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Understanding Menopause Symptoms: Beyond Hot Flashes

Word association game:

If I say "MENOPAUSE" your first thought is probably going to be "HOT FLASHES". It's the quintessential symptom and realistically has a huge impact on daily life that it's easy to understand why we think of this first. But it's not the only symptom you may have.

Other common symptoms that happen from the change in your hormones include:

  • Depression, anxiety, or irritability. Up to 40% of women will experience mood changes during menopause?

  • Insomnia: 30-60% of women experience insomnia during perimenopause.

  • Irregular bleeding/menses

  • Vaginal dryness, leading to pain during intercourse or discomfort throughout the day

  • Decreased libido

  • Urinary incontinence or increased urinary frequency

  • Dry eyes

  • Body aches

  • Fatigue

  • Brain fog

Menopause causes depression anxiety mood changes

If you're in your mid-forties and feel like you've really been beyond run-down lately, it might be due to your changing hormones. The symptoms above can understandbly compound and make you feel terrible but may also be subtle enough for you to not have made the connection to menopause, leaving you wondering why you feel so "off".

Depression is not a typical symptom that is thought of with menopause. Why does it even happen? The main factors that are going to impact mood here boil down to: a history of depression, stress (there is a lot going on during this time in your life!), the impact of menopause symptoms on your daily life (if you have a ton of hot flashes this can really depress you, or if you have a lot of body aches this is also going to negatively affect your mood), body image (muscle and metabolic change here is huge), low progesterone, and estrogen fluctuations.

Insomnia is another symptom that has such an overarching impact on how well you feel that I really wanted to elaborate on it. Menopause or not, when a patient comes in and has crumby sleep I know that if I can get them sleeping better the concern that they came in with is going to also improve. Sleep has that effect on us that really cannot be overlooked. In menopause not only are nightsweats waking you up, but the lowered progesterone is also decreasing your ability to get a good night's rest. Research shows that after the transition the sleep issues likely improve so helping with supplements during perimenopause is there to aid in this adjustment period.

There are so many menopause "hacks" out there but it really depends on what your symptoms are that you want help with. This is why it's important to talk to a healthcare provider who is well-versed in the menopause transition to guide you instead of getting talked into buying whatever with a 'menopause' label slapped on it.

Did you know of the other common symptoms that happen during menopause?

  • No!

  • Yup


Süss, Hannah, Jasmine Willi, Jessica Grub, and Ulrike Ehlert. “Estradiol and Progesterone as Resilience Markers? - Findings from the Swiss Perimenopause Study.” Psychoneuroendocrinology 127 (May 2021): 105177.

Kalmbach DA, Cheng P, Arnedt JT, Anderson JR, Roth T, Fellman-Couture C, Williams RA, Drake CL. Treating insomnia improves depression, maladaptive thinking, and hyperarousal in postmenopausal women: comparing cognitive-behavioral therapy for insomnia (CBTI), sleep restriction therapy, and sleep hygiene education. Sleep Med. 2019 Mar;55:124-134. doi: 10.1016/j.sleep.2018.11.019. Epub 2018 Dec 28. PMID: 30785053; PMCID: PMC6503531.

Garcia-Alfaro, P., Garcia, S., Rodriguez, I., & Vergés, C. (2021). Dry eye disease symptoms and quality of life in perimenopausal and postmenopausal women. Climacteric: The Journal of the International Menopause Society, 24(3), 261–266.

Geiger, P. J., Eisenlohr-Moul, T., Gordon, J. L., Rubinow, D. R., & Girdler, S. S. (2019b). Effects of perimenopausal transdermal estradiol on self-reported sleep, independent of its effect on vasomotor symptom bother and depressive symptoms. Menopause (New York, N.Y.), 26(11), 1318–1323.

Chiu, H.-H., Tsao, L.-I., Liu, C.-Y., Lu, Y.-Y., Shih, W.-M., & Wang, P.-H. (2021). Using a short questionnaire of the perimenopausal fatigue scale to evaluate perimenopausal women prone to fatigue syndrome. Taiwanese Journal of Obstetrics & Gynecology, 60(4), 734–738. /j.tjog.2021.05.026


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