Symptoms

The duration and severity of menopause symptoms vary markedly. They typically last for five to seven years, but some women continue to experience them for up to 10-15 years.

• Hot flushes and night sweats
  Vasomotor symptoms are the most commonly experienced menopausal symptoms. Hot flushes are often described as a sudden sensation of heat in the chest, face and head, followed by flushing, perspiration and sometimes chills. Headaches and palpitations are other common vasomotor symptoms.
• Urogenital symptoms
  Urinary and genital symptoms occur due to the effects of diminishing oestrogen levels, which cause thinning and shrinking of the tissues of the vulva, vagina, urethra and bladder. Multiple symptoms can result, including vaginal dryness, vaginal irritation, and urinary symptoms such as a frequent need to urinate and urinary tract infections. Loss of oestrogen changes the urethral and vaginal bacterial flora, resulting in a higher (more alkaline) pH, predisposing both to infection.
  As women age, a loss of muscular tone of the pelvic floor muscles together with thinning of vaginal and urethral tissue can lead to urinary incontinence. There may be insufficient vaginal secretions for comfortable sexual activity, so discomfort or pain on intercourse (dyspareunia) may be experienced.
• Altered sexual function
  Some women experience lower libido (sex drive) during and after perimenopause, partly due to diminishing levels of oestrogen and testosterone. Vaginal dryness, leading to discomfort or pain during intercourse, may further reduce libido. However, some women experience higher libido once they no longer need to use contraception or worry about the risk of pregnancy.
• Musculoskeletal symptoms
  Joint, bone and muscle pain may be experienced and are commonly reported, alongside tiredness.
• Sleep disturbance and fatigue
  Some women notice disturbed sleep in association with irritability, poor concentration and depression. Night sweats can further cause or aggravate disturbed sleep. Sleep deprivation can lead to fatigue during the day and difficulty concentrating on tasks at work or home.
• Mood disorders
  It is common for women to experience loss of confidence, low mood, irritability, forgetfulness, difficulty concentrating, panic attacks, anxiety and depression at the time of the menopause. It is important to recognise these features and provide reassurance and support.
• Hair and nail changes
  Many women notice that their hair grows more slowly and becomes thinner. Nails can also become brittle.