Symptoms and signs of menopause
Menopause symptoms and the associated signs of menopause are part of a woman’s natural reproductive cycle.
During the early teens, your ovaries will start releasing an egg every month. If the egg is fertilized, pregnancy occurs. If there is no fertilization the egg dies. The uterine lining (endometrium) which was built up in preparation for pregnancy, breaks down and is shed – menstruation.There are 4 main hormones involved in the menstrual cycle:
- estrogen
- progesterone
- follicle stimulating hormone (FSH)
- luteinizing hormone (LH)
The two that concern you most with regard to signs of menopause and symptoms of menopause are estrogen and progesterone. The menstrual cycle can be divided into 3 parts:
- pre-ovulation
- post-ovulation
- menstruation
In the pre-ovulatory phase, the developing egg releases estrogen predominantly. This causes the endometrium to proliferate and thicken. In the post ovulatory phase, progesterone is secreted in increasing amounts from the corpus luteum which is left in the ovary after ovulation.
It acts to increase the blood supply to the endometrium making it water-logged and rich in nutrients. If pregnancy does not occur, the corpus luteum dies through lack of stimulation from a growing fetus. Following this, the secretion of estrogen and progesterone declines. The endometrium does not have enough hormonal stimulation to thrive and starts to break down shedding the top 2 layers and leaving the basal layer intact. This is referred to as menstruation. In the absence of pregnancy, this cycle occurs roughly every month (22-35 days).
There is a limited number of eggs in the ovaries and as you get older, more and more of them die off. By the time you’re in your 40s, most of the eggs have been released during ovulation or died and the few that are left are usually of poor quality. Ovulation may not occur every month and the length of the menstrual cycle gradually increases. Menstruation becomes irregular until eventually periods stop altogether.
During this time of irregular ovulation/menstruation, there is marked fluctuation in estrogen and progesterone levels. Estrogen levels tend to be higher than those of progesterone, leading to the use of the term ‘estrogen dominance’ to describe this imbalance. Without a corpus luteum there is minimal secretion of progesterone. However, estrogen is still produced (in the fat cell for example) from conversion of androgens (male sex hormones) produced by the ovaries and adrenal glands. Menopause symptoms and menopause signs are thus caused by several factors:
- imbalance between estrogen and progesterone
- progesterone deficiency
- estrogen deficiency
The following list of menopause symptoms and menopause signs is very long and far from exhaustive. Fortunately, no woman will have all the menopause symptoms and signs and some women are fortunate enough to have relatively mild menopause symptoms.
- hot flashes (the most common menopause symptom, affecting about 85% of women)
- depression
- forgetfulness
- headaches
- inability to concentrate
- irritability
- mood swings
- chest pain
- palpitations
- sore breasts
- irregular/heavy bleeding
- vaginal dryness
- itchy vulva
- loss of sex drive
- slower sexual arousal
- painful intercourse
- constipation
- abdominal bloating
- irritable bladder
- frequent bladder infection
- frequent urination
- increased facial hair
- thinning hair
- itchy skin
- brittle nails
- pins and needles
- sore muscles
- stiff/swollen joints
- back pain
These menopause symptoms occur at various times. Early symptoms of menopause include irregular or heavy vaginal bleeding while menopause symptoms like thinning of the hair and brittle nails may not occur for several years after the menopause.
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