Menopause symptoms: What to expect

Whether someone is just entering perimenopause (the transitional stage before menopause) or they are already experiencing menopause, many symptoms of these stages of life can disrupt their day-to-day experiences and affect their well-being.

No matter where someone is on their menopause journey, the more they know about the symptoms, the easier it will be to address them.

Here’s an overview of the most common symptoms as well as information about options to help address symptoms. 

In this article: 

Perimenopause symptoms

Menopause can be broken into several stages, including premenopause, perimenopause, menopause and postmenopause.

During premenopause, people typically won’t experience any symptoms. But during perimenopause, which typically begins in a person’s forties and lasts for several years, the body starts reacting to a slowing in hormone production.

“Someone might have breast tenderness, migraines, hot flashes, night sweats, joint aches, sleep disturbances, anxiety and irritability,” says Stephanie Faubion, MD, director of the Mayo Clinic Center for Women’s Health and medical director of The Menopause Society.

Other common symptoms include:

• Dry skin
• Insomnia or difficulty sleeping
• Irregular periods (lighter flow, heavier flow and shorter or longer cycles)
• Mood changes (such as depression)
• Weight gain
• Vaginal dryness

If someone has any of these symptoms, they should speak to a health care provider, who can help them determine if they have begun perimenopause. Health care providers can also share ways that may help people manage the discomfort that can come with perimenopause. 

Menopause symptoms

A person is considered to have reached menopause about 12 months after their last menstrual period. Menopause and later-stage perimenopause symptoms may be similar. Although these symptoms may occur at different times, some may last longer than others, and some will disappear altogether.

Postmenopausal symptoms

After menopause, a person is in the postmenopausal stage for the rest of their life. “It doesn’t necessarily feel different,” Dr. Faubion says, “People in this stage are just not having periods.”

During this time, people may still experience some symptoms, such as changes in sex drive, hair loss, hot flashes, urinary incontinence and others. Symptoms may be less intense and diminish over time depending on someone’s age of onset, their genetic factors and other lifestyle factors.

Because estrogen levels are low and will remain so (unless a person goes on hormone replacement therapy), people likely won’t experience the fluctuating hormones of perimenopause again. Symptoms like sore breasts, increased migraines and mood swings should lessen or disappear over time.

If any symptoms continue to be too intense or concerning, consult a health care provider to see if an underlying condition may be at play.

What can a hot flash feel like?

Hot flashes — waves of full-body heat that come on suddenly — are the most common menopause symptom, experienced by approximately 75% of people.

“We know hot flashes are not the same for everyone,” says Lisa Larkin, MD, president of The Menopause Society. One-third of people experiencing menopause have more than 10 hot flashes a day. Some experience hot flashes that are so intense they break out in a drenching sweat. Others may just feel extremely uncomfortable until the hot flash passes (a few seconds to five minutes or longer).

Natural options for hot flashes

While there are no natural products that can cure hot flashes, there are some easy ways to support relief, including:

• Dressing in light layers that can be shed easily when a hot flash occurs.
• Maintaining a healthy weight, as obesity may be a risk factor for hot flashes.
• Noticing whether alcohol, caffeine or spicy foods trigger hot flashes — and if so, avoiding them when possible.
• Practicing mindful breathing or meditation techniques to stay calm. Mood changes and stress may trigger hot flashes.
• Sleeping in a cool bedroom, with lightly layered bedding.
• Using a portable fan. 

Coping strategies for menopause symptoms

Depending on someone’s menopause symptoms, a health care provider may review prescription options with them. In addition, there are lifestyle changes and at-home strategies people can try to help mitigate their discomfort.

As with any over-the-counter medicine (OTC) or supplement, speak with a health care provider first before starting or stopping any therapy.

Some coping strategies include:

• Maintaining a healthy diet filled with whole grains, lean proteins and fresh produce.
• Quitting smoking.
• Staying active and incorporating weight training for better bone health into an exercise routine.
• Sticking to a regular sleep-wake schedule.
• Talking to a health care provider about menopause supplements. However, other than calcium and vitamin D supplements, science hasn’t confirmed consistent benefits of any other supplement.
• Trying mindful meditation, acupuncture or both.
• Trying vaginal moisturizers to help replace moisture loss.

When to seek medical attention

There is never a wrong time to discuss new or bothersome symptoms with a health care provider. If someone suspects their symptoms might be related to perimenopause or menopause, they should say so.

Having a frank discussion with a health care provider about symptoms may help someone frame what they’re going through and put them on the path to symptom relief support.