What are the symptoms of menopause?

During menopause and even in the few months or even years that lead up to the start of it (the period known as perimenopause), you may experience some of the following symptoms:

• Irregular periods - As menopause is fast approaching, your menstrual period will begin to change, these changes are normal. However, if you experience heavy bleeding for more than a week or have any uncomfortable changes, then speak to your doctor or gynaecologist.
• Vaginal dryness – Declining oestrogen levels mean less lubrication ‘down there’ which can lead to vaginal dryness. If this becomes a problem or makes sexual intercourse uncomfortable or even painful, discuss the issue with your doctor who may prescribe vaginal oestrogen (in tablet - Vagifem, cream – Premarin and Estrace or a vaginal oestrogen ring – Estring) or recommend the use of a vaginal moisturizer like Lubrin or Replens or a lubricant like Astroglide or KY before sex.
• Hot flushes - Hot flushes, also known as hot flashes, are the most common symptom of menopause. A hot flush is a brief sensation of heat that may make your neck and face become flushed and result in a flushed complexion, temporary red patches or blotches appearing on your arms, back and chest area. This may also be followed by chills and sweating. These are caused by complex interactions in the body involving a variety of function from fluctuating hormone levels that affect brain chemicals and receptors in the region of the brain, known as the hypothalamus, that controls temperature as well as blood vessels and sweat glands in the body. Hot flushes will vary in their intensity and tend to last about 30 seconds or even 10 minutes and may cause some concern or irritation, especially if you cannot find a way to get cool quickly enough. It can help to dress in light layers of clothing which can be easily removed and while it may seem counterintuitive, to also get regular exercise which has been proven to ease hot flashes. It also helps to avoid any hot or spicy foods. Some women have also noted that managing their stress levels can also be beneficial.
• Night sweats – As with hot flushes, night sweats are primarily due to fluctuating hormone levels and their effect on the body which result in sweating that leads to chills, an increased heart rate as well as a feeling of anxiety. Relaxation breathing techniques may help to reduce incidences of night sweats.
• Sleep issues – Hormones are responsible for a whole lot more than reproduction, they also play a role in sleep regulation. Changes in hormone levels, coupled with night sweats and hot flushes all contribute to difficulty in falling and staying asleep.
• Mood changes - These are due to the change of hormones in your body. A variety of women have reported feelings of depression, irritability and mood swings that range from extreme highs to episodes of severe lows over a short period of time, feeling highly irritable from time to time is also common. It is important to note that these fluctuations in your hormones are normal and feeling down or irritable is not an unnatural thing to go through.
• Thinning hair and dry skin - As you get older, you will start to notice some changes in your hair and skin. This is as a result of the loss of collagen and fatty tissue, making your skin thinner and drier. The loss of these elements will affect the lubrication and elasticity of your skin near your urinary tract and vagina. A reduction in the oestrogen levels may also contribute to hair loss and can make your hair feel dry and brittle. Try to avoid using any harsh chemicals on your hair that can further damage it and it may also be beneficial to take collagen supplements. Speak to your doctor about what is best for you if you encounter these symptoms.
• Slowed metabolism resulting in weight gain - Your metabolism will naturally slow down as you get older. The biggest changes in your body that result in weight gain are the decreasing levels of oestrogen and progesterone. We will get into more detail about this in the next section.
• Breasts losing their fullness – Again this is attributed to the ageing process and lowering of hormone levels.
• Sexual discomfort - With less oestrogen, which often leads to vaginal dryness, intercourse may become painful or uncomfortable. It can help to use a water-based lubricant. Speak to your doctor about what options are available to you and what other factors such as health and lifestyle may be contributing to your sex drive.
• Headaches - Headaches are typically experienced leading up to menopause, during the perimenopause phase, due to the fluctuations of hormones. Some relief lies in the period of postmenopause as migraines tend to stop as your hormones levels stabilise and remain consistently low. 

When to see a doctor

When you start to experience perimenopause, it is advisable to begin regular visits with your doctor in order to receive preventive healthcare and clear up any medical concerns you may have. You are likely to have to continue these appointments during as well as after menopause.

Preventive healthcare can include a number of screenings during menopause such as:

• Colonoscopy
• Mammography
• Lipid screening
• Thyroid testing

If you experience any vaginal bleeding after menopause then you should consult with your doctor immediately.