Most people associate the menopause with hot flashes (also known as hot flushes); however there are many other potential symptoms that a woman might experience during this time in her life. Most of these symptoms are completely normal and vary from woman to woman; so don’t worry if you, or someone you know, are experiencing different symptoms and timings to your female friends of a similar age.

Changes in the pattern of periods

Although it is widely known that the menopause involves the stopping of a woman’s periods, many people are unaware that this process can cause a variety of symptoms. For some women their periods will begin to occur more frequently, for example every two or three weeks; whereas for others there may be long gaps between periods, these gaps may even last for months.

Another change that can occur is that the menstrual flow may become lighter or heavier. It is more common that the periods become heavier; however, very heavy bleeding may be a sign of an underlying condition and thus it is worth checking with your GP if you are at all concerned.

Hot flashes and night sweats

Perhaps the most commonly known symptoms of the menopause are hot flashes and night sweats (hot flashes that occur at night). These again can vary from person to person, but generally involve an overall hot feeling which may also be accompanied by sweating.

The hot flashes generally last between a few seconds and a few minutes and can be of varying severity.

Did you know: hot flashes may also be associated with a change in heart rate? Some women experience what are known as palpitations, which is a feeling that your heart is pounding or fluttering. These are generally harmless.

Changes to the vagina

As you grow older, the walls of the vagina become thinner due to a decreasing amount of oestrogen in the body. This can often lead to dryness of the vagina which can also become itchy and cause discomfort. These symptoms are collectively known as vaginal atrophy.

The prevalence of vaginal atrophy tends to increase as a woman progresses through the menopause. The symptoms can become very uncomfortable and sexual activity is often compromised. Despite this, “only a minority (about 25% in the Western world and probably considerably less in other areas) will seek medical help”, according to a recent study published in Climacteric.

There are several options for dealing with these symptoms. Many women use vaginal lubricants. Others apply oestrogen cream to the vagina; however, this is only suitable for women that have already been through the menopause.

Urinary symptoms

Urinary tract infections, such as Cystitis, are also common during the menopause.

Some women may also experience some form of incontinence, such as stress incontinence. This involves an increasing tendency to leak urine during certain activities, such as coughing and laughing. Also, some women find that they need to urinate more frequently.

Mental symptoms

In addition to the various physical symptoms, many women also experience mental symptoms during the menopause.

Some women experience anxiety. This can even lead to panic attacks, in which you may feel an overwhelming number of sensations such as a pounding heart, sweating, faintness, nausea, chest pains and shaking limbs.

Other common mental symptoms associated with menopause are a decrease in memory and concentration. This is again due to the decreasing levels of oestrogen in the body, which is involved in healthy functioning of nerve cells in the brain.

Age on onset of menopausal symptoms

In addition to the variation in symptoms women experience, there is also a variation in the age that these symptoms begin. A study by The John Hopkins University School of Hygiene and Public Health found the median age of natural menopause to be 51.4 years.

The study also found that certain factors seemed to be linked to the age at the onset of menopause. They found that “current smoking, lower educational attainment, being separated/widowed/divorced, nonemployment, and a history of heart disease were all independently associated with earlier natural menopause.” In contrast, they found that “parity, prior use of oral contraceptives and Japanese race/ethnicity” were associated with later onset of natural menopause.

But whatever symptoms menopause throws at you and whatever age it occurs, it is important to remember that there is life after the menopause. In fact, many post-menopausal women enjoy a great sense of freedom. They no longer have to worry about birth control, they are free from PMS and cramps and their family circumstances generally allow them to find more time for themselves.