Navigating midlife years can be a challenging journey for many women, especially due to the gap in menopause education. So many women are experiencing the same symptoms and have no idea they are due to hormonal changes!

So let’s talk about the science: During perimenopause, estrogen and progesterone levels can fluctuate drastically, causing many bothersome symptoms. Once you have gone 12 months without a period, you are considered menopausal, which is when your estrogen and progesterone hormone levels will remain low. Although the average age of menopause is 51, women can start to experience symptoms of hormonal changes beginning in their late 30s… That's the majority of our lives!

Most women are familiar with menopausal symptoms such as hot flashes and night sweats, but are you aware of the myriad of other symptoms associated with these hormonal changes?

Here are the top 34 menopause symptoms that could be affecting you:

1. Hot flashes

Hot flashes, a type of vasomotor symptom, are some of the most common symptoms of menopause. They cause you to become suddenly hot, sweaty and flushed in the face, neck and chest. The fear of when the next hot flash will strike is a major concern for most women in menopause.

2. Night sweats

Night sweats are also a type of vasomotor symptom and extremely common in menopause. They are hot flashes that can cause you to be abruptly awakened in your sleep, soaking bed sheets and dripping with sweat. Night sweats can lead to poor sleep, weight gain and feeling tired during the day.

3. Irregular and heavy periods

As you start transitioning toward menopause, your cycles can become irregular or space out before stopping completely. Sometimes they also become heavier. Pregnancy can still occur during this time, so use protection!

4. Vaginal dryness and discomfort

Estrogen receptors in the vagina control the natural lubrication of the tissues. When estrogen levels decrease, the vaginal tissue can become thinner and more dry, causing irritation and itchiness - similar to what a yeast infection feels like.

5. Painful sex

With lower levels of estrogen, vaginal tissue can become less elastic and less lubricated. This “sandpaper” sensation can ruin your sex life.

6. Decreased libido

Libido can be directly influenced by decreased levels of estrogen and testosterone in menopause. It can also be related to other menopause symptoms, such as painful sex, mood changes, fatigue and low self-esteem.

7. Difficulty reaching orgasm

Decreased blood flow to the genital tissues can make reaching orgasm more challenging and sex less enjoyable.

8. Frequent vaginal infections

Estrogen receptors in the vagina not only improve lubrication, but can also keep vaginal pH balanced. Decreased estrogen can make the vagina more vulnerable to vaginal infections, such as yeast infections or bacterial vaginosis.

9. Urinary urgency, frequency or incontinence

Estrogen receptors line the urinary tract and pelvic muscles, so a decrease in estrogen can cause many uncomfortable urinary symptoms that can mimic a UTI.

10. Frequent urinary tract infections

Decreased estrogen can alter the protective microflora of the urinary system and cause anatomical changes that can make you more vulnerable to UTIs.

11. Pelvic organ prolapse

Because estrogen receptors line the pelvic floor muscles, a drop in estrogen can cause drooping of your uterus, bladder and rectum - leaving you with an uncomfortable "pressure" sensation.

12. Mood swings

Hormone fluctuations can cause unpredictable shifts in your mood that are unrelated to life events. Increased stress and poor sleep can leave you trapped in a cycle of hormonal mood fluctuations.

13. Depression, unhappiness and loss of interest

Decreased estrogen can affect our serotonin, norepinephrine and dopamine, which help to control mood. When these levels are altered, you can feel flat, exhausted or that you’ve lost interest in the things you enjoy. Women with mood disorders prior to menopause are more likely to experience these symptoms in menopause.

14. Anxiety and tension

Women describe constant feelings of overwhelm, tension and nervousness, potentially due to hormone changes and/or worrying over other bothersome menopause symptoms.

15. Panic attacks

Panic attacks can be extremely frightening and overwhelming and these can be triggered by hormonal changes.

16. Irritability and anger

You may feel constantly “on edge” and anger quickly at the smallest things when your hormones are imbalanced.

17. Feeling tearful

With all the mood changes and physical changes your body is enduring, it can be

common to feel the urge to burst into tears at any moment.

18. Difficulty concentrating and memory lapses

A decline in estrogen can cause brain fog, making even the simplest tasks feel challenging. Often other menopause symptoms, such as poor sleep and depression, can also contribute.

19. Low confidence

With all the changes during your menopause journey, you may feel like you're having an out-of-body experience and like you can’t feel comfortable in your own skin.

20. Headaches

Some women are already prone to menstrual headaches. Hormones fluctuate even more during the menopause transition, which can lead to worsening headaches.

21. Fatigue or feeling tired

A drop in hormone levels and changes in sleep patterns can leave you feeling low in energy and not yourself.

22. Poor sleep

Sometimes poor sleep is due to hormone fluctuations, and sometimes it is due to night sweats or anxiety that are disrupting the sleep cycle. Either way, poor sleep can have detrimental effects on your day.

23. Breast soreness

Hormones control fluid content in the breast tissue that can lead to breast swelling and tenderness. Hormone fluctuations are more drastic during perimenopause, which can cause worsening breast symptoms.

24. Joint pain

Estrogen aids in keeping joints lubricated with movement. When estrogen levels drop, you may experience more musculoskeletal issues.

25. Aches and pains

When our muscles and bones have adequate estrogen, inflammation naturally decreases. That’s why in menopause we can experience more aches and pains due to increased inflammation.

26. Restless legs

Restless legs, or the inability to keep your legs or arms still at night, can keep you from getting a good night’s sleep. Often, this sensation is also accompanied by tingling, or pins and needles sensation.

27. Weight gain

Metabolism and muscle mass can naturally decrease with age. As estrogen levels decrease, weight shifts and women can also develop increased belly fat, making your waistband a little more snug.

28. Bloating

During menopause and perimenopause, the gut’s microflora can change, causing digestive changes, including bloating and food sensitivities. Nutrition is extra important during this phase in life.

29. Heart palpitations

You may notice your heart suddenly beating out of your chest or fluttering-  though alarming, it is often harmless. These can be due to hormonal fluctuations, hot flashes or increased anxiety and panic attacks associated with the menopause transition.

30. Hair thinning

Decreased estrogen levels can cause hair follicles to shrink, making it harder to grow more hair and easier to shed existing hair, causing overall hair thinning. Stress, illness and hair dying can worsen this problem.

31. Dry, itchy skin

Estrogen helps to control collagen production and skin hydration, so when estrogen levels drop, your skin can feel more dry and itchy.

32. Skin sensations- pins and needles, tingling, skin crawling

“Paraesthesia” or strange skin sensations can appear during menopause caused by hormone fluctuations interfering with our central nervous system.

33. Dry or burning mouth

Estrogen impacts saliva production, so when these levels drop, you may experience a dry, burning sensation in your mouth, lips and cheeks. Sometimes this is accompanied by an unpleasant metallic taste.

34. Dry eyes and visual problems

Estrogen can affect the lubrication in our eyes and put us more at risk for eye disorders.

Navigating the many changes during this period of life can be scary and overwhelming.  Although menopause is a natural biological process, you do not need to suffer from symptoms. There are many options for lifestyle management and safe, effective medications to help relieve your symptoms.   Certified menopause specialists, like the providers at MyMenopauseRx, can help you feel better so you can continue to live your life to the fullest through perimenopause and beyond!