, others experience prolonged discomfort and extreme changes. 

Some of the common signs and symptoms of menopause have been listed below: 

• Irregular periods: Changes in the flow, severity, duration, and frequency of menstrual periods are hallmarks of menopause. These fluctuations typically begin during perimenopause (the transitional phase leading up to menopause). Some women may experience lighter or heavier bleeding, longer or shorter cycles, or even skipped periods. All of these changes occur due to declining levels of oestrogen and progesterone. Heavy bleeding with clots should be investigated to rule out any underlying pathology. During perimenopause, periods usually become infrequent and lighter, rather than heavier.

• Hot flashes and night sweats: Many women report sudden sensations of heat, known as hot flashes, as if the body’s internal thermostat has been cranked up. Night sweats are essentially hot flashes that occur during the night. It disrupts your sleep and creates feelings of fatigue, irritability, and overall discomfort. 

• Vaginal dryness: Women during menopause experience vaginal changes due to a sudden dip in oestrogen levels. During menopause, the walls of the vagina dilate and lose their elasticity, blood flow, and lubrication. These changes can lead to reduced arousal and a general decline in sexual desire. 

• Mood swings and anxiety: Many women report symptoms of irritability, low moods, and anxiety during menopause. Fluctuating hormone levels, especially the drop in oestrogen, can affect neurotransmitters like serotonin (the happy hormone responsible for regulating your mood). As a result, plummeting levels of these hormones lead to increased anxiety, irritability, and other mood swings during this period. Menopause depression can also worsen if left unaddressed. 

• Memory lapses or brain fog: Memory lapses and fuzzy thinking are common symptoms of menopause. Low levels of oestrogen can impact cognitive functions like concentration, focus, and memory,  often leaving women feeling forgetful.

• Weight gain: Many women in menopause experience weight gain, particularly around the midsection. Low oestrogen levels are directly linked to a slower metabolic rate, leading to changes in body composition, uneven fat distribution and menopause bloating. 

• Joint pain and muscle stiffness: Many women experience aches and stiffness in their joints and muscles during menopause. This can make daily movements feel more difficult, reduce flexibility, and contribute to overall discomfort, often worsening in the morning or after periods of inactivity.

• Breast tenderness: Some women notice increased sensitivity, swelling, or soreness in their breasts during menopause. These changes are linked to fluctuating hormone levels and can cause discomfort or a heavy feeling in the chest.

Emotional and mental health symptoms

During menopause, the ovaries, which produce up to 80% of the key reproductive hormones like oestrogen, progesterone, and testosterone, start depleting at the onset of menopause. All of these factors could trigger other menopause symptoms, which can be both physically uncomfortable and emotionally overwhelming. 

As the hormones zigzag out of control, many women go through a turmoil of emotions like mood swings, self-doubt, and overthinking. Some of the most common emotional and mental health symptoms include: 

• Mood changes: Many women deal with persistent feelings of anxiety, sadness, irritability, frustration, or even depression. 

• Changes in cognitive functions: Memory lapses and brain fog are common during this time. Difficulty concentrating, low focus levels, and being indecisive are some of the common signs of menopause that can feel more challenging. 

• Difficulty in managing stress: Completing tasks, coping with stressful situations, and dealing with problems effectively becomes tough during menopause, which was once felt manageable.

• Loss of interest: Sleep disturbances, hormonal imbalance, and chronic fatigue can lead to a general disinterest in hobbies, socialising, or trying new things.

Severe menopause and perimenopause symptoms

While many women experience mild to moderate symptoms during menopause and perimenopause, some face more severe and disruptive changes that can significantly impact their quality of life. Here are some severe signs and symptoms of menopause to watch for:

• Intense or frequent hot flashes: Severe and prolonged hot flashes can lead to sleep disturbances, fatigue, and anxiety. 

• Persistent vaginal discomfort: Severe vaginal dryness can lead to discomfort, reduced sexual drive or pain during intercourse, and increased risk of infections if left unaddressed. 

• Extreme fatigue: Not your general tiredness, but sapping fatigue that makes you weak and constantly feel low on energy.

• Palpitations or irregular heartbeat: Some women experience palpitations or a racing heartbeat when they are hit by sudden hot flashes, extreme fatigue, or mood disorders. 

• Insomnia: Hormonal imbalances can interfere with your ability to fall asleep or get quality sleep. 

• Severe mood swings: Prolonged episodes of menopause depression, anxiety, and stress can lead to extreme mood disorders and hamper daily functioning.

When do menopause symptoms stop, or do they?

One of the most common questions women ask during menopause is, 'Will the menopause symptoms ever end?'. The answer, unfortunately, is often ambiguous. Menopause is officially marked when you’ve gone 12 straight months without a period, signalling the end of your reproductive years. For some women, symptoms like hot flashes, night sweats, and brain fog gradually fade. For others, they may linger in milder forms or come and go unpredictably. 

Let’s redefine menopause

It is time that society redefines menopause, not as the end of fertility, but as the beginning of a new chapter marked by wisdom, strength, and resilience. Shifting our mindset to celebrate this transition, rather than fear it, can make all the difference. When paired with mindful lifestyle tweaks, consistent physical activity, and a positive attitude, women can navigate the signs of menopause with greater ease and newfound confidence. Fueling your body with the right balance of nutrient-dense foods, healthy lifestyle choices, and regular movement is key to managing menopause symptoms and staying energised. 

Frequently Asked Questions

1. What are the first signs of menopause?

The earliest signs usually appear during perimenopause and can include irregular periods, hot flashes, night sweats, mood swings, sleep disturbances, and vaginal dryness. 

2. How long do menopause symptoms last?

Menopause symptoms can begin several years before your periods stop and may continue for years afterwards. On average, symptoms last about 4 to 7 years. 

3. Can menopause symptoms come and go?

Yes. Many symptoms, especially hot flashes, mood changes, and brain fog, can be intermittent. You might have good days and tough days, or even symptom-free weeks followed by a flare-up.